Meta tags:
Headings (most frequently used words):
sexual, disorders, dysfunction, menopause, contents, types, causes, diagnosis, treatment, research, see, also, references, external, links, desire, arousal, orgasm, pain, with, ssri, medication, pelvic, floor, female, aging, in, women, list, of, males, females, erectile, anorgasmia, premature, ejaculation, post, orgasmic, dsm, other, problems,
Text of the page (most frequently used words):
sexual (290), and (252), the (205), #dysfunction (101), women (67), sex (64), #disorder (55), with (54), disorders (52), for (49), may (48), can (39), men (38), have (38), doi (38), are (37), pmid (36), that (36), from (35), ejaculation (31), syndrome (31), erectile (31), edit (31), problems (30), desire (29), not (28), female (27), treatment (27), this (26), disease (26), pain (24), which (24), health (23), other (23), orgasm (22), arousal (22), intercourse (22), was (21), male (21), anxiety (21), also (21), sexuality (19), therapy (19), such (19), cause (19), pelvic (17), activity (17), who (17), journal (17), premature (17), has (17), causes (17), retrieved (16), symptoms (16), physical (16), include (16), these (16), medicine (15), related (15), vaginal (15), were (15), most (15), but (15), reproductive (14), post (14), psychological (14), testosterone (14), impotence (14), psychiatric (14), menopause (14), during (14), been (14), pregnancy (13), research (13), human (13), orgasmic (13), lack (13), genital (12), penis (12), masters (12), johnson (12), when (12), some (12), use (11), dysfunctions (11), erection (11), 2015 (11), floor (11), than (11), aging (11), between (11), many (11), factors (11), about (10), rights (10), history (10), orientation (10), illness (10), chronic (10), diseases (10), drugs (10), partner (10), 1016 (10), low (10), american (10), function (10), they (10), after (10), common (10), anorgasmia (10), condition (10), main (10), united (9), states (9), penile (9), response (9), clinical (9), 978 (9), isbn (9), s2cid (9), ssri (9), among (9), normal (9), there (9), changes (9), wikipedia (8), international (8), control (8), social (8), education (8), pois (8), schizophrenia (8), depression (8), physiological (8), psychogenic (8), specific (8), relationship (8), stimulation (8), libido (8), assault (8), medical (8), 2010 (8), impact (8), their (8), article (8), policy (7), 2021 (7), all (7), one (7), birth (7), system (7), identity (7), behavior (7), body (7), mood (7), vascular (7), functioning (7), work (7), age (7), see (7), person (7), people (7), 2013 (7), diagnosis (7), found (7), study (7), cases (7), both (7), often (7), due (7), several (7), those (7), toggle (6), articles (6), child (6), movement (6), gender (6), sexually (6), hormonal (6), coital (6), substance (6), dissociative (6), stress (6), life (6), archived (6), 2008 (6), prevalence (6), studies (6), difficulties (6), present (6), medications (6), medication (6), partners (6), 2025 (6), how (6), into (6), despite (6), based (6), before (6), help (6), any (6), its (6), known (6), however (6), blood (6), citation (6), needed (6), failure (6), occurs (6), distress (6), lead (6), individuals (6), terms (5), using (5), non (5), page (5), april (5), unsourced (5), september (5), two (5), development (5), andrology (5), patients (5), self (5), safe (5), postorgasmic (5), peyronie (5), external (5), prostatitis (5), childhood (5), psychosis (5), drug (5), abuse (5), phobia (5), adult (5), mental (5), theory (5), urology (5), lubrication (5), cycle (5), differences (5), october (5), 1111 (5), original (5), 2020 (5), new (5), july (5), experience (5), march (5), psychology (5), side (5), effects (5), rare (5), aged (5), cite (5), possible (5), program (5), culture (5), defined (5), develop (5), only (5), had (5), treatments (5), estrogen (5), dryness (5), important (5), menopausal (5), headaches (5), including (5), inability (5), associated (5), poor (5), unknown (5), time (5), contents (4), search (4), view (4), contact (4), available (4), under (4), additional (4), commons (4), categories (4), wikidata (4), references (4), index (4), national (4), abortion (4), three (4), transmitted (4), care (4), gynaecology (4), intersex (4), counseling (4), risk (4), balanitis (4), priapism (4), prostate (4), testicular (4), general (4), type (4), like (4), induced (4), perception (4), hypoactive (4), hypersexuality (4), eating (4), panic (4), brain (4), dementia (4), bipolar (4), emotional (4), behaviour (4), portal (4), lgbtq (4), love (4), model (4), vagina (4), physiology (4), manual (4), activities (4), links (4), january (4), 2016 (4), 1097 (4), waldinger (4), pmc (4), 1038 (4), hard (4), vol (4), interest (4), aversion (4), issues (4), role (4), association (4), diagnostic (4), statistical (4), pdf (4), information (4), neurology (4), 444 (4), 63247 (4), antidepressants (4), reasons (4), times (4), 2005 (4), primary (4), cardiovascular (4), create (4), dyspareunia (4), vaginismus (4), week (4), experiences (4), seen (4), believed (4), result (4), section (4), sources (4), does (4), levels (4), experiencing (4), recommended (4), effective (4), nausea (4), fatigue (4), alcohol (4), counselling (4), patient (4), technique (4), types (4), become (4), avoidance (4), areas (4), absence (4), dsm (4), following (4), woman (4), well (4), painful (4), pleasure (4), strongly (4), without (4), difficulty (4), caused (4), population (4), will (4), behaviours (4), hypothesis (4), underlying (4), interpersonal (4), characterized (4), thought (4), conditions (4), hide (4), move (4), sidebar (4), subsection (4), privacy (3), organization (3), wikimedia (3), last (3), statements (3), 2024 (3), short (3), description (3), sexology (3), title (3), country (3), infertility (3), transgender (3), obstetrics (3), rape (3), sperm (3), contraception (3), pre (3), genetic (3), contraceptive (3), persistent (3), cancer (3), acute (3), pct (3), dhat (3), delusional (3), effect (3), postpartum (3), specified (3), cognitive (3), high (3), autism (3), disability (3), behavioral (3), fear (3), compulsive (3), fetishism (3), classification (3), surrogate (3), positive (3), consent (3), communication (3), attraction (3), marriage (3), group (3), relationships (3), free (3), celibacy (3), asexuality (3), society (3), addiction (3), events (3), biology (3), monasticism (3), erotic (3), icd (3), nih (3), clinics (3), 2014 (3), loss (3), 2019 (3), drive (3), book (3), treated (3), intracavernous (3), implant (3), practice (3), pharmacotherapy (3), 1996 (3), ejaculatory (3), 1999 (3), jama (3), 2007 (3), gynecology (3), york (3), 2017 (3), reported (3), specifically (3), handbook (3), cure (3), ijir (3), diabetes (3), world (3), abnormal (3), mcgraw (3), hill (3), nolen (3), hoeksema (3), tinea (3), increase (3), turn (3), experienced (3), being (3), autonomic (3), therapist (3), could (3), number (3), over (3), would (3), problem (3), couples (3), individual (3), certain (3), improvement (3), frigidity (3), earlier (3), list (3), learn (3), improve (3), androgen (3), more (3), androgens (3), increased (3), treat (3), atrophy (3), maintaining (3), leads (3), flow (3), decreased (3), while (3), flibanserin (3), should (3), shown (3), others (3), either (3), insertion (3), stop (3), start (3), another (3), because (3), although (3), now (3), burning (3), classified (3), what (3), decline (3), affect (3), current (3), less (3), menstrual (3), injury (3), assaults (3), multiple (3), circumstances (3), account (3), image (3), unable (3), younger (3), insufficient (3), decrease (3), occur (3), theories (3), ssris (3), persist (3), gland (3), systems (3), trauma (3), excitement (3), aphasia (3), rapid (3), muscle (3), maintain (3), contribute (3), tools (3), languages (2), table (2), conduct (2), legal (2), safety (2), site (2), foundation (2), category (2), link (2), needing (2), different (2), cs1 (2), names (2), accept (2), law (2), teen (2), philippines (2), india (2), china (2), dysphoria (2), infections (2), endocrinology (2), genitourinary (2), prenatal (2), options (2), report (2), behaviors (2), sterilization (2), condom (2), planning (2), integrity (2), movements (2), seminal (2), hyperplasia (2), testis (2), internal (2), pelvis (2), psychiatry (2), tristesse (2), illnesses (2), burden (2), simple (2), dependence (2), sleep (2), night (2), nervosa (2), anorexia (2), otherwise (2), ptsd (2), adjustment (2), mild (2), nos (2), spectrum (2), affective (2), major (2), linked (2), intellectual (2), selective (2), learning (2), personality (2), anhedonia (2), paraphilia (2), revolution (2), worker (2), ethics (2), capital (2), swinging (2), repression (2), abstinence (2), romance (2), promiscuity (2), foreplay (2), flirting (2), conventional (2), committed (2), casual (2), diversity (2), split (2), plissit (2), infection (2), obesity (2), hyposexuality (2), ejaculate (2), thrust (2), nocturnal (2), emission (2), insemination (2), clitoral (2), erogenous (2), zones (2), mechanics (2), ancient (2), sacred (2), prostitution (2), religion (2), pornography (2), industry (2), imperative (2), trafficking (2), cybersex (2), exposure (2), talk (2), penetration (2), oral (2), penetrative (2), masturbation (2), fingering (2), anal (2), media (2), north (2), america (2), 100 (2), topical (2), coconut (2), oil (2), skin (2), trial (2), approaches (2), com (2), first (2), guideline (2), college (2), physicians (2), 2003 (2), satisfaction (2), rates (2), surgery (2), 170 (2), mcmahon (2), etiology (2), 1998 (2), directed (2), flaccid (2), knowledge (2), advances (2), psychosomatic (2), beyond (2), labs (2), utexas (2), edu (2), marital (2), laumann (2), paik (2), rosen (2), february (2), 1001 (2), 281 (2), 537 (2), quarterly (2), august (2), 1743 (2), 6109 (2), 111 (2), 2018 (2), bahrick (2), 2006 (2), close (2), change (2), taking (2), publishing (2), consequences (2), initial (2), doctors (2), 002 (2), reviews (2), 130 (2), 26003261 (2), b978 (2), 00027 (2), bladder (2), 2009 (2), discontinuation (2), antidepressant (2), evidence (2), taylor (2), cd003382 (2), 1002 (2), systematic (2), wentzell (2), archives (2), kaplan (2), institute (2), kidney (2), curvature (2), statpearls (2), center (2), gard (2), wylie (2), 118 (2), eds (2), correlates (2), identified (2), attitudes (2), serotonergic (2), behavioural (2), date (2), edition (2), chapter (2), publisher (2), 368 (2), worldwide (2), 270 (2), viagra (2), quality (2), dapoxetine (2), rather (2), situational (2), according (2), process (2), inhibited (2), couple (2), discussion (2), approached (2), limited (2), psychopathology (2), psychopathological (2), considered (2), proposed (2), inadequacy (2), prior (2), approach (2), regarding (2), negative (2), usually (2), back (2), involving (2), remove (2), message (2), please (2), material (2), challenged (2), removed (2), adding (2), citations (2), reliable (2), approved (2), commonly (2), used (2), oophorectomy (2), postmenopausal (2), controversial (2), pharmacological (2), alternative (2), creams (2), vulva (2), area (2), estrogens (2), urogenital (2), tract (2), tissues (2), deficiency (2), lubricants (2), able (2), pleasurable (2), per (2), month (2), satisfactory (2), prescribed (2), referred (2), females (2), since (2), method (2), fail (2), option (2), techniques (2), squeeze (2), just (2), directly (2), localized (2), smoking (2), community (2), arises (2), bad (2), males (2), inadequate (2), muscles (2), delay (2), adequate (2), dissatisfaction (2), paraphilias (2), dihydrotestosterone (2), prevalent (2), produce (2), affects (2), frequency (2), throughout (2), status (2), play (2), take (2), excessive (2), medically (2), unexplained (2), irregularity (2), lower (2), african (2), complete (2), aroused (2), discomfort (2), achieving (2), her (2), themselves (2), engage (2), anxious (2), incomplete (2), achieve (2), older (2), leading (2), justification (2), cognitions (2), restore (2), overjustification (2), make (2), feelings (2), treatable (2), sometimes (2), natural (2), part (2), participate (2), she (2), immediately (2), period (2), injuries (2), damage (2), various (2), adrenal (2), tumors (2), sclerosis (2), spinal (2), cord (2), narcotics (2), guilt (2), past (2), hours (2), severe (2), permanent (2), difficult (2), estimated (2), potentially (2), vulvar (2), pathology (2), immune (2), nervous (2), nature (2), relating (2), incorrectly (2), diagnosed (2), adrenergic (2), breathing (2), itchy (2), eyes (2), weakness (2), fever (2), palpitations (2), paresthesia (2), length (2), must (2), origins (2), million (2), primarily (2), performance (2), management (2), replaced (2), four (2), assessing (2), stage (2), preference (2), appearance (2), upload (2), file (2), read (2), english (2), log (2), donate (2), menu (2), add, topic, mobile, cookie, statement, statistics, developers, code, contacts, disclaimers, text, apply, you, agree, registered, trademark, profit, inc, creative, attribution, sharealike, license, edited, 2026, utc, hidden, matches, long, volume, value, vancouver, markup, https, org, php, sexual_dysfunction, oldid, 1348825474, yale, lux, israel, czech, republic, bnf, data, france, gnd, authority, databases, timeline, legislation, hygiene, condoms, kingdom, singapore, pakistan, ireland, iran, clinic, modification, precocious, puberty, teenage, pregnant, childbirth, unintended, maternal, vulvovaginal, fertility, fraud, bank, gamete, cryopreservation, egg, icsi, vitro, fertilization, assisted, reproduction, intrauterine, device, theft, foster, adoption, parenting, spacing, childlessness, childfreeness, conception, circumcision, controversy, security, compulsory, justice, retrograde, hematospermia, pneumoscrotum, varicocele, fournier, gangrene, scrotum, xerotica, obliterans, fracture, spontaneous, paraphimosis, phimosis, pseudoepitheliomatous, keratotic, micaceous, plasmacellularis, balanoposthitis, vesiculitis, vesicle, benign, prostatic, asymptomatic, inflammatory, bacterial, hematocele, spermatocele, epididymitis, epididymis, ectopic, teratospermia, necrospermia, oligospermia, hypospermia, hyperspermia, azoospermia, asthenozoospermia, aspermia, torsion, hydrocele, orchitis, genitals, petite, mort, allergy, specialties, headache, honeymoon, rhinitis, caregiver, stereotypy, psychomotor, agitation, klüver, bucy, impulse, uncategorized, catatonia, pseudoneurotic, disorganized, hebephrenic, schizophreniform, schizoaffective, brief, reactive, folie, deux, schizotypal, withdrawal, stimulant, rebound, intoxication, hallucinogen, persisting, overdose, substances, psychoactive, postnatal, rem, nightmare, terror, parasomnia, insomnia, hypersomnia, nonorganic, feeding, rumination, pica, avoidant, restrictive, food, intake, binge, bulimia, nosophobia, mass, hypochondriasis, false, epileptic, seizures, globus, pharyngeus, ganser, conversion, dysmorphic, somatic, symptom, fugue, amnesia, depersonalization, derealization, reaction, paranoia, attack, ocd, generalized, claustrophobia, anthropophobia, agoraphobia, depressed, somatoform, neurotic, concussion, organic, delirium, wandering, sundowning, pick, parkinson, impairment, huntington, frontotemporal, creutzfeldt, jakob, alzheimer, aids, complex, savant, pdd, asperger, neurological, symptomatic, mania, seasonal, melancholic, depressive, dysthymia, atypical, cyclothymia, pervasive, developmental, disabilities, lujan, fryns, tourette, tic, stuttering, cluttering, speech, mutism, rad, dad, stereotypic, separation, odd, adhd, trichotillomania, pyromania, kleptomania, dermatillomania, intermittent, explosive, intimacy, munchausen, factitious, maturation, voyeurism, ego, dystonic, stanley, georgia, script, norm, jealousy, feminism, workers, right, public, territory, decriminalization, sociosexuality, frustration, attractiveness, hypergamy, dynamics, single, polyamory, aromanticism, romantic, stand, friends, benefits, fictosexuality, herbivore, shyness, phenomena, homosexuality, heterosexuality, pansexuality, bisexuality, demisexuality, gray, klein, grid, kinsey, scale, sexecology, environmental, demographical, hormones, neuroscientific, handedness, order, biological, semen, throat, rectum, nipples, clitoris, breasts, anus, anatomy, differentiation, adolescent, outline, magic, thelema, greece, mormonism, affirming, religions, judaism, islam, daoism, jain, hindu, catholic, church, buddhist, clerical, christian, demonology, christianity, tantric, hinduism, buddhism, webcam, strip, club, doll, toy, tourism, shop, museum, red, light, district, survival, film, actor, erotica, video, games, south, korea, japan, rome, slang, objectification, premarital, gap, family, extramarital, anarchism, depictions, feminist, wars, revenge, violence, slavery, misconduct, harassment, obscenity, indecent, incest, criminal, transmission, hiv, binary, fantasy, foot, wet, shirt, contest, virtual, urolagnia, urethral, tribadism, sumata, positions, sexercise, quickie, pompoir, irrumatio, fellatio, cunnilingus, anilingus, nipple, handjob, mammary, gang, bang, frot, forced, footjob, fisting, facial, denial, edging, creampie, bdsm, bareback, d020018, mesh, 302, f52, wright, connor, 628, 25841603, mcna, 011, 607, evangelista, mara, therese, padilla, abad, casintahan, flordeliz, lopez, villafuerte, lillian, 108, 24320105, ijd, 12339, dermatology, virgin, scorad, transepidermal, water, capacitance, moderate, pediatric, atopic, dermatitis, randomized, double, blind, amato, online, blog, document, update, therapeutic, www, webmd, fda, approves, boost, parry, medscape, qaseem, horwitch, vijan, etxeandia, ikobaltzeta, kansagara, forciea, 133, 31905405, 7326, m19, 0882, 126, 172, annals, heal, rajpurkar, dhabuwala, comparison, sildenafil, prostaglandin, 163, 12796670, 0000072524, 82345, 159, jannini, 2012, springer, science, business, 470, 2646, rodríguez, vela, moncada, iribarren, gonzalvo, ibarra, sáenz, tejada, gorman, 319, 9658642, 291, actas, urologicas, espanolas, merck, sharpe, dohme, jarow, nana, sinkam, sabbagh, eskew, outcome, analysis, goal, 1612, 8627834, s0022, 5347, 66142, 1609, 155, gryzinski, gustavo, hammad, muhammed, moukhtar, alzweri, laith, azad, babak, barham, david, lumbiganon, supanut, serefoglu, ege, yafi, faysal, 447, 38898174, 12185328, 1476, 5489, issn, s41443, 024, 00917, 446, survey, practitioners, ucsf, department, rellini, clifton, 2011, 207708545, 22005203, 8055, 9825, 1159, 000328807, connection, crenshaw, 1985, 292, 4078910, 1080, 00926238508405454, 285, 544, 10022110, predictors, users, library, full, access, golding, jacqueline, 121, 12296010, 1471, 6402, tb00667, 101, overview, davis, susan, 745, 39167808, 1056, nejmcp2313307, 736, 391, england, rosenbaum, owens, cme, 523, 18304280, 00761, 513, handa, cundiff, chang, helzlsouer, 1052, 18448734, 2746737, aog, 0b013e31816bbe85, 