Sexual dysfunctions are when there is a consistent or recurrent difficulty during any phase of the sexual response cycle such as excitement, plateau, orgasm, resolution that causes distress or interferes with normal functioning. Sexual dysfunctions affect both men and women, but they differ from each other based on various factors like age, relationship status, sociocultural norms, health history, etc. Relationship difficulties may also contribute to sexual problems, while physical conditions like diabetes, cardiovascular disease, neurological disorders, hormonal imbalance, medication side effects, etc., can cause sexual dysfunction. Partners often experience relational and physiological challenges simultaneously and differentiating them may be difficult. How do partners distinguish between relational and physiological causes of sexual challenges?
Physiological Causes
Physiological causes of sexual dysfunction include low testosterone levels in males, hormonal changes associated with aging, medical conditions like high blood pressure, diabetes, heart disease, Parkinson's disease, stroke, depression, anxiety, alcoholism, drug abuse, smoking, obesity, and certain surgeries. These conditions may reduce blood flow to sexual organs leading to decreased arousal or erection. Side effects of prescription drugs for these conditions may also have a negative effect on sexual function. Aging reduces libido due to declining levels of sex hormones like estrogen, progesterone, and testosterone, which slow down sexual response. Menopause in women reduces estrogen production, causing vaginal dryness, pain during intercourse, and decreased lubrication that lead to difficulty achieving orgasm. Physical injuries and pelvic surgery such as prostatectomy, bladder surgery, or gynecologic procedures may affect the nerves responsible for sexual function.
Relational Causes
Relationship issues may involve communication difficulties, lack of emotional intimacy, infidelity, lack of trust, fear of rejection, unresolved conflicts, stress, depression, anxiety, resentment, guilt, fear of pregnancy, body image concerns, and past trauma or abuse. Low self-esteem, feelings of shame, insecurities, and poor body image can also impact sexual desire. The frequency of sexual activity, mismatched expectations, and unrealistic expectations about sex add more challenges. Partners with relational dysfunction may find it difficult to focus on the present moment while engaging in sexual activities or stay connected emotionally. This may cause performance anxiety, decreased sexual satisfaction, and reduced interest in sex.
If one partner suffers from ED, they might feel ashamed and embarrassed, leading to further problems.
Differentiating between Physiological and Relational causes
Partners should see a healthcare provider for physical evaluation and medical treatment if there is a physiological condition. They may prescribe medications, hormone replacement therapy, counseling, exercise regimen, lifestyle changes, etc., depending upon the underlying cause. For relational dysfunctions, partners need to communicate openly about their sexual desires, needs, expectations, and fears. Couples' therapy and relationship counseling can help build trust and resolve conflicts. Self-exploration, meditation, journaling, and mindfulness exercises can improve emotional intimacy. Sexual education and exploration outside the bedroom through masturbation and role play can enhance arousal and reduce anxiety.
How do partners distinguish between relational and physiological causes of sexual challenges?
Partners may find it difficult to differentiate between relational and physiological factors causing sexual difficulties due to several reasons. Firstly, there is often an overlap between physical and emotional causes of sexual dysfunction. Secondly, individuals may not be aware of their body's reactions during sex, making it hard to determine if they are experiencing problems related to hormonal imbalances, medications, or other physical issues.