It is important to understand the basics about sexual dysfunction. Sexual dysfunction can affect both men and women. It is also common. Many men and women will experience some degree of sexual dysfunction at some point in their lives, and it becomes increasingly common as we age.
In men, sexual dysfunction refers to issues such as decreased desire, difficulty obtaining and/or maintaining an erection, and a variety of problems with ejaculation, ranging from premature ejaculation to the inability to ejaculate. Of these, difficulty obtaining or maintaining an erection (erectile dysfunction) tends to be of greatest concern. A variety of conditions can cause ED. Some causes include spinal cord injuries; high blood pressure and the medications used to treat high blood pressure, diabetes, heart disease, and depression and some medications used to treat depression.
There are different prescription medications available to treat erectile dysfunction. They all work in a similar way. They improve the functioning of nitric oxide, a naturally occurring chemical responsible for relaxing smooth muscle tissue. This helps increase blood flow to many areas, including the penis, allowing a man to achieve and maintain an erection.
Men who have had a heart attack, stroke, or abnormal heart rhythm within the past 6 months should not use these medications. Furthermore, men who already use nitrate medications (for example, to treat angina) or alpha-blockers should never use any of these medications. Men with severe liver or kidney disease; certain eye disorders; uncontrolled, high, or significantly low blood pressure; or who have been advised to avoid sexual activity due to unstable heart disease should also not take these medications. These medications may cause arteries to widen and blood pressure to drop, even in healthy men. Talk to your doctor about how these medications may affect you and any other health conditions you may have.
In women, sexual dysfunction can take the form of decreased sexual desire or libido, difficulty becoming sexually aroused, decreased sexual enjoyment, inability to have an orgasm, abnormal vaginal muscular contractions (vaginismus), lack of natural lubrication, or actual pain with intercourse. Sexual dysfunction in women may be caused by mood disorders, certain medications, diseases like diabetes and high blood pressure, alcohol use, or vaginal infections.
Research is ongoing in the area of the treatment of female sexual dysfunction. There has been research to find out if medication used to treat men is effective for women, however the results are mixed. Bupropion, which is a type of antidepressant, has been found to be helpful in studies of women with decreased sexual desire. In 2015, flibanserin was approved by the FDA to treat sexual desire disorder.
Studies have shown that sex therapy appears to be effective in addressing symptoms of sexual dysfunction. In cases of vaginal dryness, using an over-the-counter vaginal lubricant may be a simple solution for some women who do not produce enough.
Centers for Disease Control and Prevention
Family Doctor—American Academy of Family Physicians
The College of Family Physicians of Canada
American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: A Couple’s Problem—2003 Update. Available at: https://www.aace.com/files/sexdysguid.pdf. Accessed July 19, 2016.
Are erectile dysfunction pills safe for men with heart disease? The Harvard Medical School Family Health Guide website. Available at: http://www.health.harvard.edu/fhg/updates/update0705a.shtml. Updated July 2005. Accessed July 19, 2016.
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Erectile dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 29, 2016. Accessed July 19, 2016.
FDA approves first treatment for sexual desire disorder. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm. Published August 18, 2015. Accessed July 19, 2016.
Female sexual dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 28, 2016. Accessed July 19, 2016.
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Phillips NA. Female sexual dysfunction: evaluation and treatment. Am Fam Physician. 2000 1 Jul;127-140.
Last reviewed July 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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