1045, basics, city, manhattan, perineum, sore, advanced, massage, bodywork, tablet, advancement, healy, e55, takers, serotonin, reuptake, inhibitor, degree, sensory, within, min, 31543091, 8061302, 1017, s2045796019000519, epidemiology, sciences, enduring, 5th, arlington, 449, 89042, 555, reisman, 433, registration, fewer, asked, emergent, 28642048, sxmr, 429, eli, lilly, company, prozac, highlights, prescribing, 479, kennedy, rizvi, 164, 739831, 19512977, jcp, 0b013e31819c76e9, 157, psychopharmacology, 2174, 1874350100801010042, open, persistence, emerging, rudkin, bullemor, day, lubin, chukwujekwu, hawton, 23728643, 12052305, 14651858, pub3, cochrane, database, strategies, managing, respectably, rejecting, medicalization, mexican, 23674320, maq, 12013, anthropology, kingsberg, 2002, 437, 7762943, 12238611, 1023, 1019844209233, 431, saks, coretti, baldi, ayurveda, cooper, june, 1969, potency, 5789606, 0022, 3999, 90055, 143, 1988, suppl, 3170497, michetti, rossi, bonanno, tiesi, simonelli, 174, 16151475, 3901386, regulation, emotions, alexithymia, emedicine, emergency, digestive, niddk, sandean, darren, leslie, stephen, lotfollahzadeh, saran, treasure, island, 32809463, 16th, meeting, ashby, goldmeier, postorgasm, 1981, 20214722, 01707, 1976, institutes, john, wiley, sons, 66556, abc, balon, segraves, francis, 8247, 5826, nicolosi, glasser, gingell, moreira, wang, 13187709, 15215881, 3901250, global, diaz, 489, 20705194, pop, 473, elsevier, berendsen, blok, olivier, holstege, delayed, involvement, 23494410, 9638953, s0166, 4328, 00183, 6th, 259, 06072, ask, strange, gupta, chaudhry, elewski, corporis, cruris, nigra, piedra, 400, 12956194, s0733, 8635, 00031, 395, dermatologic, billups, december, early, sign, s24, 16391539, 3901425, s19, ayta, mckinlay, krane, likely, 1995, 35772517, 10444124, 1046, 1464, 410x, 00142, bju, consensus, panel, 1993, raymond, 2001, 278, s0094, 0143, 70137, 269, urologic, rishabh, bhola, ncats, hartley, pinking, efforts, repackage, 365, 143113254, 1177, 1363460706065058, sexualities, maurice, 4th, guilford, press, principles, leiblum, van, andel, boer, towns, gynaecological, andrological, urological, ethnopharmacological, perspective, heinrich, jäger, 212, 93071, 9781118930717, ch18, 199, ethnopharmacology, norton, jehu, 1984, review, 19396561, 6145405, 1007, bf01542150, 165, 469, eden, 396, 19586430, 2217, whe, 385, chen, huang, 200, 218643956, 32421290, pra, 0000000000000460, 185, 10th, geneva, switzerland, sexless, orgastic, agony, aunt, overrun, enthusiastic, blurring, space, enrichment, defining, range, boundary, deviations, transitory, included, secondary, every, functionally, intact, responses, successful, climax, incompetence, basic, intensive, efficient, led, began, sensate, focus, shared, determined, developed, abandoned, ethical, raised, moved, thinking, did, respond, educative, whereas, individually, joint, act, key, issue, specifics, pair, therapists, match, clients, arguing, lone, fully, comprehend, largely, derived, held, pessimism, chance, merely, deeper, malaise, viewpoint, little, distinction, variations, nor, perversion, psychotherapists, balint, crudely, acquired, connotations, popular, sigmund, freud, modern, dated, 1970, published, decade, louis, 790, grew, 1966, investigational, small, benefit, state, higher, scores, compared, placebo, acne, density, lipoproteins, risks, gels, applied, endometrial, polycythaemia, hirsutism, responsible, maintenance, collagen, elastic, fibers, vasculature, structure, functional, moisture, keep, lubricated, protected, prolonged, fibrosis, reduced, cannot, commercial, replacement, outside, indicated, criticized, efficacy, warnings, contraindications, limit, trials, dizziness, drowsiness, taken, modestly, increasing, flushing, relievers, desensitizing, agents, awareness, helpful, counselor
Text of the page (random words):
y found that african american women are the most optimistic about menopausal life caucasian women are the most anxious asian women are the most inhibited about their symptoms and hispanic women are the most stoic 37 since these women have sexual problems their sexual lives with their partners can become a burden without pleasure and may eventually lose complete interest in sexual activity some of the women found it hard to be aroused mentally while others had physical problems several factors can affect female dysfunction such as situations in which women do not trust their sex partners the environment where sex occurs being uncomfortable or an inability to concentrate on the sexual activity due to a bad mood or burdens from work other factors include physical discomfort or difficulty in achieving arousal which could be caused by aging or changes