Sexual disorder

Sexual disorders, dysfunctions, and paraphilias (atypical sexual interests) can impact your
everyday functioning and enjoyment of sex.

As we grow up, we learn about our personal sexual interests and what we like or don’t like.
Sometimes, we also face roadblocks that make sex and sexuality more challenging.

If you’re experiencing ongoing issues with sexual pleasure or sexual response that are causing
you significant distress, you may have sexual dysfunction.

Paraphilias are sexual interests and behaviors that involve objects, activities, or situations that
aren’t typical. They are persistent and recurrent.

What is sexuality?

Sexuality refers to your inherent capacity to experience pleasure from sexual activity, including
but not limited to sexual intercourse. Sexuality is fluid — there’s no right or wrong way to
experience it, as long as you don’t impose on someone else’s sexual experiences or interests.

Your sexuality is a fundamental part of who you are and influences your thoughts, feelings, and
behaviors. The ability to accept and enjoy your sexuality positively affects your physical and
mental health.

Sexual dysfunctions

Sexual dysfunction is when you’re facing significant challenges related to your ability to
experience pleasure or respond sexually.

If you’re having difficulty with sexual activity, getting aroused, or experiencing pleasure during
sexual activity, you might be experiencing sexual dysfunction.

It’s important to note that not everyone who is experiencing changes in their sexual thoughts or
behavior has sexual dysfunction. Your sexual feelings and behaviors may change as yo
 4 Main categories

There are four main categories of sexual dysfunction:

 Desire disorders: characterized by low sexual interest or desire

 Arousal disorders: focused on the physical inability to become sexually aroused
 Orgasm disorders: characterized by a delay or absence of orgasms
 Pain disorders: marked by physical discomfort and pain during sexual activity

Sexual disorders that only affect males

There are other sexual disorders exclusive to males:

 premature or early ejaculation

 erectile disorder
 male hypoactive sexual desire disorder

Sexual disorders that only affect females

These sexual disorders occur only in females:

 female orgasmic disorder

 female sexual interest/arousal disorder
 genito-pelvic pain/penetration disorder

Other conditions that overlap

There are also other conditions that sometimes overlap with sexual dysfunctions:

 exhibitionistic disorder
 fetishistic disorder
 frotteuristic disorder
 sexual masochism and sadism
  transvestic disorder
 voyeuristic disorder

What are the DSM-5 diagnostic criteria?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a handbook that the
American Psychiatric Association publishes with guidelines on diagnosing and treating
sexual disorders and many other mental health conditions.

Compared with previous versions of the manual, the DSM-5 has expanded on the number of
conditions that they define as sexual dysfunctions. The updated text includes more
information on gender dysphoria and paraphilic disorders.

The new manual also groups female disorders involving desire and arousal into a new
disorder called “female sexual interest/arousal disorder.”

A doctor may look for the following symptoms that could suggest a sexual dysfunction:

 difficulty getting aroused

 lack of interest in having sex
 pain during intercourse

Descriptions of each sexual disorder

Below are brief descriptions of the different types of sexual dysfunctions that may help you
recognize them.

Delayed ejaculation

Delayed ejaculation occurs when people with a penis have trouble reaching ejaculation or take a
longer time than they would like to ejaculate.

There are physical and psychological factors that may cause delayed ejaculation, such as a
medical condition or fear of intimacy.

Talking with a doctor will help you determine the cause of this condition and whether
medication might help. These might include drugs that treat physical issues, such as Viagra, or
antidepressants for psychological issues.
 Erectile disorder

Erectile disorder is also known as erectile dysfunction. You might have this condition if you
have trouble maintaining an erection throughout sexual intercourse.

Erectile disorder is common in people with a penis as they get older. About 30 million people
who identify as menTrusted Source in the United States experience it.

The good news is you can reduce your chances of erectile disorder by taking steps to maintain
your health.

