What is sexual dysfunction?

Sexual dysfunction is a problem that can happen during any phase of the sexual response cycle. It prevents you from experiencing satisfaction from sexual activity.

The sexual response cycle traditionally includes excitement, plateau, orgasm and resolution. Desire and arousal are both part of the excitement phase of the sexual response. It’s important to know women don’t always go through these phases in order.

While research suggests that sexual dysfunction is common, many people don’t like talking about it. Because treatment options are available, though, you should share your concerns with your partner and healthcare provider.

What are the types of sexual dysfunction?

Sexual dysfunction generally is classified into four categories:

  • Desire disorders: lack of sexual desire or interest in sex.
  • Arousal disorders: inability to become physically aroused or excited during sexual activity.
  • Orgasm disorders: delay or absence of orgasm (climax).
  • Pain disorders: pain during intercourse.

Who is affected by sexual dysfunction?

Sexual dysfunction can affect any age, although it is more common in those over 40 because it’s often related to a decline in health associated with aging.

What are the symptoms of sexual dysfunction?

In men:

  • Inability to achieve or maintain an erection (hard penis) suitable for intercourse (erectile dysfunction).
  • Absent or delayed ejaculation despite enough sexual stimulation (retarded ejaculation).
  • Inability to control the timing of ejaculation (early, or premature, ejaculation).

In women:

  • Inability to achieve orgasm.
  • Inadequate vaginal lubrication before and during intercourse.
  • Inability to relax the vaginal muscles enough to allow intercourse.

In men and women:

  • Lack of interest in or desire for sex.
  • Inability to become aroused.
  • Pain with intercourse.

What causes sexual dysfunction?

Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of some medications, including some antidepressant drugs, can affect sexual function.

Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, concerns about body image and the effects of a past sexual trauma.

What medications can cause sexual dysfunction?

Some prescription medications and even over-the-counter drugs can have an impact on sexual functioning. Some medicines can affect libido (desire) and others can affect the ability to become aroused or achieve orgasm. The risk of sexual side effects is increased when an individual is taking several medications.

Sexual side effects have been reported with the following medications:

Non-prescription medicines

Some over-the-counter antihistamines and decongestants can cause erectile dysfunction or problems with ejaculation.

Antidepressants

  • Tricyclic antidepressants, including amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor)
  • Monoamine oxidase inhibitors (MAOIs), including phenelzine (Nardil) and tranylcypromine (Parnate)
  • Antipsychotic medications, including thioridazine (Mellaril), thiothixene (Navane), and haloperidol (Haldol)
  • Anti-mania medications such as lithium carbonate (Eskalith, Lithobid)
  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).

The following medications may cause erectile dysfunction:

Anti-hypertensive medications (used to treat high blood pressure)

  • Diuretics, including spironolactone (Aldactone) and the thiazides (Diuril, Naturetin, and others)
  • Centrally acting agents, including methyldopa (Aldomet) and reserpine (Serpasil, Raudixin)
  • a-Adrenergic blockers, including prazosin (Minipress) and terazosin (Hytrin)
  • b-adrenergic (beta) blockers, including propranolol (Inderal) and metoprolol (Lopressor)

The following medications may decrease sexual desire:

Hormones

  • Leuprolide (Lupron)
  • Goserelin (Zoladex)

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy