Sexual dysfunctions cover a wide variety of problems, including erectile dysfunction (ED) and premature or delayed ejaculation in men, spasms of the vagina, pain with sexual intercourse, and 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. Decreased sexual desire is the most common complaint among women, affecting up to 43% of women. The problem may be psychological, physical, or a combination of both.
Sexual dysfunction can be temporary or long-lasting. Causes of sexual disorders vary and may include:
Your health care provider 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 libido (sex drive) in both men and women.
If sexual dysfunction is caused by depression, antidepressants may help.
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 respond to other treatment.
Problems related to menopause -- When estrogen drops after menopause, women may experience vaginal dryness and other changes that may make sex painful for some. Women who experience painful intercourse after menopause may want to ask their doctor about estrogen therapy (as a vaginal ring or cream). Over-the-counter products are available as creams or gels for women who experience vaginal dryness. Your doctor may also consider a testosterone patch or cream, although there is controversy about using testosterone for sexual dysfunction.
A variety of psychological, behavioral, and interpersonal therapies are also available for many sexual disorders. For example, combination therapy, including both sex therapy and sexual pharmaceuticals, is often the best treatment approach for premature ejaculation.
Sexual dysfunction caused by decreased circulation, hormonal imbalance, depression, or anxiety may be helped by alternative therapies. Unless noted, treatments are for both men and women.
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem 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 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 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 - 18 months) for effectiveness.
Contrast sitz baths promote circulation. You will need two basins that you can comfortably sit in. Sit in hot water for 3 minutes, then in cold water for 1 minute. Repeat three times to complete one set. Do one to two sets per day 3 - 4 days per week. Do not use this technique if you have prostate cancer or other malignancies.
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 routinely use acupuncture and TCM to address hormonal imbalances.
Yoga and meditation can reduce the effects of stress and relieve anxiety about the condition.
Therapeutic massage can reduce the effects of stress.
Some sexual dysfunctions are long-term and require professional care.
Some drugs and herbs used for treating psychological or physical disorders may have serious side effects. Marital counseling and other forms of interpersonal therapy are also important.
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