Editing Sexual dysfunction (section)

==Types==
Sexual dysfunction can be classified into four categories: [[Hypoactive Sexual Desire Disorder|sexual desire disorders]], [[sexual arousal disorder|arousal disorders]], [[Anorgasmia|orgasm disorders]], and [[pain disorder]]s. Dysfunction among men and women are studied in the fields of [[andrology]] and [[gynaecology|gynecology]] respectively.<ref>{{cite book | vauthors = van Andel T, de Boer H, Towns A | chapter = Gynaecological, andrological and urological problems: an ethnopharmacological perspective. | veditors = Heinrich M, Jäger AK | title = Ethnopharmacology | date = September 2015 | volume = 18 | pages = 199–212 | doi = 10.1002/9781118930717.ch18  | isbn = 9781118930717 }}</ref>

===Sexual desire disorders===
{{Main|Hypoactive sexual desire disorder}}
[[Sexual desire]] disorders or decreased [[libido]] are characterized by a lack of [[sexual desire]], [[libido]] for [[Human sexual activity|sexual activity]], or [[sexual fantasies]] for some time. The condition ranges from a general lack of sexual desire to a lack of sexual desire for the current partner. The condition may start after a period of normal sexual functioning, or the person may always have had an absence or a lesser intensity of sexual desire.

The causes vary considerably but include a decrease in the production of normal [[estrogen]] in women, or [[testosterone]] in both men and women. Other causes may be aging, fatigue, pregnancy, medications (such as [[selective serotonin reuptake inhibitor|SSRIs]]), or psychiatric conditions, such as [[Depression (mood)|depression]] and [[Anxiety disorder|anxiety]]. While many causes of low sexual desire are cited, only a few of these have ever been the object of empirical research.<ref>{{cite book | vauthors = Maurice W | date = 2007 | chapter = Sexual Desire Disorders in Men. | veditors = [[Sandra Leiblum|Leiblum S]] | title = Principles and Practice of Sex Therapy | edition = 4th | publisher = The Guilford Press | location = New York }}</ref>

===Sexual arousal disorders===
{{main|Sexual arousal disorder}}
Sexual arousal disorders were previously known as [[Hypoactive sexual desire disorder|frigidity]] in women and [[impotence]] in men, though these have now been replaced with less judgmental terms. Impotence is now known as [[erectile dysfunction]], and frigidity has been replaced with a number of terms describing specific problems that can be broken down into four categories as described by the [[American Psychiatric Association|American Psychiatric Association's]] ''[[Diagnostic and Statistical Manual of Mental Disorders]]'': lack of desire, lack of arousal, pain during intercourse, and lack of orgasm.<ref>{{cite journal | vauthors = Hartley H | year = 2006 | title = The 'pinking' of Viagra culture: Drug industry efforts to create and repackage sex drugs for women | doi = 10.1177/1363460706065058 | journal = Sexualities | volume = 9 | issue = 3| page = 365 | s2cid = 143113254 }}</ref>

For both men and women, these conditions can manifest themselves as an aversion to and avoidance of sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.

There may be physiological origins to these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease and the partners' relationship can also contribute to dysfunction.

Additionally, [[postorgasmic illness syndrome]] (POIS) may cause symptoms when aroused, including adrenergic-type presentation: rapid breathing, [[paresthesia]], palpitations, headaches, [[aphasia]], nausea, itchy eyes, fever, muscle pain and weakness, and fatigue.

From the onset of arousal, symptoms can persist for up to a week in patients.

The cause of this condition is unknown; however, it is believed to be a pathology of either the immune system or autonomic nervous systems. It is defined as a rare disease by the [[National Institutes of Health|National Institute of Health]], but the prevalence is unknown. It is not thought to be psychiatric in nature, but it may present as anxiety relating to coital activities and may be incorrectly diagnosed as such. There is no known cure or treatment.<ref name="rarediseases.info.nih.gov">{{Cite web | url=https://rarediseases.info.nih.gov/diseases/10809/postorgasmic-illness-syndrome | title=Postorgasmic illness syndrome | work = Genetic and Rare Diseases Information Center (GARD) – an NCATS Program}}</ref>

====Erectile dysfunction====
{{Main|Erectile dysfunction}}
Erectile dysfunction (ED), or impotence, is a sexual dysfunction characterized by the inability to develop or maintain an erection of the [[penis]]. There are various underlying causes of ED, including damage to anatomical structures, psychological causes, medical disease, and drug use. Many of these causes are medically treatable.

