Sexual Dysfunction: You’re Not Alone

• 1 in 3 women and 1 in 5 men have little or no sex drive, totaling 25% of the population.

• 20% of women 5-20% of men face sexual arousal issues.  This includes lack of lubrication and erectile dysfunction.

• 1 in 4 women have an orgasmic disorder (e.g. inability to orgasm), while about 1 in 3 men experiences premature ejaculation.

• An estimated 3-6% of Americans struggle with sexual addiction, including compulsive masturbation, porn use, and cybersex.

It's easy to feel ashamed if you have a sexual problem.  The media inundates men and woman alike with conflicting messages about what sexuality should be – fast/long, hard/soft, multiple partners/save your virtue, multi-orgasmic/earth shaking, etc.  Other forces encourage us not to discuss sex at all, including abstinence-only sex education and avoidance of the topic in many families and religious/cultural groups.

Considering all this, it’s no surprise that many feel alone and ashamed when sexual problems arise. Yet, 43% of women and 31% of men struggle with a significant sexual problem abd most if not all couples face a sexual issue at one point or another.

So, if you’re struggling with a sexual issue, know that what you're experiencing is normal.  Sex is a complex interaction of personal expression and interpersonal connection, ripe for both pleasure and difficulty. 

What Causes Sexual Problems?

Sexual difficulties may arise from:

• Fear of poor sexual performance
• Psychological issues
• Trauma, sexual or otherwise
• Pent up resentment and other relationship issues
• Stress
• Lack of time
• Aging
• Physical issues, e.g. chronic health conditions
• Medication side effects, including antidepressants
• Smoking, poor diet, lack of exercise, and other lifestyle choices

It’s important to look at all potential causes when identifying the cause of a sexual issue, as some issues are multi-faceted (while others are quite simple and straightforward).  A great way to do this is by speaking with a professional who specializes in sexuality such as a primary care doctor or therapist who specializes in sexuality.

Therapy for Sexual Dysfunction

While they can feel insurmountable, you can manage and even overcome sexual problems by unraveling their psychological roots.  A therapist who specializes in sexuality can help you do just that. 

Both couples and individuals can seek out therapy for sexual issues such as:

• Cheating, including online affairs
• Erectile Dysfunction (E.D.)
• Best sex practices
• Sex drive differences in a couple
• Low or high libido
• Premature Ejaculation
• Difficulty orgasming
• Sex and infertility, pregnancy, and birth
• Sex and aging
• Sex addiction, including addiction to porn
• Sexual assault, violence, and child abuse
• Psychoeducation for better sex, e.g. info on anatomy, sexual positions, etc.
• Vaginitis, vaginismus, and other issues that cause vaginal pain during sex
• Transgender, sexual orientation, and other queer identity exploration
• Polyamory, kink, and alternative sexuality questions

Therapy for sexual problems may include a range of activities, from education about the mechanics of orgasm to an in-depth exploration of your past sexual experiences.  As a therapist specializing in sexuality, I offer advice, tips, and concrete tools that you and your partner can benefit from in the short term.  I also help you understand and resolve the emotional roots of your sexual difficulties that can't be solved with quick tricks.  

If you would like to learn more about how therapy can help you resolve your sexual problem and build a fulfilling sex life, please contact me at (510) 595-5500, ext. 36 or jessicaengle@livingartscenter.org for a free 30-minute consultation.

Resources 

1. “Female Sexual Arousal Disorder (FSAD) Facts.” http://www.hystersisters.com/vb2/article_209459.htm
2. Hatzimouratidis, K., et. al. (2010) “Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation.” http://www.uroweb.org/fileadmin/tx_eauguidelines/2010/Trans/2010_Guidelines_on_Male_Sexual_Dysfunction.pdf
3. Pappas, S. (2010).“Orgasm-Seeking Women Find Little Help From Science
4.  “http://www.livescience.com/6755-orgasm-seeking-women-find-science.html
5. Weiss, R. (2012). Who Is a Sex Addict?. Psych Central. Retrieved on December 31, 2012, from http://psychcentral.com/lib/2012/who-is-a-sex-addict/
6. The Cleveland Clinic Foundation. (2012) “An Overview of Sexual Dysfunction” http://my.clevelandclinic.org/disorders/sexual_dysfunction/hic_an_overview_of_sexual_dysfunction.aspx

Shame on You

In the experience of shame, one's whole being seems diminished or lessened. The expression of shame is not just the desire to hide, or to hide my face, but the desire to disappear, not to be there. It is not even the wish, as people say, to sink through the floor, but rather the wish that the space occupied by me should be instantaneously empty. -- Bernard Williams, British philosopher

Shame often stands at the heart of social anxiety, dating difficulties, and rocky relationships.  

Mental health experts and philosophers have long studied and attempted to explain the nature and impact of shame.  Many define it as a sense of being flawed and unworthy, feelings that easily sabotage intimacy.

Sound familiar? Got some shame on you?

Thankfully, there are a number of resources for dealing with shame.  A list of resources for dealing with shame follows.  If you find yourself needing extra support as you work through shame, I encourage you to make an appointment with a psychotherapist.

1. Shame: The Power of Caring by Gershen Kaufman
2. Letting Go of Shame by Ronald Potter-Effron 
3. www.healingshame.com - training for therapists plus a list of excellent resources
4. Soul Without Shame by Byron Brown
5. I Thought It was Just Me (but it isn't): Making the Journey from "What Will People Think?" to "I Am Enough" by Brene Brown.  (Note: this book used to be called Women & Shame.)
6. The Gifts of Imperfection by Brene Brown
7. Brene Brown also has a TED talk worth watching: http://www.ted.com/talks/brene_brown_on_vulnerability.html
8. Alice Miller's works
9. John Bradshaw's Healing the Shame that Binds You.  He often mentions other resources on shame in his lectures.  
10. Reconciliation: Healing the Inner Child by Thich Nhat Hanh
11. Patrick Carnes' works
12. Tara Brach's Radical Acceptance
13. James Gilligan, Preventing Violence - his field is violence prevention but his whole career is based upon his theory of shame and death of the self.
14. Crime, Shame and Reintegration by John Braithwaite

Therapy Ain't Just for Women

If you think depression and anxiety don't affect men, think again.  The CDC reports that "males take their own lives at nearly four times the rate of females and represent 78.8% of all U.S. suicides."  

I recently came across a great website on exactly this topic: www.mantherapy.org.

Like Dr. Mahogany says, manliness is not defined by the absence of emotions or mental health issues.  All  men face difficulties from time to time -- when life has lost its luster and/or thoughts of ending things start to creep up, the manly (and womanly) thing to do is to pick up the phone and make an appointment to talk with a mental health professional.

If you are contemplating hurting yourself in the immediate future, call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 9-1-1.

“Keep in mind that part of growing up is dealing with difficult issues, and the benefits can be great if you have the courage to ask for help. Human beings are not designed to go through life alone. No one has to bear the burden of tough times all by themselves.”  ― Jack Canfield