What causes sexual dysfunction?

For both women and men, good sexual health is about much more than simple arousal and climax. In contemporary society a healthy sex life gets nurtured through interpersonal relationships built on mutual respect, open lines of communication and commitment. However, today's high stress lifestyle puts pressure on partnerships, so its not uncommon for people to experience sexual dysfunction. Sexual response depends on a complex interplay of physical and emotional factors. Sexual dysfunction is generally defined as any problem that occurs in the course of sexual activity, such as not being in the mood, having trouble becoming aroused, not achieving orgasm or experiencing pain.

Some patients have an underlying psychological or emotional issue which can be treated with psychotherapy or medication. But physical condition also plays a major role. Good sexual response depends on healthy nerves, muscles, hormones and blood vessels. Most physical problems result in pain, pelvic muscle spasm or weakness and sensitivity issues.

What is female sexual dysfunction (FSD)?

Everyone risks a greater likelihood of sexual dysfunction as they age but a higher percentage of women are affected than men. According to the National Association for Continence (NAFC), 43% of all women over the age of 18 experience some form of sexual dysfunction. Women often come to PhysioDynamics for treatment of pain, post-natal lack of feeling and menopausal diminished orgasms. We also treat vaginismus, an involuntary muscle contraction that makes intercourse painful or impossible. Just as she would blink to protect her eyes, a patient with vaginismus subconsciously instructs pelvic floor muscles to clamp shut to avoid pain.

Any pain in the pelvic, genital or vaginal area is a sign that you may have a problem. Dyspareunia, for instance, is pain that occurs during or after sex. It can be on the surface or deep, along the middle of the pelvis, or on one or both sides. The most common cause is lack of lubrication. There is mounting evidence that pelvic health may impact female infertility problems (for more information).

What sexual dysfunctions do men experience?

Sexual dysfunction affects about 31% of the male population. Men, like women, experience desire and arousal problems but they also experience pain, premature ejaculation and erectile dysfunction (formerly referred to as impotence, the inability to maintain an erection for satisfactory intercourse). ED is not an inevitable part of aging, although nearly half of men over 50 will experience it. Medical conditions such as diabetes, hypertension and atherosclerosis can cause ED. Physical therapy can be an effective treatment for ED, particularly in cases where the condition is exacerbated by physical and lifestyle issues. A recent study conducted in Italy found that in one-third of the test subjects weight loss and exercise improved the condition.

Does obesity impact erectile dysfunction?

According to a 2004 report in the Journal of the American Medical Association (JAMA), weight loss achieved through dieting and increased exercise can improve sexual function for obese men with ED. About one-third of a test group involving 110 healthy men regained sexual function after working on behavior modification and lifestyle changes. ED is a common problem in the U.S. and is linked to increased cardiovascular risk. By encouraging obese men to reduce smoking, alcohol consumption, while increasing their activity level, it is possible to improve their sex life.

How does physical therapy help sexual dysfunction in men and women?

Physical therapy can be successful for the prevention, treatment and management of sexual dysfunction. We conduct a comprehensive initial evaluation to determine underlying physical problems. The therapeutic program is based on medical history, physical exam results and biofeedback assessments. In general, our treatments aim to reduce pain, loosen stiff tissues and tone or relax muscles. In the case of sexual dysfunction, we aim to help people achieve comfortable sex, improve orgasmic intensity and raise awareness of sexual response. Fortunately, some problems go away on their own or can be worked out with patience between caring and informed partners. Other cases take more effort, treatment and a change of approach which we can provide.

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