Lahey Health is now part of Beth Israel Lahey Health

by Preda A
(Sexual Aversion; Sexual Apathy; Hypoactive Sexual Desire)

Definition

With psychosexual dysfunction, you can’t become aroused or satisfied during sex. It can lead to major problems with your partner and self-esteem.

Causes

Mental health problems are the cause of psychosexual dysfunction.

These may be:

  • Depression
  • Anxiety
  • Prior abuse or rape
  • Guilty feelings
  • Stress
  • Not feeling good about yourself
Brain in silhouette
In psychosexual dysfunction physical problems have been ruled out. Mental or emotional problems are at the center of the dysfunction.
Copyright © Nucleus Medical Media, Inc.

Risk Factors

At some point, many adults have these problems. They’re very common in both women and men. Your risk is higher for:

  • Having any of the problems listed above
  • Problems at work
  • Problems with the people in your life
  • Just having a baby—caused by hormone changes, postpartum depression , or getting used to a new baby
  • Worrying about your sexual orientation
  • Worrying about having sex or how you’ll perform
  • Prior bad feelings or pain
  • Conflict with your spouse
  • Guilt or worry because of religion or the way of life where you live
  • Money problems
  • Family problems
  • Abuse from your partner

Symptoms

Symptoms differ for men and women.

Men:

  • Not able to keep an erection
  • Ejaculate too soon or not at all
  • Not able to be aroused at the right moments
  • Not able to reach orgasm
  • Lessened desire for sex

Women:

  • Not able to reach orgasm
  • Lessened desire for sex
  • Muscles around the vagina tighten and cause pain (this problem is out of your control)— vaginismus
  • Pain during sex
  • Dry vagina

Diagnosis

You will be asked about your symptoms and your health history. You may have:

  • A physical exam
  • Blood tests
  • A psychological exam
  • To answer questions about your sex life
  • To answer questions about your partner
  • To talk about the medicines you're taking

Treatment

How psychosexual dysfunction is treated depends on what's causing it. More than one method may be used:

  • Medicines—To balance hormones or treat mental health problems.
  • Counseling—There are many types of therapy to help you with:
    • Talk—To talk and figure out ways to deals with stressful or painful issues.
    • Sex—To help you talk to your partner, and learn about sex fantasies and stimuli.
    • Behavior—Will teach you how to change the way you think and learn healthy ones.
    • Marriage or relationships—Will help you talk with your partner and work through problems talking to each other. This may also involve the other person.

Prevention

There is no way to prevent psychosexual dysfunction since the cause is unknown. Try to be open with your partner. If you're still having problems with sex or your partner, talk to your doctor for help.

RESOURCES

American Psychiatric Association  https://www.psychiatry.org 

National Institute of Mental Health  https://www.nimh.nih.gov 

CANADIAN RESOURCES

Canadian Mental Health Association  https://cmha.ca 

Canadian Psychiatric Association  https://www.cpa-apc.org 

References

Erectile dysfunction. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T113875/Erectile-dysfunction  . Updated December 15, 2017. Accessed August 31, 2018.

Female sexual dysfunction. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116816/Female-sexual-dysfunction  . Updated August 28, 2018. Accessed August 31, 2018.

Guay AT, Spark RF, Bansal S, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of male sexual dysfunction: A couple’s problem—2003 update. Endocrine Practice. 2003; 9(1):77-94.

Overview of female sexual function and dysfunction. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gynecology-and-obstetrics/sexual-dysfunction-in-women/overview-of-female-sexual-function-and-dysfunction. Updated April 2013. Accessed August 31, 2018.

Premature ejaculation. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115092/Premature-ejaculation  . Updated July 3, 2017. Accessed August 31, 2018.

Revision Information

  • Reviewer: EBSCO Medical Review Board Adrian Preda, MD
  • Review Date: 05/2018
  • Update Date: 08/31/2018