Male Sexual Disorders
Sexual desire disorders are categorized according to the phase of the human sexual response cycle in which they occur. In classifying male sexual disorders, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) divides the process of having sex into four phases:
- The initial phase is desire, during which one may fantasize about sex and, logically, experience the desire to engage in sexually fulfilling activities.
- During the excitement phase, one experiences sexual pleasure and the physical changes such as excretion of natural lubricants in the vaginal area and male erection.
- During orgasm, sexual pleasure reaches its peak and sexual tension eases.
- Lastly, one enjoys a sense of relaxation and well-being during the resolution phase.
Sexual dysfunction can lessen or completely prevent any or all of these phases; one may experience sexual desire but none of the physical changes that make intercourse possible. One may become sexually excited but find that orgasm is elusive and thus, without orgasm, cannot the satisfaction of the fourth phase of sex.
Sexual dysfunctions are also labeled as to type. Those who spend their entire lives battling with their symptoms are considered to have a lifelong type of sexual dysfunction. Others may have had no previous difficulties, but then develop what are called an acquired type of sexual dysfunction. Some people experience sexual dysfunction during all sexual situations; that is called a generalized type of disorder. Others are diagnosed with a situational type of dysfunction, meaning it only occurs in certain circumstances.
The causes of sexual dysfunction may be biological or psychogenic (due to psychological or interpersonal conflicts). There are many possible biological reasons that a person has difficulty with sexual function; age, disease, injury and fatigue can all play a role. Lack of experience can be a factory; a young person may not know a great deal about the mechanics of sex or their bodies. There are many possible psychological influences that can affect how one thinks about, reacts to, and engages or chooses not to engage in sexual activity
Male Sexual Disorders:
What is Hypoactive Sexual Desire Disorder?
Hypoactive sexual disorder falls into the first category of sexual dysfunction, the desire phase, and is diagnosed in persons who have a general lack of interest in sex. It can affect women and men. Because at least some degree of hypoactive sexual disorder has been reported by twenty to thirty percent of women and only 15% of men, it was until quite recently considered to be more of a problem for females that for men. However, whether due to a greater prevalence of the disorder or to an increase in the number of men willing to discuss their problem, males have been seeking therapy for hypoactive sexual desire disorder in increasing numbers over the last several decades.
The diagnostic criteria for this disorder are somewhat vague; the DSM-IV refers to a low number of sexual fantasies and desire for sexual activity. Yet, there is no specific number or amount of desire which is considered normal. Rather than trying to define what is “normal,” experts in this field have come to believe that the only time that one should concern themselves about his/her degree of sexual desire is when its lack becomes a problem, either personally or to a relationship.
What is Sexual Aversion Disorder?
As the term suggests, the primary symptom of sexual aversion disorder is an aversion to sex which can affect both men and women. Those who are diagnosed with this disorder do not merely lack interest in sexual activity; they find the prospect deeply disturbing. We live in what many consider to be a highly sexualized world; sexual images are everywhere from billboards to movies to television. For people with sexual aversion disorder, this can result in great anxiety, disgust and even fear.
What is Premature Ejaculation?
The Diagnostic and Statistical Manual of Mental Disorders describes premature ejaculation as “persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it.” Masters and Johnson, the well-known research team from the 1950’s, added to performance anxiety when they incorporated the satisfaction of a sexual partner. They considered ejaculation premature if the man failed to satisfy at least half of the time.
There is a very high prevalence of premature ejaculation, with approximately 35 to 40 percent of men treated for sexual problems mentioning the disorder as their primary concern. Anxiety, lack of experience, immaturity, and infrequency of sex are the most common causes of premature ejaculation.
What is Male Orgasmic Disorder?
Male orgasmic disorder is diagnosed when a man either has enormous difficulty ejaculating during sex or cannot have an orgasm at all. It can either be termed a lifelong orgasmic disorder if he has never been able to ejaculate or categorized as an acquired disorder if it developed following normal function. There is some controversy among experts as to whether or not an orgasm must include ejaculation as men have reported that they do ejaculate, but fail to achieve the pleasure normally associated with orgasm.
With a prevalence of only 5%, male orgasmic disorder is much less common than premature ejaculation or impotence. The lifelong variety frequently reflects an inability to achieve intimacy or even closeness, not just sexually, but with all relationships. Often, a rigidly religious upbringing resulted in the perception of sex as sinful and genitals or contact with genitals as “dirty”. Those with obsessive-compulsive disorder are especially at risk for this sexual disorder.
Problems within an already existing relationship such as loss of sexual attraction, a demanding partner can be the source of acquired male orgasmic disorder; failing to ejaculate can indicate hostility toward a partner or toward women in general.
Where Can I Find Additional Information on Male Sexual Disorders?
Many of the books about male sexual disorders are written from the standpoint of mental health clinicians and physicians. However, two that have received good reviews from the general public are Coping with Erectile Dysfunction: How to Regain Confidence & Enjoy Great Sex by Michael E. Metz and Barry W. McCarthy,and Sexual Healing: The Complete Guide to Overcoming Common Sexual Problems, written by Barbara Keesling.
Comer, R.J. (1996). Fundamentals of Abnormal Psychology. New York: W.H. Freeman and Company.
Kaplan, H.I., &Sadoc, B.J. (1996). Concise Textbook of Clinical Psychiatry. Baltimore, MD: Williams & Wilkins.