The term sexual dysfunction (or sexual malfunction or sexual disorder) describes a complex medical condition that affects both men and women alike. It is the difficulty experienced by an individual or a couple during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. Types of dysfunction vary according to sex and cause. Sexual dysfunction can be caused by genetics, congenital abnormalities, illness, injury, psychological issues, cultural and social values, and side effects of certain prescription medications and recreational drugs. The Diagnostic and Statistical Manual of Mental Disorders defines sexual dysfunction as sexual difficulties that last six months or longer, causing extreme distress and strained relationships.

Many forms of sexual dysfunction have physical origins but they all impact feelings of self-worth and quality of life in general. Due to the complicated nature of this disorder, effective treatment may require a multi-faceted approach.

Female sexual dysfunction (FSD)

Many FSDs that seem psychological may have underlying physical causes. When distress related to consensual sexual activities lasts longer than a few months, a thorough medical examination may reveal physical causes that can often be eliminated or treated. Some of the most common FSDs include:

• Dyspareunia — pain during intercourse
• Hypoactive sexual desire disorder — chronic lack of interest
• Non-coital sexual pain — genital pain that occurs during foreplay, before penetration
• Orgasmic disorder — long-term difficulty or lack of success in achieving orgasm during consensual sexual activities
• Sexual arousal disorder — the inability to feel or maintain excitement during sex
• Sexual aversion disorder — debilitating fear of sexual contact
• Vaginismus — involuntary spasms of the vagina that make penetration difficult or impossible

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Male sexual dysfunction (MSD)

Most men will experience sexual performance issues at some point in their life. Stress is a major factor in intermittent performance concerns in young healthy men but a medical consultation is warranted when diminished performance or lack of desire lasts several months. Chronic (long-term) sexual dysfunction at any age signals the need for a medical consultation. Some of the most common forms of MSD include:

• Anejaculation — the inability to ejaculate even after extended sessions of consensual sexual activity
• Decreased libido — chronic lack of interest (hypoactive sexual desire disorder)
• Delayed ejaculation — the need for extended sessions of sexual activity before ejaculation can occur
• Erectile dysfunction — the inability to achieve or maintain an erection
• Low testosterone — testosterone production levels so low it impairs sex drive and performance
• Premature ejaculation — ejaculation that occurs sooner in the sex act than partners desire it
• Retrograde ejaculation — dry orgasms caused by semen being ejected into the bladder rather than the penis

Sexual dysfunction can be especially alarming for couples hoping to start a family. Couples who experience distress over sexual activities often have a difficult time conceiving a child. If these or any other symptoms of sexual dysfunction exist, consultation with a fertility specialist may be needed to overcome them.