What Is Sexual Dysfunction? Types, Causes, and More

If you’ve been having problems getting or staying hard, reaching orgasm or noticing your libido has tanked, you could be dealing with sexual dysfunction. 

From desire disorders to premature ejaculation, sexual dysfunction affects around 31 percent of American men. It can have a number of causes — both physical and psychological.

Whether it’s the first time you’re facing these issues or you’ve finally worked up the courage to do something about it, seeking help is no small feat. 

But before making any recommendations, we’ll lay out some basic info, including what sexual dysfunction is, common causes of sexual dysfunction and, finally, what steps you can take to start having better sex.

Sometimes called sexual disorders, sexual dysfunction is a broad term for anything that negatively impacts your ideal sexual experience and ability to have fulfilling sex. The various types of sexual dysfunction are typically categorized by which part of the sexual experience they impact: arousal or orgasm. 

But, first things first, here’s a quick breakdown of how the sexual response cycle should work in men:

• Desire. Your brain and hormones stir up biological and psychological excitement to prepare you for sex.

• Arousal. Signals from the brain dilate blood vessels within the penis, allowing blood to flow in, get trapped and give you an erection. 

• Orgasm. When things work properly, arousal makes you hard, and your erection is maintained until you orgasm, which, in turn, causes you to ejaculate. 

• Resolution. Your erection slowly returns to its non-erect state and you slowly return to your normal level of functioning (albeit a bit sleepier).

Sexual dysfunction can happen at any point during the sexual response cycle, keeping you from performing the way you want to or making the experience less pleasurable.

Keep in mind, sexual dysfunction happens in both men and women. Though low libido can affect anyone, regardless of gender, female sexual dysfunction may manifest as vaginal dryness or vaginismus (a sexual pain disorder). Women’s low libido can also be related to menopause.

No matter what’s causing these sexual behavior issues, it can have a substantial negative effect on your well-being when not addressed.

Symptoms of sexual dysfunction vary but may include:

• Inability to obtain or maintain an erection (aka erectile dysfunction or ED)

• Ejaculating too quickly (premature ejaculation or PE)

• Delayed ejaculation

• Failure to have an orgasm

• Low or no interest in sex 

• Sexual pain (dyspareunia)

Remember, sexual function issues look different for everyone. Some guys might experience most or all of these, while others may only struggle with one.

Now that you know the meaning of sexual dysfunction, let’s talk about what it looks like. 

Though the Diagnostic and Statistical Manual of Mental Disorders (DSM) lists 10 sexual dysfunctions across men and women, sexual dysfunction in men is generally categorized into four major groups:

• Sexual desire disorders (low libido)

• Orgasm disorders (premature or delayed ejaculation) 

• Arousal disorders (erectile dysfunction)

• Sexual pain (dyspareunia)

Keep reading to learn about the symptoms of sexual dysfunction for each category.

Sexual Desire Disorders (Low Libido)

Also known as hypoactive sexual desire disorder (HSDD) or sexual arousal disorder, a sexual desire disorder is a lack of interest in sex. You may have also heard it called low sex drive or low libido.

This shouldn’t be confused with asexuality, a legitimate sexual orientation in which a person experiences little or no sexual attraction. A desire disorder will typically cause distress for the person experiencing it and/or their partner. 

Symptoms of desire disorders:

• Lack of desire to have sex

• Avoidance of sexual activity

• No sexual thoughts or fantasies

Causes of desire disorders include:

• Sexual identity issues 

• Developmental abnormalities

• Sexual trauma

• Low testosterone or other hormone imbalances

• Relationship problems

• Side effects of medication (like antidepressants)

Beyond psychological and physical causes, it’s also possible for one sexual dysfunction issue to trigger another. For instance, men with erectile dysfunction sometimes lose interest in sexual activity, often as a way of avoiding further embarrassment.

Orgasm Disorders (Premature or Delayed Ejaculation)

Orgasm disorders like premature ejaculation involve ejaculating before orgasm — or sometimes before penetration even begins. 

PE can negatively impact sexual function and psychological health, hurt relationships and — for any guy who’s experienced it — cause shame and low self-esteem. But its prevalence may be higher than you think, seeing as PE affects one in three adult men in the U.S.

Symptoms of premature ejaculation include:

• Less than a few minutes (if any) of pleasure 

• Lack of orgasm (for you and/or your partner) 

• Inability to delay ejaculation

• Relationship strain

Causes of premature ejaculation include:

• Performance anxiety

• Depression

• Anxiety related to erectile dysfunction

• Endocrine disorders

• Withdrawal from certain drugs or medications

Learn more about the symptoms and causes of premature ejaculation in our guide to premature ejaculation.

As for delayed ejaculation, it involves taking much longer to ejaculate than desired. One potential cause of this could be medication side effect. We discuss the causes and treatments of delayed ejaculation in more detail in our blog.

Arousal Disorders (Erectile Dysfunction)

Erectile dysfunction is the inability to obtain or maintain an erection long enough to have a satisfactory sexual experience.

ED affects an estimated 52 percent of men ages 40 to 70 in the U.S. alone, which comes out to 30 to 50 million men nationwide. That’s a huge number.

