American Sexual
Health Association

Sexual Functioning—Understanding and Overcoming Sexual Difficulties

Sexual difficulties

An important part of overall sexual health is healthy sexual functioning—being able to experience sexual pleasure and satisfaction when desired.

Sexual pleasure can be experienced in many ways, from solo masturbation to oral sex to sensual massage to a range of other possibilities. When we are sexually exited, our bodies respond in certain ways. A racing heart, rapid breathing, a rush of blood to the genitals. The vagina will become more lubricated and the clitoris will swell. Increased blood flow to the penis leads to an erection. This is all part of the sexual response cycle.

But what happens when something in this response cycle doesn’t work as expected? Maybe a woman has trouble getting aroused or finds her body producing less lubrication, making intercourse painful. A man might have trouble getting or maintaining an erection, or may have difficulty reaching orgasm.

Sexual problems like these are not uncommon, and can have either psychological or physical causes. These can include:

  • diabetes
  • high blood pressure
  • chronic illnesses
  • hormonal changes
  • stress
  • anxiety
  • depression
  • medications to treat chronic conditions

But when does the occasional problem become a more serious one? When sexual difficulties are more than occasional, when they are persistent and upsetting and interfere with a healthy sex life, it is time to talk to a health care professional.

The good news about sexual difficulties is that there are solutions. Sometimes, medication might be the answer. In other cases, therapy may be the right approach. What is important is to find the help you need to have a satisfying sex life.

Talking to a Partner

When there are sexual difficulties in a relationship, both partners are affected. For example, erectile dysfunction (ED) isn’t just a problem for the person experiencing it—partners are affected as well. ED can cause a man to withdraw from sex and his partner. Partners may blame themselves, thinking that they are no longer desirable or suspecting infidelity as the cause behind the ED.

A lack of communication can be destructive for couples dealing with ED. Talking with a partner is an essential part of managing the condition.

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