Overview

Are your troubles in the bedroom a sexual dysfunction or a minor setback? That may be hard to answer. Everyone has problems from time to time - having desire, becoming aroused, reaching orgasm and feeling satisfied. It's normal. However, experts say the problem becomes a sexual dysfunction depending on how long the trouble lasts, how you feel about it and how it affects your relationship.

Four out of 10 women and three out of 10 men have sexual problems, according to a study in the Journal of the American Medical Association. That could be the tip of the iceberg, given that many people are reluctant to talk about the problem, much less see a doctor about it. Other studies have reported that 34 percent to 99 percent of women believe they have some type of sexual problem. The most frequent concerns were lack of interest in sex, difficulty with orgasm, and insufficient lubrication.

Sex involves four stages:

• Desire.
• Arousal.
• Orgasm.
• Resolution (satisfaction).

The most common sexual dysfunctions in men include:

• Erectile dysfunction (ED): Erectile dysfunction occurs when a man cannot get an erection firm enough for intercourse. ED is a common problem, particularly among older men and is often undiagnosed. About 20 million American men, mostly older than 65, are affected. But less than 10 percent seek treatment.
• Hypoactive sexual desire disorder (HSDD): Persistent lack of sexual desire.
• Male orgasmic disorders: Also called ejaculatory disorders, they include inhibited ejaculation (orgasm does not occur) and premature ejaculation (when ejaculation occurs before, during or too soon after penetration).
• Peyronie's disease: Affecting about 1 percent of men between the ages of 40 and 60, Peyronie's disease is characterized by the formation of a hard, fibrous layer called plaque under the skin on one side of the penis.
• Dyspareunia: Men who have dyspareunia, or pain during intercourse, usually have an underlying problem such as prostatitis (inflammation of the prostate gland) or some kind of nerve damage.

Women's sexual dysfunctions include:

• Hypoactive sexual desire disorder (HSDD): Persistent lack of desire. A Journal of the American Medical Association study says sexual dysfunction is common in 40 percent of women.
• Female sexual arousal disorder (FSAD): A woman's desire for sex may be intact but she cannot get aroused and cannot lubricate; the vagina does not swell and the muscle that surrounds the outer third of the vagina does not tighten.
• Female orgasmic disorder: Aroused by sexual stimulation but then are unable to have an orgasm. This is a common problem.
• Dyspareunia or sexual pain disorder: Painful intercourse. This is a condition that can occur at any age. Pain can appear at the start of intercourse, as the man is inserting his penis, at the time of orgasm or after intercourse. Pain may be burning, sharp or cramping. It can be external, in the vagina or in the pelvic region or abdomen.

  Some types of dyspareunia are vaginitis and vaginismus. Vaginitis is an itchy, inflammation of the vagina and caused by bacteria and yeast. Most women have had some kind of vaginitis at least once in their lives. Vaginismus is a relatively rare condition and causes painful, involuntary spasm of the muscles surrounding the vaginal entrance.

Prognosis

Sexual problems are common and treatable. Part of restoring your sex life usually includes understanding your body and your emotional needs, talking with your partner and seeing a health care provider.

More on Sexual Problems

In the Encyclopedia:

This article was reviewed and updated June 2007.