Use Total Force Fitness to address sexual dysfunction

Sexual dysfunction is when people experience pain or other physiological issues around desire, arousal, or orgasm, causing distress or negatively impacting relationships. Sexual dysfunction can manifest in many ways and have many causes, which means there are many avenues to explore when trying to treat it. It’s important to get a solid understanding of what’s causing the issues, how it affects you or your relationship, and different options that can help you achieve sexual satisfaction.

Sex and relationships

What’s a functional sexual relationship? And what does it mean to have a healthy relationship with sex?

The answers to these questions really depend on what works for you and your partner(s). It also depends on your beliefs around what sex “should” be or even cultural understandings of what sex “ought” to look like.

When it comes to relationships, it’s important to have open and honest conversations about sex, your expectations, and what safe sex looks like. But even if you have a clear and mutual understanding of your goals, issues can still arise. And when those issues start to cause stress or distress, or when they affect other areas of your life or relationship, then they might be considered dysfunctional.

Sex can be an important part of a relationship. For example, engaging in sexual activities can often build intimacy (which needs to be nurtured in and out of the bedroom). It can also be enjoyable, relieve stress, and even improve your health. When your sexual relationship is satisfying, it usually promotes other aspects of your relationship to a small, but important, degree. However, when there’s an issue with your sexual relationship, suddenly sex can become a much bigger part of your overall relationship dynamic. When a lack of sex, unsatisfying sex, or sexual dysfunction are in play, your relationship will likely “feel it” much more than when the sexual side of things is going well. You might experience conflict or other personal and relationship issues too.

What is sexual dysfunction?

Again, while there are some formal definitions of sexual dysfunction, it’s really about how an issue affects you, your well-being, or your relationships. The most common sexual problems fall into four categories.

  • Sexual desire is related to your interest or drive for sex. It includes fantasies, foreplay, wants, and needs. Symptoms of sexual-desire problems are decreased interest in sex, fewer fantasies, and less willingness to start sex.
  • Sexual arousal is related to how your mind and body change as you prepare for intercourse. Sexual arousal problems include trouble getting or maintaining an erection (men) or difficulty lubricating (women).
  • Orgasm is the sudden release of sexual tension. Orgasmic dysfunctions include orgasming very quickly, taking a long time to orgasm, or not orgasming at all (by any means).
  • Sexual-pain problems are related to genital pain during or after sex. Painful intercourse is more common among women. It can include deep pain, burning, aches, and throbbing that persists after penetration.

Causes of sexual dysfunction

There are many potential causes of sexual dysfunction. Issues can be caused by one or multiple outside factors. But as you explore any issues you might be experiencing, consider some of the following reasons.

  • Physical fitness, illness, or injury. From a physical perspective, in order to achieve healthy sexual functioning, many of your body’s biological systems have to work well together. For example, to achieve sexual arousal, it takes a combination of your vascular systems, your brain, and even some hormones all getting on the same page. If different areas of your health aren’t optimized (for example, if you have high blood pressure), or if you smoke or drink to a degree that your health is impacted, you might find it difficult to engage in sexual activity. On the other hand, if your partner has become your caretaker due to combat or other injury, it might be tough to navigate between that role and their role as romantic partner.
  • Limited emotional connection. If you’re experiencing conflict or lack of closeness in your relationship, it can affect your ability to engage sexually. While it’s normal for partners in healthy relationships to have “bad” sex and for unhappy partners to sometimes have “good” sex, it’s not uncommon for relationship issues to impact sex as well. Anger or hurt in your relationship can play a role, especially if those feelings are due to infidelity or the lack of sex itself. Sometimes sex might be used as a weapon and withheld during arguments or disagreements too. Any or all of these factors can make performing sexually difficult.
  • Internal attitudes or trauma. Personal inhibitions around sex can also affect your ability to engage in healthy sexual activity. For example, negative body image or insecurities about your physical appearance can play a role. For many, guilt or shame might be a factor too, particularly if you were raised in a culture that views sex (or certain sexual behaviors or contexts) negatively. Or you might feel embarrassed about certain aspects of your desires. Trauma can also play a big role. If you’ve experienced abuse, sexual trauma, or sexual assault (in or out of the military), it might be challenging to move forward.
  • Medication. It’s not uncommon for medication to have side effects. Sometimes those side effects can lead to sexual dysfunction. For example, many anti-depressants, anti-psychotics, and other medications that treat mental health disorders have side effects that impact sex functioning. An important distinction about sexual dysfunction caused by medications is that you’ll notice the dysfunction in all sexual contexts (for example, during masturbation or with a partner).

Total Force Fitness strategies to combat sexual dysfunction

Since sexual functioning is so complex, there can be a lot of interconnected reasons you might be struggling with sexual dysfunction. It’s important to explore what’s really going on and consult with multiple health and mental health professionals. In some cases, lifestyle changes might work, a medical intervention might make sense, adjusting medications might be an appropriate course, or seeking therapy (alone or with a partner) might be the best course of action. Whatever the case, a multipronged approach is often the most effective. Consider some Total Force Fitness strategies to keep the spark alive and get your groove back.

