Sexual function

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Sexual function is how the body reacts in different stages of the sexual response cycle. It is defined as the ability of an individual to react sexually or to experience pleasure sexually. [1]

Contents

Assessment

Relevant aspects of sexual function are described on the basis of a modified version of Masters and Johnson's work. [2] The aspects of sexual function determined as being relevant to the assessment include; sexual desire, erection, orgasm and ejaculation. Guidelines for assessing sexual function are suggested and divided into four stages:

Stage 1 deals with the documentation of the defined aspects of sexual function. The main questions are:

  1. Is the function intact? For example: Have there been any occurrences of erections or orgasms during a given period of time?
  2. If the function is intact, what is the frequency and/or intensity of the function? For example: How often has the person had an orgasm or erections during the given period of time and how intense is the orgasmic pleasure and erection stiffness compared to youth or the best period in life. The suggested explanations for the absence or waning of functions at this stage are physiological and psychological.

Stage 2 deals with the assessment of the frequency of different sexual activities, such as intercourse, within a given time frame. The possible explanations for an absence or a decreased frequency of sexual activities may include physiological, psychological, social, religious and ethical reasons.

Stage 3 it is estimated if or to what extent waning sexual functions and/or activities cause distress.

Stage 4, the association between the distress due to waning sexual function and well-being and emotional isolation is assessed.

These guidelines were constructed to assess male sexual function [3] in relation with treatment for prostate cancer. However, the concept has been modified and adapted for females. [4]

See also

Related Research Articles

<span class="mw-page-title-main">Human sexual activity</span> Manner in which humans engage sexually

Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone to acts with another person in varying patterns of frequency, for a wide variety of reasons. Sexual activity usually results in sexual arousal and physiological changes in the aroused person, some of which are pronounced while others are more subtle. Sexual activity may also include conduct and activities which are intended to arouse the sexual interest of another or enhance the sex life of another, such as strategies to find or attract partners, or personal interactions between individuals. Sexual activity may follow sexual arousal.

<span class="mw-page-title-main">Orgasm</span> Intense physical sensation of sexual release

Orgasm or sexual climax is the sudden discharge of accumulated sexual excitement during the sexual response cycle, resulting in rhythmic, involuntary muscular contractions in the pelvic region characterized by sexual pleasure. Experienced by males and females, orgasms are controlled by the involuntary or autonomic nervous system. They are usually associated with involuntary actions, including muscular spasms in multiple areas of the body, a general euphoric sensation, and, frequently, body movements and vocalizations. The period after orgasm is typically a relaxing experience, attributed to the release of the neurohormones oxytocin and prolactin as well as endorphins.

Sexual desire is an emotion and motivational state characterized by an interest in sexual objects or activities, or by a drive to seek out sexual objects or to engage in sexual activities. It is an aspect of sexuality, which varies significantly from one person to another and also fluctuates depending on circumstances.

The Masters and Johnson research team, composed of William H. Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1990s.

<span class="mw-page-title-main">Sexual stimulation</span> Stimulus that causes and maintains sexual arousal

Sexual stimulation is any stimulus that leads to, enhances and maintains sexual arousal, and may lead to orgasm. Although sexual arousal may arise without physical stimulation, achieving orgasm usually requires it.

Persistent genital arousal disorder (PGAD), previously called persistent sexual arousal syndrome, is spontaneous, persistent, unwanted and uncontrollable genital arousal in the absence of sexual stimulation or sexual desire, and is typically not relieved by orgasm. Instead, multiple orgasms over hours or days may be required for relief.

Hypoactive sexual desire disorder (HSDD), hyposexuality or inhibited sexual desire (ISD) is sometimes considered a sexual dysfunction, and is characterized as a lack or absence of sexual fantasies and desire for sexual activity, as judged by a clinician. For this to be regarded as a disorder, it must cause marked distress or interpersonal difficulties and not be better accounted for by another mental disorder, a drug, or some other medical condition. A person with ISD will not start, or respond to their partner's desire for, sexual activity. HSDD affects approximately 10% of all pre-menopausal women in the United States, or about 6 million women.

Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.

The human sexual response cycle is a four-stage model of physiological responses to sexual stimulation, which, in order of their occurrence, are the excitement, plateau, orgasmic, and resolution phases. This physiological response model was first formulated by William H. Masters and Virginia E. Johnson, in their 1966 book Human Sexual Response. Since that time, other models regarding human sexual response have been formulated by several scholars who have criticized certain inaccuracies in the human sexual response cycle model.

Female sexual arousal disorder (FSAD) is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity. The diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.

Emotional isolation is a state of isolation where one may have a well-functioning social network but still feels emotionally separated from others.

The trade-off dilemma, or patient trade-off, refers to the choice between the expected beneficial and harmful effects in terms of patient survival and quality of life for a particular medical treatment. The choice involves a trade-off so it is of central importance for the patient and the physician to have access to empirical information on established treatment benefits and side effects. Research on this issue has been done upon prostate cancer.