in the body s condition 54 sexual assault has been associated with excessive menstrual bleeding genital burning and painful intercourse attributable to disease injury or otherwise medically unexplained dysmenorrhea menstrual irregularity and lack of sexual pleasure citation needed physically violent assaults and those committed by strangers were most strongly related to reproductive symptoms multiple assaults assaults accomplished by persuasion spousal assault and completed intercourse were most strongly related to sexual symptoms citation needed assault was occasionally associated more strongly with reproductive symptoms among women with lower income or less education possibly because of economic stress or differences in assault circumstances associations with unexplained menstrual irregularity were strongest among african american women ethnic differences in reported circumstances of assault appeared to account for these differences assault was associated with sexual indifference only among latinas 55 menopause edit the most prevalent of female sexual dysfunctions that have been linked to menopause include lack of desire and libido these are predominantly associated with hormonal physiology specifically the decline in serum estrogens causes these changes in sexual functioning androgen depletion may also play a role but current knowledge about this is less clear the hormonal changes that take place during the menopausal transition have been suggested to affect women s sexual response through several mechanisms some more conclusive than others aging in women edit whether or not aging directly affects women s sexual functioning during menopause is controversial however many studies have demonstrated that aging has a powerful impact on sexual function and dysfunction in women specifically in the areas of desire sexual interest and frequency of orgasm 3 37 56 the primary predictor of sexual response throughout menopause is prior sexual functioning 3 which means that it is important to understand how the physiological changes in men and women can affect sexual desire 37 despite the apparent negative impact that menopause can have on sexuality and sexual functioning sexual confidence and well being can improve with age and menopausal status 3 testosterone along with its metabolite dihydrotestosterone is important to normal sexual function in men and women dihydrotestosterone is the most prevalent androgen in both men and women 37 testosterone levels in women at age 60 are on average about half of what they were before the women were 40 although this decline is gradual for most women those who have undergone bilateral oophorectomy experience a sudden drop in testosterone levels as the ovaries produce 40 of the body s circulating testosterone 37 sexual desire has been related to three separate components drive beliefs and values and motivation 37 particularly in postmenopausal women drive fades and is no longer the initial step in a woman s sexual response 37 diagnosis edit list of disorders edit this section does not cite any sources please help improve this section by adding citations to reliable sources unsourced material may be challenged and removed may 2021 learn how and when to remove this message dsm edit the fourth edition of the diagnostic and statistical manual of mental disorders lists the following sexual dysfunctions hypoactive sexual desire disorder see also asexuality which is not classified as a disorder sexual aversion disorder avoidance of or lack of desire for sexual intercourse 57 58 female sexual arousal disorder failure of normal lubricating arousal response 59 male erectile disorder female orgasmic disorder see anorgasmia 60 male orgasmic disorder see anorgasmia 61 premature ejaculation dyspareunia vaginismus additional dsm sexual disorders that are not sexual dysfunctions include paraphilias ptsd due to genital mutilation or childhood sexual abuse other sexual problems edit sexual dissatisfaction non specific lack of sexual desire anorgasmia impotence sexually transmitted infections delay or absence of ejaculation despite adequate stimulation inability to control timing of ejaculation inability to relax vaginal muscles enough to allow intercourse inadequate vaginal lubrication preceding and during intercourse burning pain on the vulva or in the vagina with contact to those areas unhappiness or confusion related to sexual orientation transsexual and transgender people may have sexual problems before or after surgery persistent sexual arousal syndrome sexual addiction hypersexuality all forms of female genital cutting post orgasmic diseases such as dhat syndrome pct pois and sexual headaches hard flaccid syndrome 