Sexual dysfunction can be any problem that prevents a person or couple from experiencing satisfaction from sexual activity. Being unable to enjoy or not wanting to engage in sexual activities may be a sign of sexual dysfunction. A large epidemiological survey done in the United States, reported that > 40% of women and 30% of men suffer from some form of SD, with low sexual desire in women (22%) and premature ejaculation in men (21%) being the most common.
Examples of sexual dysfunctions 
- Desire disorders: Lack of sexual desire or interest in sex. This may mean you have no interest in any type of sexual activity.
- Arousal disorders: Inability to become physically aroused or excited during sexual activity. You may feel a desire for sex, but your body doesn’t respond. In people with a penis, this could mean you can’t get an erection.
- Orgasm disorders: Delay or absence of orgasm (climax). You may feel desire and arousal but be unable to orgasm.
- Pain disorders: Pain during intercourse makes you not want to have sex.
- delayed ejaculation
Paraphilic Disorders- These involve intense and persistent sexual interests outside of typical genital-to-genital stimulation with consenting adults.
- Exhibitionism- The urge to expose one’s genitals to unsuspecting strangers.
- Fetishism- Use of non-living objects to arouse or satisfy oneself sexually (e.g., shoes, rubber, specific fabrics, dildos)
- Voyeuristic Disorder: achieving sexual arousal or satisfaction by observing an unsuspecting person who is naked, disrobing, or engaging in sexual activity.
- Sexual masochism -being humiliated, beaten, bound, or made to suffer to achieve sexual excitement
- Sexual sadism- The act of inflicting physical or psychological suffering on another person to achieve sexual excitement
- Frotteurism- touching or rubbing against a non-consenting person, often in a crowded place.
- Pedophilia- Sexual attraction to prepubescent children (typically age 13 or younger)
- Transvestic disorder- Sexual arousal from cross-dressing
Psychological causes of sexual dysfunction
Your emotions and feelings can play a major role in sexual dysfunction. These could include:
- Stress & depression related issues like chronic work, financial, or family stress
- Anxiety e.g. fears of pregnancy or intimacy
- Marital or relationship problems, poor communication, unmatched libido, unresolved conflicts
- Cognitive factors like; Poor body image, unrealistic expectations, sexual myths (sex should always be spontaneous” or “a real man always performs”)
- History of sexual trauma or abuse, negative early learning about sex, child sexual abuse.
- Feelings of guilt like in case of conflict of values e.g. religious, infidelity, premarital sex
- Concerns about your sexual performance.
- Strict religious upbringing, obsessive personality traits,
Psychological interventions/treatment
The success of treatment for sexual dysfunction depends on the underlying cause of the problem. Counselling interventions for sexual disorders involve a combination of sex therapy, cognitive-behavioral therapy (CBT), and education to address physical, emotional, and relational factors.
- Sensate focus exercises -These are structured exercises where a couple is helped to recognize that sexual activity is not limited to sexual intercourse and that ‘Pleasuring’ and ‘Receiving Pleasure’ can be enjoyable without being regarded as foreplay or a preliminary to sexual
- Systematic Sensitization and Desensitization -‘Start-Stop Sensitization’ technique used for premature ejaculation where one partner provides manual stimulation to the other and is stopped at a signal from him when orgasm becomes imminent. Intra vaginal containment, a Female Superior Position where partners should increase the rhythmic movements until the man gives the signal to stop. Repeating this activity for certain duration of time, leads to some degree of control over ejaculation.
- Educating the couple -The couple is advised to talk on issues bothering them in a nonjudgmental way, encourage partners to see, hear and understand each other’s perception and teach verbal and nonverbal communication skills, in all situations and during sexual activity in particular.
- Acceptance and commitment therapy, which is a form of CBT that emphasizes accepting thoughts and urges and committing to a plan to deal with them. You can learn to choose actions that are in line with your important values.
- Mindfulness-based therapies, which help you live in the present and cope with difficult emotions and negative thoughts. These can help lower your anxiety and depression and improve your general well-being.
- Psychodynamic psychotherapy, which is therapy that focuses on being more aware of unconscious thoughts and behaviors. You can develop new insights into what motivates you. You also learn ways to resolve conflict.
- Self-help and support groups can be helpful for people with compulsive sexual behavior and for dealing with some of the issues it can cause. These groups can help you to learn about your disorder, find support and understanding of your condition, identify additional treatment options, coping behaviors and resources, help prevent relapse.
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