Sexuality is three-dimensional: it is made up of the biological, the psychophysiological, and the socio-cultural. Therefore, the satisfaction or dissatisfaction that arises from the sexual act is determined by a large number of factors, such as anxiety, imagination, or lack of confidence. These are the ones that shape the different known dysfunctions that affect people’s sexual lives. What are the most common sexual problems?
Factors that promote sexual problems
As we have seen, the sexual act is not a practice isolated from the environment. It is influenced by a large number of biopsychosocial elements. From expectations and lived experiences, through genetic, anatomical, and hormonal disposition, to an endless number of cultural, educational, ethical, and religious aspects.
Hence, the effectiveness of sexual stimulation is determined by sensory or organic, psychological, attentional, emotional, motivational, and cognitive factors. That is why the adequacy of all the sensory organs and systems, the interaction between the participants in the act, or the ability we have to focus our attention at that moment is so important.
Our emotional and motivational state also plays a role. If we are tired or suffer from anxiety, our libido often decreases. Similarly, fatigue or cognitive aspects, such as sexual fantasies, also determine satisfaction as a result of this stimulation.
Sexual dysfunctions and deviations
Although both are pathologies of sexual conduct, it is necessary to establish a differentiation between them.
- Deviations are appropriate sexual responses in the presence of inappropriate sexual stimuli. For example: fetishism, masochism, transvestism or zoophilia.
- Sexual dysfunctions are alterations in the response in the presence of appropriate sexual stimuli. Thus, depending on the level of sexual desire, arousal, or orgasm experience, different types can be distinguished. We will go into more detail below.
Sexual problems in them…
Erectile dysfunction
This is one of the most common. It occurs when a man is unable to achieve or maintain an erection to have sexual intercourse. It is also known as impotence and generally does not affect sexual drive.
It is estimated that between 20% and 30% of cases have a psychological origin. For example, a very strict moral upbringing, inadequate sexual information, or previous traumatic experiences that have not been processed appropriately. In addition, some drugs can cause the dysfunction as a side effect. Diseases such as diabetes and hypertension, heart or hormonal problems, as well as tobacco and alcohol also contribute to its appearance.
Premature or late ejaculation
Premature ejaculation is the inability to control the release of semen to the desired degree. Although it is often associated with the end of sexual intercourse, ejaculation does not necessarily end with it. Delayed ejaculation, on the other hand, is the delay or absence of ejaculation. It is either delayed or completely absent. It becomes a problem if it occurs too frequently.
The origin of both sexual problems is usually due to psychological factors. Therefore, the intervention is usually aimed at controlling arousal, either by directly intervening on the stimuli that produce it or by training certain mental mechanisms that inhibit it to some degree. Two of the most widely used protocols in this regard are the “stop and start” and “compression” protocols.
In them…
Vaginismus
It refers to the difficulty in having intercourse due to the involuntary contraction of the muscles in the lower third of the vagina. In other words, spasms occur in these muscles that close the vagina and prevent penetration. Depending on its origin, there are two types of vaginismus: primary vaginismus (the woman has never been able to have sexual relations without pain) and secondary vaginismus (the woman has been able to have sexual relations without pain before the appearance of vaginismus).
It is due to physical or psychological factors, or a combination of both. Furthermore, it is one of the sexual problems that does not usually get worse if it is not treated. It only gets worse if the woman continues trying to penetrate despite the pain it causes her: in these cases, the woman “learns” to increase the involuntary contraction to avoid penetration and thus the pain.
Anorgasmia
We are referring to the inability to reach orgasm. People with this problem are unable to reach this climax in sexual intercourse.
It is one of the most common sexual problems in both genders, although it occurs mainly in women. It is more common in women due to their morphology, given the greater number of nervous and muscular structures they have. In men, it is more difficult to detect because there is a tendency to assume that if he ejaculates, he has already achieved orgasm.
Thus, some people, especially pre-adolescents, report orgasms without ejaculation. On the other hand, some paralyzes cause some people to reach orgasm without ejaculating, other men experience the orgasmic sensation a few seconds after ejaculating, some perceive multiple orgasms just before the final ejaculation and, finally, some ejaculate in an anhedonic or anesthetic way without experiencing orgasm.
Anorgasmia is usually the result of psychological factors, such as some type of sexual trauma, depression, anxiety, fears, or false beliefs about sex and sexuality. It can be treated and only 5% of cases have no solution.
Dyspareunia or coitalgia
It is painful or uncomfortable intercourse before, after, or during sexual intercourse. It occurs in both women and men, but its prevalence is higher in women. It is characterized by the existence of genital discomfort associated with penetration. In men, this pain usually occurs during ejaculation. A very probable cause for this symptomatology is a urinary tract infection.
In women, dyspareunia may be associated with vaginismus and causes burning, contractions, and cutting pains. If it does not occur at the beginning of sexual intercourse, but after the plateau phase, it may be due to decreased lubrication. Its causes are more organic than psychological.
Loss of sexual desire
This dysfunction affects both sexes equally. In the case of women, it can be caused by hormones, due to a low level of estrogen, which can be caused by, among other possible causes, menopause. In this sense, desire also tends to decrease during pregnancy or breastfeeding. In the case of men, 70% of cases of loss of sexual desire are due to a testosterone deficiency. The other 30% are due to causes related to stress or relationship problems.
On the other hand, the loss of desire can be classified into two different categories:
- Primary-Secondary : Primary refers to the lack of desire experienced by people who have never experienced it or who have experienced it at very low levels. Secondary refers to those people who did have sexual desire and have seen how it has noticeably reduced to the point of negatively affecting their sexual life.
- Generalized-Situational : On the other hand, we would speak of a generalized loss of desire when the person has lost sexual desire in all situations and with all people. On the other hand, we would speak of a situational or circumstantial loss of desire when this desire has only been reduced in certain situations or with certain people.
In summary, we could say that the sexual act is a behaviour that responds to more complex mechanisms than is usually considered. Sexual stimulation is susceptible to being altered by a multitude of factors. Therefore, the aspects that may surround sexuality, such as communication, the feeling of security or intimacy , are fundamental .