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Sexual dysfunction -- having a problem with sexual desire or response -- covers a wide variety of problems. In men, sexual dysfunction may refer to erectile dysfunction (ED) and premature or delayed ejaculation. For women, sexual dysfunction may include spasms of the vagina and pain with sexual intercourse. For both sexes, it can include problems with sexual desire (libido) and response.
Men over age 65 are at higher risk for ED, although ED is not a normal part of aging. Among women with sexual dysfunction, 43% say decreased sexual desire is their No. 1 complaint. The problem may be psychological, physical, or a combination of both.
Signs and Symptoms
What Causes It?
Sexual dysfunction can be temporary or long lasting. Causes vary and may include:
What to Expect at Your Doctor's Office
Your doctor will do a physical examination. Many times, lab tests and a physical exam may not show a cause. Your doctor may ask about your ethnic, cultural, religious, and social background, which can influence your sexual desires, expectations, and attitudes. Your doctor may test your hormone levels, particularly levels of testosterone, which affects sex drive in both men and women.
If depression is causing sexual dysfunction, antidepressants may help. Although some antidepressants may cause low libido, others may not. It may take some time for you and your doctor to find the right antidepressant for you.
Erectile dysfunction -- Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can treat erectile dysfunction, but may have potentially serious side effects in some men. Vasodilators (drugs that dilate blood vessels, improving blood flow) may be injected into the penis. Vacuum devices may also be used. Vascular surgery or an implant in the penis may help if the problem does not get better with other treatment.
Problems related to menopause -- When estrogen levels drop after menopause, women may have vaginal dryness and other changes that may make sex painful. Women who have painful intercourse after menopause may want to ask their doctors about estrogen therapy, as a vaginal ring or cream. Over-the-counter products are available as creams or gels for women who have vaginal dryness. Your doctor may also consider a testosterone patch or cream, although using testosterone for sexual dysfunction is controversial. Women who have pain with intercourse may try taking naproxen or ibuprofen before having sex.
A variety of psychological, behavioral, and interpersonal therapies may also help with sexual disorders. For example, combination therapy, including both sex therapy and medications, may work best for premature ejaculation.
Complementary and Alternative Therapies
Sexual dysfunction caused by decreased circulation, hormonal imbalance, depression, or anxiety may be helped by alternative therapies. Be sure to work with an experienced provider of alternative therapies and tell all of your doctors about the herbs, supplements, and medications you are taking. Many have side effects and can interact with each other. Unless noted, treatments are for both men and women.
Nutrition and Supplements
Herbs help strengthen and tone the body's systems. As with any therapy, you should work with your doctor before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Chaste tree (Vitex agnus castus) helps your body produce hormones normally, but must be taken long term (12 to 18 months) to work.
Acupuncture and Traditional Chinese Medicine
Acupuncture and Traditional Chinese Medicine (TCM) have been used for centuries to treat sexual dysfunction. Studies show that acupuncture may help specific organs, and many people use acupuncture and TCM to address hormonal imbalances.
Yoga and Meditation
Yoga and meditation can reduce the effects of stress and relieve anxiety about sexual dysfunction.
Therapeutic massage can reduce stress.
Some sexual dysfunctions are long term and require professional care.
Some drugs and herbs used for treating sexual dysfunction may have serious side effects. Marital, psychological, and sexual counseling are also important.
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Review Date: 3/19/2014
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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