Consider eating healthier meals, limiting your alcohol intake, and exercising regularly. Your
doctor can also prescribe medication to increase blood flow in your genitals and increase sexual
stimulation.

Female orgasmic disorder

Female orgasmic disorder happens when people with a vulva have difficulty reaching orgasm.
There may be biological or psychological factors influencing this, or both.

If you experience female orgasmic disorder, a healthcare professional may help you treat the
condition with a combination of cognitive behavioral therapy (CBT) and physical therapy.

Female sexual interest/arousal disorder

The DSM-5 now considers hypoactive sexual interest and female sexual arousal disorder to be
the same condition, called female sexual interest/arousal disorder.

This condition involves a low level of — or a lack of — sexual excitement or pleasure. People
also have trouble feeling physically aroused during sex.

Genito-pelvic pain/penetration disorder

This occurs when people with a vagina feel pain during vaginal intercourse. You might have this
disorder if you experience one of the following symptoms:

 pelvic pain during intercourse

  pain during penetration
 recurring fear or anxiety of possible pain during sex
 pelvic muscles that tend to become tense during penetration

Male hypoactive sexual desire disorder

A diagnosis of this disorder means you have little to no interest in thinking about or having sex.

The lack of sexual desire needs to persist for 6 months and cause you significant distress.

Premature or early ejaculation

Premature or early ejaculation is a disorder where a person with a penis orgasms and releases
semen much sooner than they expect or want during sex. About 1 in 3 people who are
biologically male from ages 18 to 59 experience this issue, according to experts.

The condition often has a psychological cause, but at times, it can also be biological.

Substance/medication-induced sexual dysfunction

If you’re on medication and having problems with having sex, you may be experiencing
substance/medication-induced sexual dysfunction.

Research reports that using some drugs regularly, such as MDMA, can cause delayed orgasms
and erectile dysfunction.

Heavy alcohol use can reduce sexual arousal in females and suppress testosterone in males,
making it hard to maintain an erection.

Prescribed medications can also produce sexual dysfunction. These can include antidepressants
and blood pressure medication.

Paraphilias

Paraphilias are conditions involving a persistent sexual interest in inanimate objects or activities
that are atypical. Updated guidelines from the DSM-5 give paraphilias their own category.

They also make the distinction between paraphilias and paraphilic disorders.
If you have a paraphilic disorder, you not only have a recurring sexual interest but your interest
or behavior causes severe distress.

The DSM-5 says people who exhibit symptoms of paraphilia involving a nonconsenting person,
such as pedophilia, have symptoms of a paraphilic disorder when they act on their urges.

Pedophilic disorder

Pedophilic disorder is a condition where you feel a persistent sexual attraction toward a minor.

The DSM-5 updated the diagnosis of pedophilia to distinguish it from pedophilic disorder.
Pedophilic disorder involves recurring sexual thoughts and urges toward a child that impairs
your ability to function. Some people with symptoms of pedophilic disorder may act out their
urges, such as by watching child pornography.

Exhibitionistic disorder

Exhibitionistic disorder is a sexual disorder where you get sexually aroused by exposing your
genitals or acting out sexual acts for a stranger to see.

Voyeuristic disorder

Voyeuristic disorder is the chronic urge to observe a person naked, undressing, or engaging in
sexual activity without their consent.

Sexual sadism disorder

Sexual sadism disorder is when you enjoy sexual activities involving the extreme pain, suffering,
or humiliation of another person.

Sexual masochism disorder

This is when you receive sexual pleasure from experiencing extreme pain or suffering.

Frotteuristic disorder

Frotteuristic disorder is when you get sexual pleasure from rubbing your genitals on an
unsuspecting person without their consent.

Fetishism
Fetishism is a condition where your sexual fantasies or activities depend on using inanimate
objects, such as shoes, or nonsexual body parts, such as feet or hair.

It becomes a disorder when people feel extreme distress over it or the behavior starts to impair
their everyday life.