All men and women experience dissatisfaction with their sex life at some time. This is quite normal. Sex satisfaction is a part of living well. But when a sexuality problem is persistent and a cause of great concern, they are said to be suffering from sexuality dysfunction.
What causes it?
Sexual dysfunction will usually occur for psychological reasons, but in a few cases the cause is physical and a concern of Good Health. Any disease which limits movement will. obviously affect the ability to make love, an essentially physical activity. People suffering from paralysis from birth or because of an accident or stroke may need special help to achieve sexual satisfaction.
Although impotence is usually caused by anxiety, it can also result from damage to certain nerves caused by severe diabetes or from taking certain drugs.
The fear of hereditary disease being passed on to a child may also inhibit sexual intercourse. Genetic counseling - advice about the amount of risk there is of a certain disease being passed on - is now available to couples who are worried in this way, and a doctor can arrange it.
However, anxiety about personal sexuality is by far the greatest cause of sexual dysfunction. It is important to understand what a great influence attitudes, prejudices and fears about ourselves have on the ability to enjoy sex, and to some extent we are all burdened with this kind of psychological `excess baggage' which we've picked up during the course of our lives. While there is no real way to erase the experiences that give rise to debilitating anxieties over sex, trying to face up to and understand what has caused them - and how groundless these fears are - is the best way back to a healthy and enjoyable sexual relationship.
The variety of anxiety-producing situations is as wide as the variety of human experience. The following case histories, briefly related by a doctor involved in psycho sexual counseling, illustrate the many causes of this anxiety and the ways in which it is manifested in sexual problems.
If you recognize yourself, you will know you are not alone - one of the greatest fears of those who have sexual problems. Many people with sexual problems feel they are `freaks' in some way and feel the problem is too private to talk about.
Inability to `let go'
Stella complained to her doctor that her marriage was not going well, that she and her husband were tetchy with each other that he always wanted sex but she couldn't be bothered.
She had been married a year and worked as a secretary. Before she was married she , lived at home where her mother did all the housework and even washed her clothes for her. She had had a good social_ life and when she met her husband Brian, they went on holiday together where she had enjoyed making love, although she never reached a climax.
After marriage, she kept her job but did all the cooking and housework - cleaning almost became an obsession. Her husband had also lived at home before he was married, and although Stella worked, Brian expected her to do all the household chores.
Stella's sex life rapidly deteriorated: at first she was simply unhappy that she couldn't have a climax but later didn't want to make love at all.
When she came to his surgery, the doctor allowed her time to discuss her feelings: her resentment at the drudgery of marriage and at her husband's ability to enjoy lovemaking much more than she. She learned, through the discussion, that her obsession with efficiency - her strong desire to keep the house spotless and her standard of perfection in her job - was because she felt she had to prove herself to her parents. She was not allowing herself to have fun, to lose control and experience orgasm.
Once she had come to terms with this, she was, in time, able to climax. Her husband became less aggressively demanding. - Now he felt he could make his wife happy he was content to make love. When they both felt like it.
Anxiety over performance
Johnny was impotent and, as he and his wife, Jenny, wanted a child, they went to see their doctor. Both had a strict religious upbringing_; His parents pushed him hard to succeed academically but he failed his exams to get into college. H left home and married.
As a teenager, Johnny had had erections masturbated, but always felt very guilty. Before marriage was out of the question, although he had experienced erections when he and Jenny kissed and cuddled.
On his honeymoon, he had a partial erection failed to penetrate jenny. When they were settle in their home, his erections returned and they were pleased to find they could make love success fully. However, when jenny did not conceive went to see a doctor who suggested tests, some of which involved having intercourse on certain nights - and Johnny became impotent again.
Again, Johnny was encouraged to discuss his feelings with the doctor. He realized there were two causes of the anxiety which had led to his impotence. First was his fear of failure, which was brought about by his strict upbringing: he had lost his confidence when he failed his exams and later when he had an `unsuccessful' honeymoon - and this'd returned when jenny failed to conceive. Secondly, he felt guilty about masturbating in his youth and feared this had damaged his sexual ability.
When Johnny understood these feelings he realized his anxiety was unnecessary = that failing exams was not the worst thing in the world, that masturbation was perfectly natural and that his manhood was not in doubt because he had temporarily suffered from impotence.
As his anxiety waned, his potency returned; Jenny became pregnant and his self-confidence grew, helping him to make good progress in both his career and his marriage.
Sexuality and motherhood
Eleanor complained to her doctor that the Pill was making her `frigid' that she was `as cold as a fish'. She had been on the Pill for three years and had hoped to stop taking it and have a baby but found that she and her husband could not afford it.
