Lecture Notes, Biology 203, Human Sexuality and Reproduction

Sexual Dysfunctions

  1. Male
    1. Erectile dysfunction
      1. Can be primary (rare, has never had an erection) or secondary (more common, could formerly have erections but not now)
      2. Occurs in 4-9% of US men
      3. Likelihood increases with age: 25-55, 7%; 55-70, 27%
      4. Can be related to anxiety, fatigue, drugs, alcohol, or a physiological cause
      5. Can be treated orally (Viagra), by injection (papaverine), or with prostheses
    2. Premature ejaculation (second most common dysfunction in men, occurs in 35-50% of young men)
    3. Retarded ejaculation (slow, late, rare)
    4. Retrograde ejaculation (ejaculation into the bladder, occurs in 1/2 of diabetic men)
  2. Female
    1. Orgasmic dysfunction
      1. Can be primary (has never had an orgasm) or secondary (has stopped having orgasms)
      2. Occurs in 5-10% of all women
      3. Reason varies (coital stimulation inadequate, ignorance, poor communication, psychological problem)
      4. Importance varies (not a problem unless woman herself feels it is a problem)
    2. Vaginismus
      1. Muscle spasms in wall of vagina cause painful intercourse
      2. May be due to past sexual trauma, fear of intercourse, fear of partner
    3. Anatomical problem (imperforate hymen)
  3. Both male and female
    1. Painful intercourse (dyspareunia) in women may be due to infection, endometriosis; or to infection in men
    2. Decrease in sexual desire (for an extended time)--may be due to drugs, other disease, alteration in brain function
  4. Immediate psychological causes
    1. Defined by Helen Singer Kaplan and distinguished from deep psychological trauma
    2. Failure to engage in effective sexual behavior (often due to ignorance or fear)
    3. Sexual anxiety (fear of failure, rejection, incompetence)
    4. Defenses against erotic feelings
    5. Failure to communicate (with sexual partner)
  5. Organic causes
    1. Interference with blood flow to penis (severed nerves, hormones, drugs, diseases) (may account for 40-50% of erectile dysfunction
    2. Drugs
    3. Cardiovascular disease and drugs used to treat it
    4. Diabetes
    5. Alcoholism
    6. Stress, fatigue, depression (and drugs used to treat them)
    7. Prostate surgery