Sexual dysfunctions include negative experiences, traumas, sexually transmitted diseases and unwanted pregnancies.
Sexual dysfunction problems can sometimes lead to other psychiatric disorders. In this case, it is absolutely necessary to consult a psychiatrist.
In the treatment of sexual dysfunctions, the cause must first be found and then the treatment must be planned. In this case, it will be healthier to determine the path to be followed.
In the treatment of sexual dysfunctions, it is aimed to reduce the psychological causes that negatively affect the person's life and to restore the person to normal sexual life.
If the person with sexual dysfunction receives treatment support at this point, it will prevent other psychological problems in the future. Sexuality is important in a healthy relationship.
What is Sexual Dysfunction?
Sexuality is a concept with multiple dimensions and stages. Disruptions in at least one of these stages are called sexual dysfunction. The stages of sexuality are; increasing sexual desire, sexual arousal with the hardening of the penis and wetting of the vagina, and orgasm. In each of these stages, different and interdependent or independent sexual disorders can occur one by one.
What are the Symptoms of Sexual Dysfunction?
In Men
- Lack of sufficient hardness in the penis
- Sufficient hardness in the penis but not enough pleasure
- Premature ejaculation and therefore reduced penile hardness
- Uncontrollable ejaculation
- Insufficient sexual satisfaction
- Tension before, during and at the end of sexual intercourse
In women
- Painful sexual intercourse
- Vagina and penis union is very difficult or not possible at all
- Pain and soreness when using tampons
- Pain in the vagina during gynecological examination
- Muscle contraction during sexual intercourse
What Causes Sexual Dysfunctions?
Healthy sexual life supports happiness, good sleep, physical and mental health.
Sexual dysfunctions and negative experiences in sexual life bring psychiatric problems.
According to the World Health Organization's definition, sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as a pleasant and safe sexual experience free from coercion, discrimination and violence.
In order to overcome the problems of sexual dysfunctions and to ensure and maintain sexual health, the sexual rights of all persons must be protected and fulfilled.
A person begins to recognize and experience sexuality from early childhood. The first lines of our sexual identity are formed between the ages of 3-6; they become more apparent during adolescence. Every detail about sexuality that the person hears, learns and experiences during these periods are the basic determinants for the quality of his/her sexual life in the future. In order to avoid the problems of sexual dysfunctions, people should spend this period healthy in all respects.
- Low testosterone level
- Use of antidepressant and hypertension-like drugs
- Atherosclerosis, i.e. hardening of the arteries and other circulatory disorders
- Nerve damage or stroke caused by diabetes or any surgery
- Smoking
- Excessive use of alcohol and addictive substances
- Side effects of some medicines
- Pregnancy and postpartum breastfeeding
- Worrying about sexual performance
- Relationship and marital problems
- Becoming depressed and feeling guilty
- Traumas from previous sexual relationships
- Stress at work
- Old age
- Having exaggerated performance expectations
- Incomplete sex education
- Taboos on sexuality
- Growing up in an oppressive environment on sexuality and many other issues
- Personal characteristics
- Lack of self-confidence
- Problematic family relationships
What are Sexual Dysfunctions in Men?
Sexual dysfunction is frequently seen in men, but it is not mentioned and covered up for many reasons, especially related to the society in which we live. As a result, the situation can progress further with ineffective or temporary solutions found by the person himself instead of professional support.
Premature Ejaculation (Impotence)
Premature ejaculation is when a man ejaculates involuntarily with less sexual stimulation than normal, before or immediately after the penis and vagina come together. Premature ejaculation is a common sexual dysfunction in men. If this problem is not experienced constantly, there is nothing to worry about. There is no clear diagnosis of premature ejaculation valid for everyone, but if the listed features are seen, premature ejaculation can be diagnosed:
- In most relationships, ejaculation occurs immediately after the penis enters the vagina
- Ejaculation without the penis entering the vagina
- Avoiding sexual intercourse due to stress and anxiety
Premature ejaculation is seen as an embarrassing situation for most men and they avoid talking about it, but premature ejaculation is both common and treatable. Premature ejaculation may be mild at first and then increase. If premature ejaculation is ignored and not taken into consideration, this causes both communication problems between the couple and causes other sexual dysfunctions. There are four types of premature ejaculation.
- Lifelong premature ejaculation: This type of premature ejaculation is experienced during the first sexual intercourse and continues to be experienced during all other sexual intercourse. In general, this is the least common type of ejaculation.
- Acquired premature ejaculation: This type of ejaculation, which occurs when physiological or psychological changes occur, is more common among men.
- Variable premature ejaculation: This type of premature ejaculation, in which sometimes premature and sometimes normal ejaculation occurs, is the most common type.
- Sensory (subjective) premature ejaculation: In this type of premature ejaculation, no premature ejaculation actually occurs physically, but for some cultural and psychological reasons, the person may think that he is experiencing premature ejaculation.
