Sexual dysfunction may result from troubled intimacy

Sexual dysfunction may result from troubled intimacy

Maria Endah Hulupi
The Jakarta Post
Jakarta

Premature ejaculation? Ashamed of your penis size? Do you
consider yourself frigid? No problem.

Now you can find medication, pills, tablets, herbal
concoctions and other treatments, claiming to "improve" sexual
performance or even cure sexual dysfunction on offer over the
counter.

Despite the wide choice of treatments, however, sex experts
advise people who have a sexual dysfunction to avoid trying to
treat the problem by themselves. They said the problems might
stem from different phases of sexual intercourse that might
require different treatments, depending on the cause.

"Further diagnosis is needed to determine the cause of sexual
dysfunction, which can affect both men and women. This way, the
problem can be treated properly," said Akmal Taher, a urologist
from the University of Indonesia, during a recent symposium to
mark the 52nd anniversary of the university's School of Medicine.

Akmal explained that the causes of sexual dysfunction needed
to be distinguished, based on the phases of intercourse from
libido, arousal, ejaculation (for men), to orgasm, during which
the problem might occur.

Most over-the-counter cures claim only to improve overall
sexual performance but they cannot deal with specific problems in
each of those sex phases.

"People with lack of libido don't need treatment for inability
to ejaculate, for example," Akmal explained.

In the initial phase, the problem that affects men and women
is mainly the loss of libido, which result in a reduced sexual
appetite. This condition can arise because of hormonal changes,
stress or depression, a traumatic sex history or after
prostectomy.

In the arousal phase, men may suffer from erectile
dysfunction, which renders them unable to have or sustain an
erection for vaginal penetration. It can be triggered by organic
problems, caused by vascular disease, diabetes mellitus,
hypertension, certain medications, or psychological problems,
such as marital difficulties or stress.

"It's also advisable to quit smoking because people who smoke
are also prone to develop erectile dysfunction," Akmal warned.

He also identified another rare factor, priapism, (abnormal
and often painful erection, even without erotic stimulus). This
is usually caused by disease.

Sexual arousal disorder in women is "dry vagina" or inability
to obtain adequate lubrication, which makes penetration painful.
Akmal said this condition often occurred with postmenopausal
women.

Women may also develop sexual pain disorders caused by
dyspareunia (a genital pain that makes intercourse almost
impossible) and vaginismus (involuntary spasms in the perineal
muscles that hamper penetration).

In the ejaculation phase for men, problems that may arise are
either premature, inhibited or retrograde ejaculation. The latter
is a term for a condition in which the ejaculate is propelled
back into the bladder rather than through the urethra. It is
often suffered by men with diabetes.

And at the end of the phase is failure to reach orgasm. This
condition affects both men and women and can be a result of
surgery, hormonal deficiencies or trauma, among other things.

Estimating that the national total of people with sexual
dysfunction was about 6 million people, Akmal said, however, that
the number seeking professional help was very low.

"Many people are still reluctant to consult anyone over sex-
related problems, and many blamed their situation on a stressful
routine and thought that their sexual performance would
automatically improve when the stress was over," he added.

According to another speaker, sex expert Wendie Pangkahila,
problems in sexual intercourse have prompted many people to
resort to ridiculous and often dangerous acts in their attempt to
please their partner.

Desperate men think that soaking their penis in lukewarm tea,
drinking certain potions, having a silicon or collagen injection
or pumping their penis to enlarge it is the solution to their
sexual problems. Other men have been reported to use penis
accessories, or place something, like a pearl, under their penis
or insert a goat feather onto the frenulum, the membrane
supporting the penis, to satisfy their partner.

Women also commit similar acts. As vaginal lubrication is
considered dirty by local men, frustrated women have been
reported to insert herbs, wooden sticks or cleanse the vagina in
their attempt to become "dry". "They are not aware that their
actions could expose them to painful infection," Wendi explained.

He said that boredom could lead to sexual problems. But that
could be prevented through a little creativity and variety, to
create something different in the surroundings, the erotic
stimulus, new positions or even appearance. "Anything pleasant
but not dangerous that has been mutually agreed to can be done,"
he said.

Wendi also advised sexually active people to maintain their
physical health (especially that of their sexual organs) by not
trying to cure themselves without prior consultation.

Another piece of advice includes never to consider sex as
routine, don't bring other problems to the bedroom and if you
have sexual problems don't expect them to disappear overnight.