62 treatment edit males edit several decades ago the medical community believed most sexual dysfunction cases were related to psychological issues although this may be true for a portion of men the vast majority of cases have now been identified to have a physical cause or a correlation 63 if the sexual dysfunction is deemed to have a psychological component or cause psychotherapy can help situational anxiety arises from an earlier bad incident or lack of experience and often leads to development of fear towards sexual activity and avoidance which enters a cycle of increased anxiety and desensitization of the penis in some cases erectile dysfunction may be due to marital disharmony marriage counseling sessions are recommended in this situation lifestyle changes such as discontinuing tobacco smoking or substance use can also treat some types of ed 64 several oral medications like viagra cialis and levitra have become available to alleviate ed and have become first line therapy these medications provide an easy safe and effective treatment solution for approximately 60 of men in the rest the medications may not work because of wrong diagnosis or chronic history citation needed another type of medication that is effective in roughly 85 of men is called intracavernous pharmacotherapy which involves injecting a vasodilator drug directly into the penis to stimulate an erection 65 this method has an increased risk of priapism if used in conjunction with other treatments and localized pain 21 premature ejaculations are treated by behavioural techniques squeeze technique and stop start technique in squeeze technique the area between head and shaft of penis is pressed using index finger and thumb just before ejaculation in stop start technique the male partner stops having sexual intercourse just before ejaculation and waits for the sense of ejaculation to pass away both techniques are repeated many times 66 when conservative therapies fail are an unsatisfactory treatment option or are contraindicated for use the insertion of a penile implant may be selected by the patient technological advances have made the insertion of a penile implant a safe option for the treatment of ed which provides the highest patient and partner satisfaction rates of all available ed treatment options 67 pelvic floor physical therapy has been shown to be a valid treatment for men with sexual problems and pelvic pain 68 the 2020 guidelines from the american college of physicians support the discussion of testosterone treatment in adult men with age related low levels of testosterone who have sexual dysfunction they recommend yearly evaluation regarding possible improvement and if none to discontinue testosterone intramuscular treatments should be considered rather than transdermal treatments due to costs and since the effectiveness and harm of either method is similar testosterone treatment for reasons other than possible improvement of sexual dysfunction may not be recommended 69 70 females edit in 2015 flibanserin was approved in the us to treat decreased sexual desire in women while it is effective for some women it has been criticized for its limited efficacy and has many warnings and contraindications that limit its use 71 flibanserin was found to increase pleasurable sexual experiences by 0 5 events per month in trials possible side effects include dizziness drowsiness nausea and fatigue 53 flibanserin should not be taken with alcohol 53 bremelanotide has been shown to modestly increase sexual desire in women but it has not shown evidence of increasing the number of satisfactory sexual experiences per month possible side effects include nausea flushing and headaches 53 women experiencing pain with intercourse are often prescribed pain relievers or desensitizing agents others are prescribed vaginal lubricants many women with sexual dysfunction are also referred to a counselor or sex therapist 72 counselling for female sexual dysfunction including sexual counselling cognitive behavioral therapy body awareness counselling and couples counselling have been found to be helpful 53 estrogen replacement therapy outside of the indicated use for menopausal symptoms is not recommended for the treatment of sexual dysfunction in women 53 menopause edit estrogens are responsible for the maintenance of collagen elastic fibers and vasculature of the urogenital tract all of which are important in maintaining vaginal structure and functional integrity they are also important for maintaining vaginal ph and moisture levels both of which help to keep the tissues lubricated and protected 3 prolonged estrogen deficiency leads to atrophy fibrosis and reduced blood flow to the