Psychological ED can often be treated by almost anything that the patient believes in; there is a very strong [[placebo]] effect. Physical damage can be more difficult to treat. One leading physical cause of ED is continual or severe damage taken to the [[nervi erigentes]], which can prevent or delay erection. These nerves course beside the prostate arising from the [[sacral plexus]] and can be damaged in prostatic and [[colorectal surgery|colorectal surgeries]].

Diseases are also common causes of erectile dysfunction. Diseases such as [[cardiovascular disease]], [[multiple sclerosis]], [[kidney failure]], [[vascular disease]], and [[spinal cord]] injury can cause erectile dysfunction.<ref>{{cite book [[Susan Nolen-Hoeksema|Nolen-Hoeksema S]] | date = 2013 | chapter = Sexual Dysfunctions. | title = Abnormal Psychology | publisher = McGraw Hill Education }}</ref> Cardiovascular disease can decrease blood flow to penile tissues, making it difficult to develop or maintain an erection.

Due to the shame and embarrassment felt by some with erectile dysfunction, the subject was [[taboo]] for a long time and is the focus of many urban legends. [[Folk remedies]] have long been advocated, with some being advertised widely since the 1930s. The introduction of perhaps the first pharmacologically effective remedy for impotence, [[sildenafil]] (trade name Viagra), in the 1990s caused a wave of public attention, propelled in part by the newsworthiness of stories about it and heavy [[advertising]].

It is estimated that around 30 million men in the United States and 152 million men worldwide have erectile dysfunction.<ref>{{cite journal | vauthors = ((NIH Consensus Development Panel on Impotence)) | year = 1993 | title = Impotence | journal = [[Journal of the American Medical Association]] | volume = 270 | pages = 83–90 | doi=10.1001/jama.270.1.83}}</ref><ref>{{cite journal | vauthors = Ayta IA, McKinlay JB, Krane RJ | title = The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences | journal = BJU International | volume = 84 | issue = 1 | pages = 50–56 | date = July 1999 | pmid = 10444124 | doi = 10.1046/j.1464-410x.1999.00142.x | s2cid = 35772517 }}</ref> However, [[social stigma]], [[Health literacy|low health literacy]], and social [[taboo]]s lead to under reporting which makes an accurate prevalence rate hard to determine.

The Latin term ''[[impotentia coeundi]]'' describes the inability to insert the penis into the [[vagina]], and has been mostly replaced by more precise terms.

ED from [[vascular disease]] is seen mainly amongst older individuals who have [[atherosclerosis]]. Vascular disease is common in individuals who smoke or have [[diabetes mellitus|diabetes]], [[peripheral vascular disease]], or [[hypertension]]. Any time [[blood flow]] to the penis is impaired, ED can occur.

Drugs are also a cause of erectile dysfunction. Individuals who take drugs that lower [[blood pressure]], [[antipsychotic]]s, [[antidepressant]]s, sedatives, narcotics, antacids, or alcohol can have problems with [[sexual function]] and loss of libido.<ref>{{cite journal | vauthors = Gupta AK, Chaudhry M, Elewski B | title = Tinea corporis, tinea cruris, tinea nigra, and piedra | journal = Dermatologic Clinics | volume = 21 | issue = 3 | pages = 395–400, v | date = July 2003 | pmid = 12956194 | doi = 10.1016/S0733-8635(03)00031-7 }}</ref>

[[Hormone]] deficiency is a relatively rare cause of erectile dysfunction. In individuals with testicular failure, as in [[Klinefelter syndrome]], or those who have had [[radiation therapy]], [[chemotherapy]], or childhood exposure to the [[mumps virus]], the testes may fail to produce testosterone. Other hormonal causes of erectile failure include brain tumors, [[hyperthyroidism]], [[hypothyroidism]], or [[adrenal gland]] disorders.<ref>[http://www.askmen.com/dating/love_tip_300/381_love_tip.html Strange sexual disorders] Ask Men. Retrieved on February 18, 2010</ref>