While men try to solve the problem of premature ejaculation themselves, they may cause other sexual problems. They may also cause a decrease in sexual pleasure and communication with their partner. For example, shortening the foreplay phase is one of these and is an ineffective solution. Another ineffective solution is to make self-injurious gestures such as biting their lips or squeezing the penis. Even if these actions prolong the time, they will reduce the quality. The best action a man can take on his own is to prolong foreplay and ensure his partner's sexual satisfaction.
In order to diagnose premature ejaculation in a man, he must first have an active sexual life. Long discussions with the doctor and a physical examination are necessary. The patient should give a detailed medical history and describe his sexual life.
The most commonly used medication for the treatment of premature ejaculation is Selective Serotonin Reuptake Inhibitor (SSRI). These drugs, which start to have an effect after about 10 days of use, cause fatigue, nausea, yawning and similar side effects, causing the patient to be reluctant to treatment. A new drug with the active ingredient dapoxetine is used a few hours before intercourse and shows success. This drug, which does not require continuous use, is more preferred by patients. Kegel exercises that exercise the pelvic muscles that hold the reproductive organs are also a method used to treat premature ejaculation. At the same time, creams, gels and sprays applied to the penis before intercourse and containing local anesthetic effects cause loss of sensation in the penis and thus cause delayed ejaculation. Since this method is locally effective, it does not show side effects like pills. However, some creams and gels can reduce or even end orgasm in both partners, depending on how much they are applied, and the bad odor of some of them can cause an uncomfortable environment during intercourse. Condoms are used to treat premature ejaculation because they reduce sensation in the same way that creams and gels do. Another method is sex therapy. The last method is surgery and this method is irreversible. It is accepted that the penis is too sensitive and the nerves in the penis are cut and thus the hypersensitivity of the penis is expected to decrease. As a result of all these, it can be said that the most accurate and problem-free treatment for premature ejaculation is to consult with a specialist and apply a personalized treatment plan.
Premature Erection
Premature erection is the problem of orgasm occurring earlier than expected. This problem can cause both reproductive problems and a decrease in the sexual pleasure of couples. Although this and other sexual problems are not discussed, premature erection, like premature ejaculation, is also common among men. If premature erection is not treated, it also brings erection problems. The cause of premature erection is not fully known. However, it can be listed as follows;
- Serotonin deficiency
- Psychological problems
- Age
Premature erection treatment can be very successful even in one session. The most important thing in treatment is that couples support each other and receive couple therapy. When medication and therapy treatments are interrupted or stopped, this problem may recur. The main cause of sexual disorders such as premature erection is mostly psychological, so treatment with an effective doctor who is an expert in the field will play a major role in overcoming this problem easily.
Premature Erection
Premature erection, also known as erectile dysfunction, can be defined as the premature hardening of the penis before entering the vagina and losing this hardness at the same time. If this situation does not recur frequently, premature erection is not diagnosed. As with other sexual dysfunctions, men have problems in sharing their problems and try to find solutions to their problems themselves. Premature erection can occur as a result of disease, medication side effects, injury and psychological problems. These can be listed as follows:
- Peyronie's disease
- Cancer
- Surgery
- Spinal cord and pelvic injury
- Hormonal disorder
- Depression
- Alcohol and smoking addiction
- Anxiety about sexual performance
- Medicines in use
If the problem of premature erection is constantly experienced, it is necessary to consult a doctor. When the person applies to the doctor, first of all, detailed information about his/her sexual life and life is obtained. Answers to questions about how much premature erection occurs and when it started are sought. Then some tests are applied to the person and finally the treatment method that will suit the person the most is chosen.
What are Sexual Dysfunctions in Women
While sexual dysfunctions in women generally appear as arousal disorders, they can also be seen in the form of decreased sexual desire, complete loss of sexual desire and sexual disgust.
Vaginismus
Vaginismus is the name given to sexual dysfunction caused by involuntary contraction of the muscles in the vagina of women. Although the woman wants to have sexual intercourse, the vagina contracts against her will and prevents the penis from entering the vagina. This disease has nothing to do with the size of the vagina, it only occurs when the vagina contracts involuntarily during intercourse. Women with vaginismus often close their legs tightly and do not allow intercourse or experience a lot of pain during intercourse.
Vaginismus is divided into two types depending on the period of a woman's sexual life.
- Primary Vaginismus Vaginismus is called primary vaginismus if it occurs during the first sexual intercourse. In this type of vaginismus, women experience contractions not only against the penis but also against anything that can enter the vagina. They cannot receive vaginal treatment and cannot allow anything like suppositories or medication to be inserted into the vagina. Primary vaginismus is usually based on fear of the first night.
- Secondary Vaginismus: Secondary vaginismus, also called acquired vaginismus, is a type of vaginismus that occurs as a result of painful gynecological treatment, miscarriage, abortion or trauma after a difficult birth in women who have a normal sexual life. This type of vaginismus is based on fear as in primary vaginismus. With the advancement of age, the estrogen level decreases and for this reason, the moistness in the vagina decreases and the elasticity gradually disappears. Therefore, there is a lot of pain during sexual intercourse. This pain sensation can also cause vaginismus over time.