urogenital tract which cause menopausal symptoms such as vaginal dryness and pain related to sexual activity and or intercourse 3 women experiencing vaginal dryness who cannot use commercial lubricants may be able to use coconut oil as an alternative 73 androgen therapy for hypoactive sexual desire disorder has a small benefit but its safety is not known 74 it is not approved as a treatment in the united states 74 it is more commonly used among women who have had an oophorectomy or are in a postmenopausal state however like most treatments this is also controversial one study found that after a 24 week trial women taking androgens had higher scores of sexual desire compared to a placebo group 3 as with all pharmacological drugs there are side effects in using androgens which include hirsutism acne polycythaemia increased high density lipoproteins cardiovascular risks and endometrial hyperplasia 3 alternative treatments include topical estrogen creams and gels that can be applied to the vulva or vagina area to treat vaginal dryness and atrophy 3 research edit this section does not cite any sources please help improve this section by adding citations to reliable sources unsourced material may be challenged and removed may 2021 learn how and when to remove this message see also list of investigational sexual dysfunction drugs in modern times clinical study of sexual problems is usually dated back no earlier than 1970 when masters and johnson s human sexual inadequacy was published it was the result of over a decade of work at the reproductive biology research foundation in st louis involving 790 cases the work grew from masters and johnson s earlier human sexual response 1966 prior to masters and johnson the clinical approach to sexual problems was largely derived from sigmund freud it was held to be psychopathology and approached with a certain pessimism regarding the chance of help or improvement sexual problems were merely symptoms of a deeper malaise and the diagnostic approach was from the psychopathological viewpoint there was little distinction between difficulties in function and variations nor between perversion and problems despite work by psychotherapists such as balint sexual difficulties were crudely split into frigidity or impotence terms which acquired negative connotations in popular culture human sexual inadequacy moved thinking from psychopathology to learning psychopathological problems would only be considered if a problem did not respond to educative treatment treatment was directed at couples whereas before partners would be seen individually masters and johnson believed that sex was a joint act and that sexual communication was the key issue to sexual problems not the specifics of an individual problem they also proposed co therapy with a pair of therapists to match the clients arguing that a lone male therapist could not fully comprehend female difficulties the basic masters and johnson treatment program was an intensive two week program to develop efficient sexual communication the program is couple based and therapist led and began with discussion and sensate focus between the couple to develop shared experiences from the experiences specific difficulties could be determined and approached with a specific therapy in a limited number of male only cases 41 masters and johnson developed the use of a female surrogate which was abandoned over the ethical legal and other problems it raised in defining the range of sexual problems masters and johnson defined a boundary between dysfunction and deviations dysfunctions were transitory and experienced by most people and included male primary or secondary impotence premature ejaculation and ejaculatory incompetence female primary orgasmic dysfunction and situational orgasmic dysfunction pain during intercourse dyspareunia and vaginismus according to masters and johnson sexual arousal and climax are a normal physiological process of every functionally intact adult but they can be inhibited despite being autonomic responses masters and johnson s treatment program for dysfunction was 81 1 successful despite masters and johnson s work sexual therapy in the us was overrun by enthusiastic rather than systematic approaches blurring the space between enrichment and therapy see also edit human sexuality portal agony aunt dapoxetine orgastic impotence premature ejaculation sex and drugs sex after pregnancy sexless marriage sexual arousal disorder dapoxetine references edit international statistical classification of diseases and related health problems 10th icd 10 ed geneva switzerland world health organization who 2010 a b c lo yc chen hh huang ss may 2020 panic disorder c...
|
