2.6.1 Non-Organic Sexual Dysfunction
Non-Organic Sexual Dysfunction, Including Lack or Loss of Sexual Desire, Lack of Sexual Enjoyment, and Failure of Genital Response
Non-organic sexual dysfunction refers to sexual problems that are not caused by physical or medical factors but rather by psychological, emotional, or relational issues. This can include a lack or loss of sexual desire, lack of sexual enjoyment, and failure of genital response. These problems can affect individuals of any gender or sexual orientation and can have a significant impact on quality of life and relationships.
Prevalence and Incidence:
The prevalence of non-organic sexual dysfunction varies depending on the population studied and the specific type of sexual dysfunction being examined. In one study of heterosexual women, approximately 33% reported experiencing low sexual desire, while 20-30% reported difficulties with sexual arousal and/or orgasm (1). In another study of men, approximately 20% reported experiencing erectile dysfunction (2).
Aetiology:
Non-organic sexual dysfunction can be caused by a variety of factors, including psychological, relational, and cultural influences. Common psychological factors include depression, anxiety, stress, and trauma. Relationship factors can include communication difficulties, sexual incompatibility, and a lack of emotional intimacy. Cultural and societal factors, such as negative attitudes towards sex or sexual shame, can also contribute to sexual dysfunction.
Gender:
Non-organic sexual dysfunction can affect individuals of any gender or sexual orientation. However, there may be differences in the types of sexual problems experienced by men and women. For example, women are more likely to report difficulties with sexual desire and arousal, while men are more likely to report problems with erectile dysfunction (3).
Onset and Presentation:
Non-organic sexual dysfunction can develop at any age but is more commonly seen in mid to later life. Individuals may present with a variety of symptoms, including a lack of sexual desire, difficulty becoming sexually aroused, difficulty achieving or maintaining an erection, and difficulty achieving orgasm.
Outcome:
The prognosis for non-organic sexual dysfunction varies depending on the underlying cause and the individual’s response to treatment. With appropriate interventions, many individuals are able to improve their sexual functioning and quality of life.
| Aspect | Information |
| Prevalence | Approximately 33% of heterosexual women report low sexual desire. Approximately 20% of men report erectile dysfunction. |
| Aetiology | Psychological factors (e.g., depression, anxiety, stress, trauma), relationship factors (e.g., communication difficulties, sexual incompatibility), and cultural/societal factors (e.g., negative attitudes towards sex) can contribute to sexual dysfunction. |
| Gender | Non-organic sexual dysfunction can affect individuals of any gender or sexual orientation. Women are more likely to report difficulties with sexual desire and arousal, while men are more likely to report problems with erectile dysfunction. |
| Onset/Presentation | Non-organic sexual dysfunction can develop at any age but is more commonly seen in mid to later life. Symptoms can include a lack of sexual desire, difficulty becoming aroused, difficulty achieving/maintaining an erection, and difficulty achieving orgasm. |
| Treatment | Treatment typically involves psychological and behavioural interventions such as sex therapy, cognitive-behavioural therapy, and mindfulness-based therapies. Medications such as phosphodiesterase inhibitors or hormone replacement therapy may also be used. |
| Outcome | The prognosis varies depending on the underlying cause and the individual’s response to treatment. Many individuals are able to improve their sexual functioning and quality of life with appropriate interventions. |
Treatment for Non-organic Sexual Dysfunction
Treatment for non-organic sexual dysfunction typically involves a combination of psychological and behavioural interventions. This can include sex therapy, cognitive-behavioural therapy, and mindfulness-based therapies. Medications, such as phosphodiesterase inhibitors or hormone replacement therapy, may also be used in certain cases.
There are various treatment approaches to non-organic sexual dysfunction, including psychotherapy, pharmacotherapy, and behavioural therapy.
Psychotherapy aims to explore the underlying psychological and emotional factors that may be contributing to sexual dysfunction. Cognitive-behavioural therapy (CBT) is a type of psychotherapy that can be effective in treating sexual dysfunction. CBT focuses on identifying and changing negative thought patterns that can contribute to sexual dysfunction, as well as addressing any behavioural patterns that may be maintaining the dysfunction.
Pharmacotherapy may also be helpful in treating non-organic sexual dysfunction. Medications such as phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), are often used to treat erectile dysfunction. Hormone therapy may be helpful in treating hormonal imbalances that are contributing to sexual dysfunction.
Behavioural therapy, such as sensate focus therapy, can also be helpful in treating non-organic sexual dysfunction. Sensate-focus therapy involves exercises that help individuals focus on their physical sensations and build sexual arousal and intimacy without the pressure of sexual performance.
Non-organic sexual dysfunction can have a significant impact on an individual’s quality of life, relationships, and overall well-being. Understanding the prevalence, aetiology, gender differences, onset, presentation, treatment, and outcome of these conditions is crucial for effective diagnosis and management. Treatment approaches for non-organic sexual dysfunction include psychotherapy, pharmacotherapy, and behavioural therapy, with a focus on addressing underlying psychological, emotional, and physical factors contributing to the condition.
Reference:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Hatzimouratidis, K., Amar, E., Eardley, I., Giuliano, F., Hatzichristou, D., Montorsi, F., … & Wespes, E. (2010). Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European Urology, 57(5), 804-814.
- McCabe, M. P., & Althof, S. E. (2014). A systematic review of the psychosocial outcomes associated with erectile dysfunction: does the impact of erectile dysfunction extend beyond a man’s inability to have sex?. Journal of Sexual Medicine, 11(2), 347-363.
- Shifren, J. L. (2008). Sexual dysfunction in women. The New England Journal of Medicine, 359(23), 2435-2444. doi: 10.1056/nejmcp0801447