Symptoms of erectile dysfunction include:

• Inability to get or stay hard

• Only being able to get an erection in specific situations (e.g., while masturbating)

• Difficulty finishing and/or failure to reach orgasm

Causes of erectile dysfunction include:

• Low testosterone

• Poor diet

• Obesity

• Stress and anxiety (including performance anxiety) 

• Underlying health conditions (like high blood pressure, heart disease, diabetes, multiple sclerosis, urinary issues, cardiovascular disease and Peyronie’s disease)

• Penile or spinal cord injuries

• Antidepressants 

• Recreational drug use

Dive deeper into ED causes, symptoms and treatments in our guide to erectile dysfunction.

Sexual Pain (Dyspareunia)

Sex should feel good, but for those with dyspareunia, it can cause pain before, during or after the experience. Sexual pain can be a result of foreskin damage, penis deformities or even sexually transmitted infections (STIs).

Symptoms of sexual pain can include:

• Burning sensation of the skin

• Sharp or throbbing pain while thrusting

• Aching after sex

• Muscle spasms or tightness

• Painful, persistent erections (priapism)

Causes of sexual pain can include:

• Foreskin abnormalities 

• Obstruction of the ejaculatory duct

• STIs like gonorrhea or chlamydia 

• Peyronie’s disease

Explore potential causes of painful erections in our blog.

Despite how common sexual dysfunction is, many guys don’t seek treatment due to shame or embarrassment. Besides continuing to have less-than-fulfilling sex, not getting help can also delay the diagnosis of underlying medical conditions that could be contributing to your sexual health problems.

A treatment plan for sexual dysfunction will largely depend on the type you have and what’s causing it.

Psychological distress, like performance anxiety, can be addressed by consulting a mental health professional. Meanwhile, physical factors, such as low testosterone, may require a visit to a urology specialist. Lifestyle changes can also help — think healthy eating, exercise and better sleep.

Figuring out what’s causing your sexual problems may take time, but here are some strategies your doctor may suggest to improve the issue.

Treatment for Desire Disorders

In many cases, addressing low sex drive means addressing mental health. Talking with a professional in psychiatry or psychotherapy might uncover any psychological issues or beliefs around sex that may be interfering with your ability to lead a fulfilling sex life.

It’s also possible that a medication you’re taking for mental health (antidepressants, for instance) is killing your sex drive.

Ask your healthcare provider about alternative medications if you sense this could be the problem. (But never stop taking a medication cold turkey without checking in with your provider first.)

Treatment for Premature Ejaculation

There are numerous ways to treat premature ejaculation and last longer in bed.

In some cases, your healthcare provider may prescribe selective serotonin reuptake inhibitors (SSRIs), which include antidepressants like sertraline and fluoxetine. These drugs might help you last longer by making your penis less sensitive.

This is considered an off-label use (meaning it’s not what the medications are FDA-approved to treat),and a prescription is required.

Topical anesthetics in the form of delay sprays or delay wipes can also extend your sex sessions by desensitizing your penis directly with benzocaine or lidocaine. These products are available without a prescription.

Treatment for Erectile Dysfunction

Beyond ruling out potential psychological issues and underlying medical conditions, you can also improve erectile dysfunction with prescription drugs like Viagra® (or generic sildenafil), Cialis® (and its generic tadalafil) and Stendra® (avanafil).

Cialis, Viagra and Stendra are all phosphodiesterase type 5 (PDE5) inhibitors. Essentially, they block the breakdown of certain bodily substances (PDE5s), which keeps blood vessels dilated longer and, more importantly, increases blood flow to the penis.

Tadalafil is a longer-effect medication, whereas sildenafil (generic Viagra) is a pill you take a certain amount of time before you plan on having sex. Stendra is a newer ED medication with a faster onset ( it can start working in as little as 15 minutes).

Since they work on blood vessels, most of these drugs started out as a treatment option for hypertension. And because of that, you’ll want to check with your provider before taking them if you have high blood pressure or are on other blood medications.

All of these medications offer a potential solution if your ED problem is physical. They can also provide a partial boost to get things normalized again even if some of your issues are psychological.

Oral erectile dysfunction medications come in easy tablet form or can even be taken as a chewable mint.

Other potential options include erectile dysfunction creams like alprostadil cream or even constriction rings (aka cock rings) that help restrict blood flow.

Treatment for Sexual Pain

A physical exam can help pinpoint what’s causing sexual pain so you and your medical provider can figure out the best treatment plan.

If genital pain is from an infection, your provider might prescribe antibiotics, antifungal medication or potentially a topical or injectable corticosteroid. 

Switching up sex positions may also help. Maybe thrusting during missionary makes you ache, but standing 69 is no big deal. With a little experimentation, you might just find your new go-to.

What is a major cause of sexual dysfunction? There are a few types and many potential causes.

If you’re having problems in the bedroom or avoiding the bedroom altogether (and not just because the kitchen is more fun), the first and best thing you can do is talk to a healthcare professional.

Here’s what to remember about sexual dysfunction:

• You’re not alone. Statistically, there’s a good chance some of your friends are dealing with similar issues. And even if they’re not, a large portion of the people you pass each day are struggling too — yes, maybe even that guy who lifts more than you at the gym.

• It can happen for many reasons. There are four main types and causes of sexual dysfunction: desire disorders like low libido, orgasm disorders like premature ejaculation, arousal disorders like erectile dysfunction and sexual pain. 

• There are physical and mental factors. Sexual dysfunction can have physical or psychological causes (sometimes both).

• It’s treatable. Treatment options include therapy, PDE5 inhibitors, topical products with anesthetics and constriction rings.

To learn more about specific sexual dysfunctions, check out our blog on how ED medication works. You can also read our guides to the common causes of low libido in men.