With this classification method, vaginismus can be divided into two as situational and spasmodic vaginismus. In situational vaginismus, the person does not allow anything other than a tampon to enter the vagina. In spasmodic vaginismus, the muscles in the vagina contract too much. In people with spasmodic vaginismus, a contraction similar to a bladder contraction occurs in the vagina during foreplay. In addition to this classification, there is also a type called complete vaginismus. Complete vaginismus is the most severe type of vaginismus and the union of vagina and penis or any other object cannot occur at any level.
In cases of vaginismus, it is difficult to measure how common it is among women, mainly because women are forced to remain silent due to social pressure. Approximately, vaginismus affects up to 20% of women.
The causes of vaginismus are divided into psychological and physical. Psychological causes account for nearly 90% of this distinction. The fear of the first night in most women, the excessive importance attributed to the hymen, the wrong concept of honor and the use of the concept of honor to constantly oppress women, social judgments and exaggerated sentences about sexual intercourse are very important factors in the formation of vaginismus. At the same time, women experiencing a lot of pain and bleeding during their first sexual intercourse, being forced by their partner and being raped are also important reasons for the development of vaginismus. In addition to these, witnessing the sexual intercourse of their parents or others, especially at a young age, and being afraid of childbirth creates trauma in the person and as a result, vaginismus occurs. In addition to these psychological reasons, some physical reasons also cause vaginismus:
- Shortness of the vagina and the curtain in the vagina
- Structural defects, such as the hymen being thicker and harder than it should be, or even having higher edges
- Infections in the vagina
- A tender, soft and painful lump around the opening in the vagina called a Bartholin's cyst
- Diseases that occur in the fallopian tubes and ovaries and are called pelvic inflammatory diseases
- Sexual pain that occurs at the edge of the hymen and is called vulvar vestibulitis
In order to diagnose vaginismus, it is very important to be transparent with the experts and to convey all complaints as they are. When the disease is first recognized, how often it occurs and what can trigger it are very important questions. In the physical examination and treatment of vaginismus, physicians should be as gentle and careful as possible. Any wounds or infections in the genital area should also be examined during the examination.
Vaginismus is a condition that can be treated. First of all, the patient should accept and face this problem. The person should accept the treatment, remove negative thoughts from her/his mind and cooperate with a specialist gynecologist. In the first stage of treatment, the vagina is examined and it is tried to understand whether there is a physical problem. If the hymen is too hard and thick, surgical intervention can be performed. At the next stage of treatment, the patient's mood and thoughts are examined with the support of psychologists and psychiatrists who are experts in sexual therapy. With the psychotherapy applied to the patient by a competent and successful team, the patient is allowed to have a smooth sexual life again.
How are Sexual Dysfunctions Treated?
For the treatment of sexual dysfunctions, first of all, the specialist should be completely transparent to the doctor. The patient should provide detailed and clear information about his/her whole life, especially his/her sexual life. In the light of this information, the specialist doctor should determine the cause of the dysfunction and choose the appropriate treatment method for the person and the condition. If the sexual dysfunction in the patient is due to a psychological reason, the specialist should refer the patient to sexual therapy specialists. The patient's level of openness and comfort with the therapist affects the success of the therapy. Often a big difference can be seen even in one session. Nevertheless, the sessions should be under expert control and the patient should not interrupt the therapy on his/her own. Because the problem may return due to this break. If the sexual dysfunction is due to a physical cause, the patient may be given some exercises and medications depending on the cause. In some cases, surgery may also be performed.
An important part of sexual health is healthy sexual functioning.
Sexual dysfunctions affect sexual life. Sexual life, sexual pleasure, satisfaction and intimacy should be experienced as a natural part of life when the person desires it.
Although there is no "right" way to define sexual life, one of the most important prejudices about sexuality is that it is experienced only with motives.
Contrary to popular belief, there is general information about sexuality and learning and practicing this information increases the quality of sexual life. However, everyone has individual qualities to discover about their own sexuality. These can be experienced to the extent that the sexual-physical and spiritual boundaries of other people and even living beings are respected; at this point, there is no accepted and defined "normal" in terms of sexual health.
As a result, sexuality is an absolute function of healthy life that should be experienced with pleasure, by recognizing and protecting our own body boundaries, respecting our partner's boundaries, with a sense of responsibility and when desired.
Once the root cause of sexual dysfunctions is analyzed (biological or psychological), treatment is easier. Sexual dysfunctions can be treated.
Another misinformation about healthy sexuality is that it must be experienced with a partner. Some people may want to experience sexuality alone (too). Regular sexual life, even alone, is beneficial for physical and mental health and for getting to know one's own body. It should be known that sexual life, sexual pleasure and sexual satisfaction are primarily one's own responsibility; the partner's satisfaction and pleasure from sexual life is the second step.
Sexual dysfunctions can affect the sexual life of the person very negatively. In order to prevent sexual problems, people should have access to information, education and medical care about sexual health. Health professionals related to the subject can be listed as gynecology and obstetrics, urology, psychiatry specialists, family physicians and midwives. Precautions should be taken against unwanted pregnancies and sexually transmitted diseases; care and treatment should be requested when necessary.
