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Causes of sexual dysfunction
Medical expert of the article
Last reviewed: 08.07.2025
A number of organic and psychological factors can cause disorders of the sexual response cycle and result in problems such as loss of sexual desire or ability to become sexually aroused, difficulty achieving orgasm, pain during intercourse, and aversion to sex.
Although it is not known exactly how many people suffer from these and other sexual dysfunctions in their lifetime, scientific evidence suggests that the percentage is very high. In a 1978 survey of 100 happily married couples published in the New England Journal of Medicine, 40 percent of the men reported that they ejaculated earlier than they would like or had difficulty getting or maintaining an erection. Three percent of the women reported difficulty becoming aroused or having orgasm. Half of the men and 77 percent of the women reported that they sometimes or often did not feel like having sex or that their sexual performance was not entirely satisfactory.
Organic and psychological factors are equally responsible for sexual dysfunction. In some cases, it is a combination of both.
- Organic causes
Any disease that affects the nervous system, hormonal status or blood circulation can cause sexual dysfunction. This is especially true for multiple sclerosis, arteriosclerosis (hardening of the arteries), thrombosis of the arteries or veins of the penis, diabetes, liver disease, hyperprolactinemia (excessive secretion of the hormone prolactin), depression and dementia. This also includes injuries to the lumbar spine and spinal cord, herniated discs and prostate surgery, which can damage the nerves of the penis.
A large number of prescription and over-the-counter medications affect sexual response. These include antiasthmatics, diuretics, and all antihypertensive drugs. Medications recommended for the treatment of psychiatric disorders, including antidepressants and antipsychotics, may in some cases have a negative effect on sexual response. Impotence and difficulty with orgasm are sometimes side effects of certain antidepressants. A detailed discussion of the side effects of psychoactive medications can be found in Chapter 5.
The use of hormones - estrogens and steroids, legal and illegal stimulants (even caffeine, nicotine and alcohol) can lead to damage to sexual functions.
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