Delayed ejaculation (DE) describes a man's inability or persistent difficulty in achieving orgasm, despite typical sexual desire and sexual stimulation. Generally, a man can reach orgasm within a few minutes of active thrusting during sexual intercourse, whereas a man with delayed ejaculation either does not have orgasms at all or cannot have an orgasm until after prolonged intercourse which might last for 30–45 minutes or more. Delayed ejaculation is closely related to anorgasmia.

Sexuality can be inscribed in a multidimensional model comprising different aspects of human life: biology, reproduction, culture, entertainment, relationships and love.

<span class="mw-page-title-main">Ejaculation</span> Euphoric stimulative semen discharge of the male reproductive tract

Ejaculation is the discharge of semen from the male reproductive tract. It is normally linked with orgasm, which involves involuntary contractions of the pelvic floor. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. Ejaculation can occur spontaneously during sleep, and is a normal part of human sexual development. In rare cases, ejaculation occurs because of prostatic disease. Anejaculation is the condition of being unable to ejaculate. Ejaculation is usually very pleasurable for men; dysejaculation is an ejaculation that is painful or uncomfortable. Retrograde ejaculation is the condition where semen travels backwards into the bladder rather than out of the urethra.

Within the work of the Austrian psychoanalyst Wilhelm Reich (1897–1957), orgastic potency is a human's natural ability to experience an orgasm with certain psychosomatic characteristics and resulting in full sexual gratification.

Sexual anhedonia, also known as pleasure dissociative orgasmic disorder, is a condition in which an individual cannot feel pleasure from an orgasm. It is thought to be a variant of hypoactive sexual desire disorder.

<span class="mw-page-title-main">Sexual arousal</span> Physiological and psychological changes in preparation for sexual intercourse

Sexual arousal describes the physiological and psychological responses in preparation for sexual intercourse or when exposed to sexual stimuli. A number of physiological responses occur in the body and mind as preparation for sexual intercourse, and continue during intercourse. Male arousal will lead to an erection, and in female arousal, the body's response is engorged sexual tissues such as nipples, clitoris, vaginal walls, and vaginal lubrication.

<span class="mw-page-title-main">Sexuality after spinal cord injury</span> Aspect of human sexuality

Although spinal cord injury (SCI) often causes sexual dysfunction, many people with SCI are able to have satisfying sex lives. Physical limitations acquired from SCI affect sexual function and sexuality in broader areas, which in turn has important effects on quality of life. Damage to the spinal cord impairs its ability to transmit messages between the brain and parts of the body below the level of the lesion. This results in lost or reduced sensation and muscle motion, and affects orgasm, erection, ejaculation, and vaginal lubrication. More indirect causes of sexual dysfunction include pain, weakness, and side effects of medications. Psycho-social causes include depression and altered self-image. Many people with SCI have satisfying sex lives, and many experience sexual arousal and orgasm. People with SCI may employ a variety of adaptations to help carry on their sex lives healthily, by focusing on different areas of the body and types of sexual acts. Neural plasticity may account for increases in sensitivity in parts of the body that have not lost sensation, so people often find newly sensitive erotic areas of the skin in erogenous zones or near borders between areas of preserved and lost sensation.

The orgasm gap or pleasure gap is the disparity in sexual satisfaction—specifically the unequal frequency in achieving orgasm during sexual encounters—between heterosexual men and women. Across every demographic that has been studied, women report the lowest frequency of reaching orgasm during sexual encounters with men. Researchers believe that multiple causes contribute to the orgasm gap. Orgasm gap researcher Laurie Mintz argues that the primary reason for this form of gender inequality is due to "our cultural ignorance of the clitoris" and that it is commonplace to "mislabel women's genitals by the one part that gives men, but not women, reliable orgasms."

References

  1. N, Komlenac; M, Hochleitner (February 2022). "Associations Between Pornography Consumption, Sexual Flexibility, and Sexual Functioning Among Austrian Adults". Archives of Sexual Behavior. 51 (2): 1323–1336. doi:10.1007/s10508-021-02201-7. PMC   8888391 . PMID   34984569. sexual functioning, which is defined as "a person's ability to respond sexually or to experience sexual pleasure"
  2. Masters, William; Virginia E. Johnson (1966). Human Sexual Response . Little, Brown & Co. ISBN   9780316549875.
  3. Helgason ÁR, Adolfsson J, Dickman P, Arver S, Fredrikson M, Göthberg M, Steineck G. Sexual desire, erection, orgasm and ejaculatory functions and their importance to elderly Swedish men: A population-based study. Age and Ageing. 1996:25:285-291.
  4. Bergmark K, Avall-Lundkvist E, Dickman PW, Henningsohn L, Steineck G. Vaginal changes and sexuality in woman with a history of cervical cancer. N Engl J Med. 1999: 304 (18):1383-9.