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Erectile dysfunction in men and sexual arousal deficits in women
Medical expert of the article
Last reviewed: 05.07.2025
Erectile dysfunction in men and sexual arousal deficit in women are the result of a disturbance in the arousal phase of the sexual response cycle. Men suffering from this disorder have difficulty achieving and maintaining an erection (impotence) or their erection is not strong enough. Women with this disorder may have impaired ability to secrete vaginal lubrication.
Some people with these disorders have a long history (anamnesis) of erectile dysfunction or sexual arousal, while in others these disorders occur suddenly, after a long period of normal sexual activity. Thus, a 50-year-old man rarely experienced difficulty achieving an erection during 25 years of marriage. A year after the death of his wife, he entered into a new relationship, and the first time he tried to sleep with his chosen one, he did not get an erection. In another case, a 27-year-old woman did not experience any sexual arousal, although she wanted sex. In the past, during her previous relationship, she always experienced physical arousal during love play. Further questioning revealed that her partner did not stimulate her in the way to which she was accustomed.
Causes of erectile dysfunction in men
If erectile or arousal problems first occur suddenly and after a long, satisfying sexual life, you should seek clarification from a doctor. As we have already mentioned, various medications and diseases cause a disorder of the sexual response cycle.
If a man has erectile dysfunction, he should probably see a urologist to find out whether the causes are organic or psychological. Often, the problems have both organic and psychological roots, as was the case with a man who could not get a full, sufficient erection. The problem began a year after he was diagnosed with diabetes (a very common cause of impotence) and prescribed insulin treatment. His wife's complaints about insufficient erections made him fear that he would no longer be able to get an erection.
Investigations of organic disorders include blood flow tests and monitoring of the arteries and veins of the penis, which also determine the likelihood of neurological damage. In most men, the level of nocturnal erection is determined in such cases. For two or three nights, patients sleep in a specially equipped laboratory. Devices record the state of the body in different phases of sleep, in particular during the REM phase. In addition, a very practical test for home use was also proposed: if an erection does not occur during the REM phase, it can be assumed that the dysfunction is based on an organic cause. Unfortunately, the development of methods for establishing organic factors in sexual disorders in women lags behind those in men, although somatic examination and hormonal tests can help to clarify their organic causes.
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Treatment of erectile dysfunction in men
In cases of erectile dysfunction or sexual arousal, behavioral psychotherapy is indicated to reduce fear. As a rule, sensitizing exercises are recommended. In this case, sex itself is postponed and tactile contact and emotional stimulation are recommended instead. In this case, both the man and the woman should encourage each other and support their partner during treatment, especially if sexual problems are associated with difficulties in relationships.
Erection difficulties in many men are caused by fear of failure. They arise either from increased self-control ("observer role") or from excessive anxiety about the degree of erection. Men with potency problems are especially sensitive to their partner's critical comments about the insufficiency of their erection; they experience a feeling of inferiority and guilt. Therapy in such cases focuses on introducing partners to other forms of sexual relations, in addition to direct genital intercourse.
For men with organically caused erectile dysfunction, penile prosthesis implantation can be used as a means of realizing the ability to penetrate. Each such operation should be based on expert opinions of psychologists, psychiatrists, sexologists and urologists. In some cases, when mental problems interfere with the enjoyment of sex, both long-term psychotherapy and behavioral sexual therapy are indicated.