===Orgasm disorders===

==== Anorgasmia ====
{{Main|Anorgasmia}}
[[Anorgasmia]] is classified as persistent delays or absence of orgasm following a normal sexual excitement phase in at least 75% of sexual encounters.<ref name="Nolen">{{cite book| vauthors = Nolen-Hoeksema S |title=Abnormal Psychology|date=2014|publisher=McGraw-Hill|isbn=978-1-259-06072-4|location=New York|pages=|author-link=Susan Nolen-Hoeksema}}</ref>{{rp|368}} The disorder can have physical, psychological, or pharmacological origins. [[SSRI]] antidepressants are a common pharmaceutical culprit, as they can delay orgasm or eliminate it entirely. A common physiological cause of anorgasmia is [[#menopause|menopause]]; one in three women report problems obtaining an orgasm during sexual stimulation following menopause.<ref>{{cite book [[Susan Nolen-Hoeksema|Nolen-Hoeksema S]] | date = 2013 | edition = 6th | chapter = Sexual Dysfunctions. | title = Abnormal Psychology | publisher = McGraw Hill Education | page = 368 }}</ref>

====Premature ejaculation====
{{Main|Premature ejaculation}}

Premature ejaculation is when ejaculation occurs before the partner achieves orgasm, or a mutually satisfactory length of time has passed during intercourse. There is no correct length of time for intercourse to last, but generally, premature ejaculation is thought to occur when ejaculation occurs in under two minutes from the time of the insertion of the penis.<ref name="pmid9638953">{{cite journal | vauthors = Waldinger MD, Berendsen HH, Blok BF, Olivier B, Holstege G | title = Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: the involvement of the serotonergic system | journal = Behavioural Brain Research | volume = 92 | issue = 2 | pages = 111–8 | date = May 1998 | pmid = 9638953 | doi = 10.1016/s0166-4328(97)00183-6 | s2cid = 23494410 }}</ref> For a diagnosis, the patient must have a chronic history of premature ejaculation, poor ejaculatory control, and the problem must cause feelings of dissatisfaction as well as distress for the patient, the partner, or both.<ref name="Diaz">{{cite journal | vauthors = Diaz VA, Close JD | title = Male sexual dysfunction | journal = Primary Care | volume = 37 | issue = 3 | pages = 473–489 | date = September 2010 | pmid = 20705194 | doi = 10.1016/j.pop.2010.04.002 | publisher = [[Elsevier]] }}</ref>

Premature ejaculation has historically been attributed to psychological causes, but newer theories suggest that premature ejaculation may have an underlying neurobiological cause that may lead to rapid ejaculation.<ref name="pmid15215881">{{cite journal | vauthors = Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T | title = Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors | journal = International Journal of Impotence Research | volume = 17 | issue = 1 | pages = 39–57 | date = 2005 | pmid = 15215881 | doi = 10.1038/sj.ijir.3901250 | s2cid = 13187709 | doi-access = free }}</ref>

====Post-orgasmic disorders====
Post-orgasmic disorders cause symptoms shortly after [[orgasm]] or [[ejaculation]]. [[Post-coital tristesse]] (PCT) is a feeling of [[depression (mood)|melancholy]] and [[anxiety]] after sexual intercourse that lasts for up to two hours. [[Sexual headache]]s occur in the skull and neck during sexual activity, including [[masturbation]], arousal or orgasm.

In men, [[POIS|post orgasmic illness syndrome (POIS)]] causes severe [[myalgia|muscle pain]] throughout the body and other symptoms immediately following [[ejaculation]]. These symptoms last for up to a week.<ref name="Balon2005">{{cite book | title=Handbook of Sexual Dysfunction | publisher=Taylor & Francis |veditors=Balon R, Segraves RT | year=2005 | isbn=9780824758264}}</ref><ref name="Wylie2015">{{cite book | url=https://books.google.com/books?id=oH64CAAAQBAJ&q=Post-orgasmic+illness+syndrome&pg=PA75 | title=ABC of Sexual Health | publisher=John Wiley & Sons | year=2015 | pages=75 | isbn=9781118665565 | veditors = Wylie KR }}</ref><ref name="GARD">{{cite encyclopedia | title=Postorgasmic illness syndrome | encyclopedia=Genetic and Rare Diseases Information Center (GARD) | publisher=[[National Institutes of Health]] | access-date=30 July 2015 | year=2015 | url=https://rarediseases.info.nih.gov/gard/10809/postorgasmic-illness-syndrome/resources/1 | archive-date=5 March 2016 | archive-url=https://web.archive.org/web/20160305193016/https://rarediseases.info.nih.gov/gard/10809/postorgasmic-illness-syndrome/resources/1 | url-status=dead }}</ref> Some doctors speculate that the frequency of POIS "in the population may be greater than has been reported in the academic literature",<ref name="Ashby2010">{{cite journal | vauthors = Ashby J, Goldmeier D | title = Postorgasm illness syndrome--a spectrum of illnesses | journal = The Journal of Sexual Medicine | volume = 7 | issue = 5 | pages = 1976–1981 | date = May 2010 | pmid = 20214722 | doi = 10.1111/j.1743-6109.2010.01707.x }}</ref> and that many with POIS are undiagnosed.<ref name="McMahon2014">{{cite journal | url=https://www.statusplus.net/issm/saopaulo2014/presentations/082.pdf | title=Post-Orgasmic Illness Syndrome | author=McMahon CG | journal=16th World Meeting on Sexual Medicine | date=October 2014 | access-date=2015-08-24 | archive-date=2016-03-04 | archive-url=https://web.archive.org/web/20160304110554/https://www.statusplus.net/issm/saopaulo2014/presentations/082.pdf | url-status=dead }}</ref>

