Wendel Abel - I AM WHAT I THINK THIS WAS Harold's fifth girlfriend in two years. His previous girlfriend, Mary, left him because their sex life was not fulfilling; he had a problem with premature ejaculation.
In the case of Patsy, she has become frustrated. Her husband is having affairs outside the marriage and he complains that she never seems to have a desire for sex.
These are common problems which couples face worldwide. There is, in fact, a number of conditions which may affect an individual's sexual desire and sexual responsiveness and which may impact his relationships.
DECREASED DESIRE FOR SEX
"I have no desire for sex. My boyfriend does not seem to understand and he thinks something is wrong with me." This individual may be experiencing hypoactive sexual desire disorder (low sex drive). This is associated with decreased desire for sex. This condition is common one in five individuals suffer from this condition. It is more common among women.
Cora's problem goes back to age 12; she was sexually abused by a cousin.
"I have never recovered from this experience and as result I have very little desire for men," she reports.
Lack of desire for sex may be due to a number of factors including low biological sex drive, unresolved conflicts, problems dating back to childhood or stress. Other factors include one's comfort level with and one's attraction to one's partner. Conflict in one's relationship could also lead to this problem. Individuals suffering from anxiety and depression may also experience a decrease in sexual desire.
DIFFICULTY IN BEING AROUSED
SEXUALLY
Impotence in males
In men, difficulty in being aroused sexually is associated with the inability to attain or maintain an erection for the completion of the sex act. This is referred to as impotence. In 20-50 per cent of males, the cause of the impotence may be due to a number of medical conditions such as infection, heart disease, diabetes mellitus, drug use (for example, cocaine and alcohol use), commonly prescribed medication used in the treatment of hypertension and for the treatment of common psychiatric disorders such as depression. Impotence may occur after certain types of surgical procedures. A decrease in sexual desire may also be due to medical conditions such as hormonal problems and medication.
PROBLEMS ACHIEVING ORGASM
A number of women either fail to achieve orgasm or they take a long time to achieve orgasm. A number of psychological problems may be involved here such as, the fear of becoming pregnant, rejection by the sex partner, hostility toward and hatred of men and guilt about sex.
In males, the commonest of this type of disorder is premature ejacualation. This is characterised by the man achieving orgasm before he wishes to. This condition may be due to anxiety regarding sex. Men who are
in unstable relationships which involve power issues and conflicts, may be at risk. Prior experience with having sex in situations where discovery could be embarrassing, for example, having sex in one's parental home or outdoors, could result in
a man being programmed to ejaculate
quickly.
PAIN DURING SEX
Some individuals may experience pain before, during or after sexual intercourse. This is more common in women than men. The basis of this pain may be psychological but pain during sex may occur after surgical procedures on the female sex organs or may be associated with an infection in the female.
Painful sex may also occur after menopause and this may be due to the thinning of the lining of the vagina or failure to produce substances that lubricate the vagina. Painful sex may also occur in women who have been raped or who were sexually abused.
For some individuals, tension and anxiety about sex itself may result in the tightening of the muscles of the vagina leading pain during sexual intercourse. Many women with this condition describe the pain as unbearable and if pressured to have sex this could make the problem worse.
If you are having problems during sex, see your doctor immediately. It is important that a proper medical be done to rule out any underlying physical problem. Where it is clearly established that the causes are psychological, then therapy is strongly advised.
Dr. Wendel Abel is a Consultant Psychiatrist and Senior Lecturer, University of the West Indies.
