PRP Therapy in Erectile Dysfunction
3 October 2025
What is Delayed Ejaculation?
7 October 2025What is Sexual Dysfunction?
Sexual dysfunction is a general term used to describe any problem that prevents a person from experiencing sufficient pleasure, satisfaction, or healthy sexual performance during sexual intercourse. This condition, which can occur in both men and women, may stem from physical, psychological, or relationship-based factors. According to the World Health Organisation (WHO), sexual health is not merely the absence of disease or dysfunction, but a state of complete physical, emotional and social well-being in one's sexual life. Therefore, sexual dysfunction can seriously affect an individual's quality of life.
Classification of Sexual Dysfunctions
Sexual dysfunctions are classified differently in both men and women. The following tables summarise the main types of sexual dysfunctions:
Sexual Dysfunctions in Men
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Peyronie's disease |
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Female Sexual Dysfunction
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Common Sexual Dysfunctions in Men
1.Erectile Dysfunction (Erection Problem):
The inability to achieve or maintain sufficient erection for sexual intercourse. Erectile dysfunction, or ED, is the most common sexual problem for which men seek medical advice. ED is defined as difficulty achieving or maintaining an erection firm enough for sexual intercourse. It is not uncommon for a man to experience erection problems from time to time. However, the gradual onset of ED or its regular occurrence during sexual intercourse is not normal and should be treated.
2.Premature Ejaculation:
It is one of the most common sexual dysfunctions in men. Premature ejaculation can be defined as the inability of a man to delay ejaculation after sexual intercourse has begun, resulting in ejaculation occurring very quickly. Since the duration is a relative concept, medical literature defines this duration as ejaculation occurring within less than one minute after the man's penis enters the woman's vagina. Psychological factors, prostate diseases, and hormonal causes may be involved.
3.Delayed Ejaculation and Orgasm Disorders:
In some men, the ejaculation time may be excessively prolonged or they may be unable to ejaculate at all. Although less common than other sexual dysfunctions, hormonal disorders and medication side effects are among the most frequent causes.
Common Sexual Dysfunctions in Women
1.Loss of Sexual Desire:
A decrease in sexual desire in women, also known as low libido, is a very common sexual dysfunction. This condition can be caused by both physical and psychological factors.
- Hormonal Factors: Decreases in oestrogen and testosterone levels, the postpartum period, breastfeeding, and especially the menopause process can cause a significant decrease in libido.
- Psychological Factors: Depression, anxiety disorders, past traumas, and relationship problems directly affect sexual desire.
- Medication Use: Antidepressants, antipsychotics, cholesterol-lowering drugs, and birth control pills can have a negative effect on libido.
- Ageing and Lifestyle Factors: Hormonal balance changes and chronic illnesses associated with advancing age can lead to a decrease in desire.
In treatment, it is important to first identify the underlying cause. Successful results can be achieved with psychological support, medication adjustments, lifestyle changes, and hormone therapy when necessary.
2.Sexual Arousal/Interest Disorder:
This disorder is characterised by insufficient physical arousal during sexual intercourse or a decrease in interest in sex. Even if the woman desires sexual intercourse, she cannot achieve satisfaction because she cannot achieve sufficient arousal.
- Symptoms: Insufficient vaginal lubrication, discomfort or pain during sexual intercourse, lack of sexual satisfaction.
- Hormonal and Physical Causes: Chronic conditions such as oestrogen deficiency, diabetes, and thyroid disorders can cause arousal difficulties.
- Psychological Factors: Stress, depression, self-confidence issues, and lack of communication with one's partner are common causes.
- Effect of Medications: Certain blood pressure medications, antidepressants, and birth control pills may trigger this condition.
During treatment, positive results can be achieved through sex therapy, hormone treatments, vaginal moisturisers and lubricants, pelvic floor exercises, and couples therapy when necessary.
3.Vaginismus:
Vaginismus is a condition in which involuntary spasms of the muscles surrounding the vagina make sexual intercourse or gynaecological examinations impossible or extremely difficult. These spasms occur beyond the woman's control and are mostly psychological in origin. Negative sexual experiences during childhood or adolescence, misinformation about sex, a history of sexual abuse, strict religious or cultural pressures, and communication problems with a partner can contribute to this condition. Women with vaginismus may experience spasms, fear, panic, or even a flight reflex during intercourse. Even touching the vaginal opening can cause pain and fear. Treatment for vaginismus usually involves psychosexual therapy, sex therapy, cognitive behavioural therapy, pelvic floor exercises, and vaginal dilator applications. The treatment success rate is quite high and significantly improves women's quality of sexual life.
4.Dyspareunia (Painful Intercourse):
Dyspareunia is persistent or recurrent pain felt at the entrance or deep within the vagina during sexual intercourse.
Possible Causes:
- Infections: Vaginal yeast infections, bacterial vaginosis, or sexually transmitted infections can cause pain.
- Hormonal Changes: A decrease in oestrogen levels after menopause can lead to vaginal dryness and loss of elasticity, making intercourse painful.
- Gynecological Diseases: Endometriosis, ovarian cysts, and pelvic inflammatory diseases can cause deep dyspareunia.
- Trauma and Surgical Interventions: Pain may also occur after birth tears, episiotomy scars, or pelvic surgery.
- Psychological Factors: Stress, anxiety, relationship problems, and past traumas can increase the severity of pain.
- Treatment: Identifying the underlying cause is important in the treatment of dyspareunia. While vaginal infections are treated with antibiotics/antifungal medications, hormone therapies and vaginal moisturisers are beneficial for post-menopausal dryness. Medical or surgical methods can be used to treat endometriosis and other pelvic diseases. Psychological support, pelvic floor physiotherapy, and regular vaginal care are effective in pain management.
Causes of Sexual Dysfunction
Sexual dysfunction is usually multifactorial:
- Physical Causes: Diabetes, hypertension, heart and vascular diseases, prostate problems, hormonal imbalances, chronic diseases.
- Psychological Causes: Depression, anxiety, stress, relationship problems, sexual trauma.
- Side Effects of Medications: Antidepressants, antihypertensive drugs, and certain hormone medications can negatively affect sexual function.
- Lifestyle Factors: Smoking, alcohol, lack of exercise, and unhealthy diet are the most important factors negatively affecting sexual health.
Diagnostic Methods
Patients presenting with complaints of sexual dysfunction require a detailed assessment:
- Detailed patient history and physical examination
- Assessment of hormone levels
- Blood sugar and cholesterol tests
- Psychiatric assessment
- Imaging and specialised tests if required (e.g. penile Doppler ultrasound)
Treatment for Sexual Dysfunction
Treatment is tailored to the cause of the problem:
- Medication: PDE5 inhibitors may be used for erectile dysfunction, and hormone therapy for hormonal disorders.
- Psychotherapy: Individual or couples therapy is particularly effective for conditions such as vaginismus, anxiety, and depression-related disorders.
- Surgical Methods: Surgical treatment may be preferred in cases of Peyronie's disease, advanced erectile dysfunction, and anatomical disorders.
- Lifestyle Changes: Healthy eating, exercise, and quitting smoking and alcohol positively affect sexual health.