POIS may involve adrenergic symptoms: rapid breathing, [[paresthesia]], [[palpitations]], [[headache]]s, [[aphasia]], [[nausea]], itchy eyes, [[fever]], [[muscle pain]] and [[Muscle weakness|weakness]], and [[fatigue]].

The etiology of this condition is unknown; however, it is believed to be a pathology of either the immune system or autonomic nervous systems. It is defined as a rare disease by the NIH, but the prevalence is unknown. It is not thought to be psychiatric in nature, but it may present as anxiety relating to coital activities and thus may be incorrectly diagnosed as such. There is no known cure or treatment.<ref name="rarediseases.info.nih.gov" />

[[Dhat syndrome]] is another condition which occurs in men: it is a [[culture-bound syndrome]] which causes anxious and [[dysphoria|dysphoric]] mood after sex. It is distinct from the low-mood and concentration problems (acute aphasia) seen in POIS.

===Sexual pain disorders===

Sexual pain disorders in women include [[dyspareunia]] (painful intercourse) and [[vaginismus]] (an involuntary spasm of the muscles of the vaginal wall that interferes with intercourse).

Dyspareunia may be caused by [[vaginal dryness]]. Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by [[menopause]], [[pregnancy]], or breastfeeding. Irritation from contraceptive creams and foams can also cause dryness, as can fear and anxiety about sex.

It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma (such as [[rape]] or [[Domestic violence|abuse]]) may play a role. Another female sexual pain disorder is [[vulvodynia]], or [[vulvar vestibulitis]] when localized to the [[vulval vestibule]]. In this condition, women experience burning pain during sex, which seems to be related to problems with the skin in the vulvar and vaginal areas. Its cause is unknown.

In men, structural abnormalities of the penis like [[Peyronie's disease]] can make sexual intercourse difficult and/or painful. The disease is characterized by thick fibrous bands in the penis that lead to excessive curvature during erection.<ref>{{cite web | url = http://www.strangesexualdisorders.com/ | title = Analysis of abnormal sexual disturbances | archive-url = https://web.archive.org/web/20100209033327/http://www.strangesexualdisorders.com/ | archive-date=2010-02-09 }}</ref>{{Unreliable medical source|date=October 2010}} It has an incidence estimated at 0.4–3% or more,<ref name=":0">{{Cite journal | vauthors = Lizza E |date=2021-04-27 | journal = Medscape |title=Peyronie Disease: Practice Essentials, Problem, Epidemiology|url=https://emedicine.medscape.com/article/456574-overview#a6}}</ref> is most common in men 40–70,<ref name=":0" /> and has no certain cause. Risk factors include genetics, minor trauma (potentially during [[cystoscopy]] or [[transurethral resection of the prostate]]), chronic systemic vascular diseases, smoking, and alcohol consumption.<ref>{{Cite journal| vauthors = Lizza E |date=2021-04-27 | journal = Medscape |title=Peyronie Disease: Practice Essentials, Problem, Epidemiology|url=https://emedicine.medscape.com/article/456574-overview#a7}}</ref>

[[Priapism]] is a painful erection that occurs for several hours and occurs in the absence of [[sexual stimulation]]. This condition develops when blood is trapped in the penis and is unable to drain. If the condition is not promptly treated, it can lead to severe scarring and permanent loss of erectile function. The disorder is most common in young men and children. Individuals with [[sickle-cell disease]] and those who use certain medications can often develop this disorder.<ref>[http://emedicine.medscape.com/article/777603-overview Priapism in Emergency Medicine], [[eMedicine]]. Retrieved on 2010-02-18</ref>