Her lack of interest in sex was improved by talking with the doctor; Eleanor came to understand that her `frigidity' was not due to the Pill but because of her sadness at not being able to have a baby. Subconsciously, she was associating making love so strongly with the desire to have a child that she had been rejecting the idea of having sex when she was using a safe contraceptive.
In the opposite situation, another patient, Emily, was referred to a special psychosexual problem clinic after she had complained to her doctor of pain during intercourse, nine months after her baby was born. But her post-natal examination had been normal, her stitches were well healed and there was no tenderness around her vagina.
Before she gave birth, Emily enjoyed working; she and her husband had plenty of money and a good social life; she spent money on fashionable clothes. Before the baby, the couple had made love whenever they felt like it but when Emily became pregnant she believed - quite wrongly - that
Intercourse would harm the baby so they stopped, and since the birth they had only made love twice Because she said it was painful.
With the presence of the baby, Emily's life had radically changed - her whole day and parts of the night were taken up caring for it. She no longer went out with her husband and she felt drab because she could not afford new clothes. She felt her vagina had been damaged and needed to be protected.
During a long chat with her doctor, she began to understand that subconsciously she believed her femininity had been spoilt by childbirth; that making love was not `right' for a mother. Her feelings about sex were improved when she came to realize that her vagina had completely healed and that it was perfectly possible to be a fully sexual woman and mother.
Feelings of inadequacy
Joe told his doctor that he `came too quickly', what doctors call premature ejaculation.
His background history revealed that he had lived with his parents until he was 35 and had been too shy to ask out any young woman and form a sexual relationship. He had always been frightened of women but also felt a need to please and make him self useful to them.
When a close male friend of his died, leaving a widow, Sally, and several children, her need for support overcame his shyness and he asked her to marry him, which she did.
After he moved into her house, she was always busy with the children and they had little time on their own. He enjoyed making love to her but always `came' too quickly. Sally became disappointed that they never made love long enough for her to experience a climax and she became irritable, occasionally comparing Joe with her former husband.
Through expressing his thoughts to the doctor, Joe realized that it was his own feeling of adequacy, hidden by his urge to be `the strong supportive one’ that was causing his premature ejaculation. Just recognizing these anxieties made him see how silly they were and that Sally, didn't love him simply because he supported the children but as a person in his own right who was allowed to have weaknesses and needs of his own. In time, as he developed confidence and learned to regard himself as someone loveable, he was able to maintain an erection for longer periods.
Fear of penetration
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| Overcoming Sexual dysfunction |
As her doctor waited quietly, she began to tell her story. She had been married for almost a year and although she enjoyed being kissed and caressed, and both she and her husband had been able to reach a climax through mutual masturbation, when he tried to have intercourse with her she froze up and pushed him away saying she was too small. Her husband, a quiet, gentle person, had since become afraid of upsetting her in bed.
Over the next few weeks, she had regular discussion sessions with the doctor. She gradually overcame her shyness and described what had led up to this fear of penetration.
Her mother had been a prim person, never allowing her daughter to get herself untidy or dirty. She learned about the `facts of life' through friends and magazines and believed sexual intercourse to be unpleasant. As a teenager, visiting her doctor for a vaginal discharge, his insensitive remark, `Relax, you'll have difficulty when you're married' confirmed her suspicions that she was too small for intercourse, as did the inability to insert a sanitary tampon later on.
Relating these experiences and describing her fears helped her relax enough to accept an internal examination and finally, to her delight, to have full sexual intercourse.
The tightening of the vagina which Susan experienced is called paganism and sufferers almost always believe they are alone in experiencing it, although it is quite common. In the past it was thought to be due to a rigid hymen - a crescent-shaped piece of skin across the vagina entrance - but this is extremely rare and the usual reason for a woman's vagina being too tight is a basic fear of sexual intercourse.
Treatment
The treatment described in these cases is called psychosomatic therapy, which simply means that the doctor talks to patients at length and helps them to understand their anxieties and thus eventually solve the sexual problem. Other treatment includes behavioral techniques, in which the doctor not only discusses the sexual problem with the. couple but suggests ways in which they can `relearn' their sexual behavior. For example, the doctor may suggest the couple kiss and caress each other at set times without actually having sexual intercourse - so that they can learn more about each others bodies without the anxieties caused by penetration.
This treatment does not provide a quick, magical cure, however. Some deep-rooted anxieties require every bit of patience, honesty, determination and understanding an individual or couple can bring to bear. But the rewards speak for themselves, and the techniques of open communication, once learned, go a long way towards sweeping away groundless fears and ensuring they will never regain their grip.