  • Consult a medical professional. If you’re concerned about your physical ability to have sex, consider getting a full physical from your doctor. Your exam should include assessing hormone levels such as testosterone, estrogen, and prolactin. Health conditions such as high cholesterol, diabetes, high blood pressure, and some heart conditions—and their medications—also can affect sexual drive. In addition, being overweight or obese, lack of sleep, sleep apnea, and some combat injuries can affect sexual interest and ability. If you’re in a couple relationship, consider attending these appointments together to discuss your concerns.
  • Get comfortable with “good enough.” Sometimes what you might think is a sexual dysfunction might really be a normal variation in sex—for example, many women do not orgasm from penetrative sex, and while one might view this as a problem, it’s also normal and simply different from one person to the next. It’s important to know that not all sex is “good,” often partners don’t climax simultaneously (or at all), and levels of desire at certain times might not match up. It’s OK for sex to have its ups and downs.
  • Talk with your prescribing doctor. If you’re concerned that your sexual problems are related to your medication, make an appointment to speak with a prescribing physician. Often, there are other medications that can be tried, substitutions that can be made, or even changes to doses. And in some cases, additional medications can help.
  • Explore your own attitudes. Take some time for self-reflection. Your reaction to what’s going on now are often rooted in the narratives you’ve been told (or told yourselves) in your youth. It’s easy to take your beliefs and attitudes about sex and what it should or shouldn’t be for granted. You might not even realize those beliefs are there under the surface. But those attitudes can impact your ability to feel desire or arousal in certain situations, so it’s important to reflect.
  • Seek support as a team. Even if you don’t feel the sexual dysfunction is directly caused by a relationship issue, chances are that it’s affecting your relationship. For example, you might feel frustrated or ashamed that you can’t satisfy or arouse your partner, which can lead you down a rough path without the right communication skills. Relationship issues, lack of trust, little connection, or safety might be in play as well. Take some time to consult with a mental health professional or couple’s therapist to explore the issue as a team.
  • Shift your mindset. If you feel you’ve identified a sexual dysfunction, and have even explored options to resolve it, but are still struggling, try shifting the way you think about it. Remember that the words you use affect how you feel, so rather than blaming yourself by saying, “I’m the problem” or “I can’t do XYZ,” try saying, “A lack of arousal is an issue in my life.” And then, be open to exploring ways around your sexual dysfunction. Consider practicing mindfulness to help catch those unhelpful thoughts before they go too far.
  • Change the goal. It might not always be possible, but you might be able to find unconventional ways to feel fulfilled or to satisfy and connect with your partner. Keep in mind that sex isn’t about proving anything. It’s not uncommon for performance anxiety to creep in and compound any issues you might already be having. So slow down and talk with your partner about goal setting for your sexual activities. Perhaps the goal is mutually satisfying intercourse, but it can be many other things too.
  • Make practical changes. Sometimes making small behavioral changes can help you and your partner with sexual issues. Before you do, though, make sure you and your partner(s) are on board and consent to any new techniques. For example, if you’re struggling with desire, arousal, or even pain, consider more purposeful touch (hugs, hand-holding, or kissing) outside of the bedroom. This can help build anticipation. You could also explore external turn-ons like pornography or increasing foreplay.
  • Maintain open communication. In any relationship, communication is key. If you and your partner(s) face sexual issues, start by getting comfortable talking. Sometimes just naming the problem can be a first step towards establishing a new sexual dynamic and even be a part of resolving the issue. Communication also helps build intimacy, which can contribute to an improved dynamic in the bedroom too.

Sexual dysfunction can be a complex issue that can be caused by any number of factors. The good news is that there are also many avenues to getting to a place where sex is fulfilling and satisfying.


CHAMP wants to know:

Did this information help change your opinion or perspective?

References

plus icon minus icon

Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States. JAMA, 281(6), 537–544. doi:10.1001/jama.281.6.537

McCarthy, B. W., & McCarthy, E. (2011). Discovering Your Couple Sexual Style. Sharing Desire, Pleasure, and Satisfaction New York, NY: Routledge.

McCarthy, B. W., & Thestrup, M. (2008). Couple Therapy And The Treatment Of Sexual Dysfunction (A. S. Gurman (Ed.) ed.). New York, NY: The Guilford Press.

Meana, M. (2011). When Love And Sex Go Wrong: Helping Couples In Distress. In S. B. Levine, C. B. Risen, & S. E. Althof (Eds.), Handbook of Clinical Sexuality for Mental Health Professionals (pp. 103–120). New York, NY: Routledge.

Segraves, T. R., & Balon, R. (2010). Recognizing And Reversing Sexual Side Effects Of Medications. In S. B. Levine, C. B. Risen, & S. E. Althof. (Eds.), Handbook of clinical sexuality for mental health professionals, 2nd edition. New York, NY.: Routledge.

Spector, I. P., & Carey, M. P. (1990). Incidence and prevalence of the sexual dysfunctions: A critical review of the empirical literature. Archives of Sexual Behavior, 19(4), 389–408. doi:10.1007/bf01541933

Tepper, M. S. (2014). Sexual healthcare for wounded warriors with serious combat‐related injuries and disabilities. Sexual Medicine Reviews, 2(2), 64–74. doi:10.1002/smrj.24

Yehuda, R., Lehrner, A., & Rosenbaum, T. Y. (2015). PTSD and sexual dysfunction in men and women. The Journal of Sexual Medicine, 12(5), 1107–1119. doi:10.1111/jsm.12856