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In many cases, even if the cause is physical, understanding the effects- for example of ageing- may be enough to reduce anxiety. Generally if the cause of your sexual dysfunction is physical, it is advisable to seek help from a medical practitioner or sex therapist.
Ageing:
Males: increased arousal time, may experience occasional loss of erection and or absence of ejaculation. Most older men need more direct genital stimulation than when they were young.
Females: after the menopause dryness of the vagina may cause discomfort during intercourse, and painful uterine contractions can occur during orgasm. [See: Sex and Ageing]
Congenital: undescended testes, spina bifida, disfigurement of genitals, cerebral palsy.
Constitutional: low sexual tension (considerable variety in arousability exists between individuals).
Contraception: oral and injectable hormones [may cause loss of libido, dry vagina], condoms [may
impair sensations], coitus interruptus [withdrawal method] and periodic abstinence [interferes
with spontaneity].
Endocrine: pituitary or thyroid disorder may impair sexual function
General: obesity, fatigue, malnutrition, stress.
Genital:
Males: inflammation at the tip of penis, Peyronie's disease [a plaque on the shaft of penis causing distortion and sometimes pain during erection]; priapism [ prolonged painful erection that can cause damage to the tissue in the penis if not treated].
Gynaecological: conditions associated with pain with penetration of the penis, vaginismus [spasm of the muscles of the outer third of the vagina causing pain at the entrance with penetration], infertility, pregnancy.
Malignancy: surgery or radiotherapy associated with destruction of genital organs.
Inflammatory:
Males: prostatitis, urethritis.
Females: vaginitis, cystitis, salpingitis [inflammation of the vagina, bladder and fallopian tubes].
Tumour: of the spinal cord, pituitary, rectum or genitals.
Neurological: stroke, spina bifida, multiple sclerosis, disease affecting nerves to the genitals, spinal cord injury.
Pharmacological: medications that depress the central nervous system [sleeping pills], medications for high blood pressure, anti-depressants, tranquillizers.
Drugs: marijuana, narcotics, alcohol, cigarette smoking.
Psychiatric: depression, anorexia nervosa, schizophrenia, personality disorders.
Surgical: major bowel surgery.
Males: prostatectomy, removal of the bladder or penis [usually for cancer, or trauma.
Females: mastectomy, hysterectomy, removal of ovaries, female circumcision.
Systemic disease: of the kidney, liver, chest, heart; diabetes, chronic infection, pain, acute illness, any debilitating disease.
Trauma: disfigurement, mutilating surgery, spinal cord injury, damage to pelvic vessels, testes or penis.
Vascular: lipid deposits on the blood vessels [atherosclerosis].
It is now recognized that erectile dysfunction may be an early warning or marker for vascular disease that should be attended to, and so this is another good reason to seek medical advice for sexual dysfunction, which is treatable.
