Sexual dysfunction in men / women refers to disturbance in any component of the physiological sexual response cycle. Changes may be seen in desire, arousal, performance (particularly in men) and / or orgasmic response.
The common problems affecting males include erectile and ejaculatory dysfunctions. In women, pain disorders such as vaginismus (involuntary muscle spasm of the vaginal wall preventing intercourse) and dyspareunia (painful intercourse) are important concerns.
Signs of Sexual dysfunction in men and women
Loss of libido / interest
Inability to attain an erection
Inability to maintain erection sufficient for intercourse
Delayed or absent ejaculation
Both men and women:
What causes Sexual dysfunction?
Some of the causes include:
Physical / organic
Vascular / neurological / metabolic problems - high blood pressure, high cholesterol, diabetes, atherosclerosis, obesity, aging related changes
Hormonal disturbances: menopause, andropause
Penile injuries, deformities (such as Peyronie's)
Prostatic, lower urinary tract problems
Prescription drugs, alcohol, smoking, substance abuse
Allergic reaction to soaps, creams, douches (in women)
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What are the treatments available and their effectiveness?
The treatment depends on the type of sexual dysfunction. Organic precipitating factors need to be appropriately treated.
For erectile dysfunction in men, the currently available drugs containing active compounds such as sildenafil, vardenafil or tadalafil are useful; these drugs act by increasing the blood flow to the penis through important cellular pathways. Other management options include intra-penile injections and vacuum devices.
For premature ejaculation - the common type of ejaculatory dysfunction (30%), topical anesthetic creams and certain centrally-acting drugs are useful.
Testosterone is helpful in improving desire and libido - both in men and women.
Women with vaginal dryness may find relief with topical gels and hormone containing creams. HRT is useful for post-menopausal women.
Couple therapy and counselling are other important management options.
Optimal strength of erection is necessary for penetration and successful intercourse. Failure of penetration due to lack of penile strength is considered as erectile dysfunction or impotence.
If a man is unable to get an erection, it could be due to physical and life style factors (such as high cholesterol, diabetes, high blood pressure or heavy smoking) or psychological factors due to stress, interpersonal/intimacy issues with partner, performance anxiety in man or female dysfunction such as vaginismus.
Getting softer soon after achieving an erection is inability to sustain an erection; this condition could be due to difficulty in maintain arousal state or swift return of the engorging blood from penis back to the body.
Healthy men with positive attitudes towards sexuality are known to enjoy sexual health to the ripe old age. However, diseases, physical disability, hormonal changes as one ages and ageing itself can compromise erectile function.
For men who are suffering from erectile dysfunction, the best solution is to seek a professional consultation who can advise on the use of well-established medications like viagra, cialis or levitra.
Tips on preventing Sexual dysfunction
Identify and treat the predisposing conditions
Prevention and active management of hypertension, diabetes, obesity, hyperlipidemia, atherosclerosis
Choosing prescription drugs without sexual side effects
Avoiding alcohol, smoking and recreational drugs
Improving physical fitness
Lifestyle changes and stress management
Open communication, resolving conflicts and relationship issues
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Please contact the Women's Clinic at (65)6772 2255 / 2277 for more information or to make an appointment, or email us at Womens_Clinic@nuhs.edu.sg
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Division of Reproductive Endocrinology & Infertility
Head of Division
Dr Stephen Chew
Prof P C Wong
Dr Anupriya Agarwal
Dr Susan Logan
Dr Shakina Rauff
Elsa Sandy Kwe
Kay Thi Tun
Jillian Policompio Acenas
Maithili D/O Mathivannan
Muhsinah Binti Abdul Aleem