Approximately 43% of women in the United States report experiencing some form of sexual dysfunction, though only about 12% meet clinical criteria for a diagnosable sexual dysfunction that causes personal distress. This includes issues with sexual desire, arousal, orgasm, or pain, and can affect women of all ages, with prevalence rates varying by life stage.
The most common problem is low sexual desire, and while many women have concerns, only about one in ten (10-12%) are significantly distressed enough to meet formal diagnostic criteria. Rates can be much higher in specific populations, such as postmenopausal women (65-96%), women with chronic illnesses, or those who are physically inactive.
Roughly 24% of men in the United States meet diagnostic criteria for erectile dysfunction (ED), the most commonly studied form of male sexual dysfunction. Prevalence increases considerably with age: around 17.9% of men ages 18–24 meet criteria, compared to 48% of men aged 65–74 and 52% of those 75 and older. Earlier large-scale studies, such as the Massachusetts Male Aging Study, found that 52% of men aged 40–70 reported some ED.
Other forms of male sexual dysfunction (such as premature ejaculation and low libido) are also recognized. Still, population-level prevalence rates for these specific problems are less well established in recent surveys. Sexual issues—including those not meeting clinical criteria—are reported by a larger share of men, but the percentage with distressing, diagnosable dysfunction is lower.
Don’t ignore the issue; it rarely just goes away.
There are many options for men and women to research to address sexual dysfunction; there are a range of strategies—both medical and behavioral—worth considering. Here are the commonly recommended approaches for each:
For Men
Medical Options:
- Oral Medications: These include PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra), which increase blood flow in response to sexual stimulation.
- ESWT Shockwave Therapy: A mechanical device that utilizes kinetic and acoustic waves to break up scar tissue and instigate angiogenesis and neovascularization to improve performance.
- PRP or Biologic injections: These utilize a patient’s blood to create increased blood vessels and improve blood flow where needed. Coupled with vacuum pumps and possibly shockwave therapy, this has proven very successful.
- Testosterone Therapy: For men with low testosterone levels, hormone replacement may help.
- Vacuum Erection Devices: These mechanically induce an erection by drawing blood into the penis.
- Penile Implants: Surgically implanted devices are an option for men with treatment-resistant erectile dysfunction.
Lifestyle & Psychological Options:
- Counseling/Sex Therapy: For psychological causes (anxiety, depression, relationship issues), talking with a therapist or counselor can be highly effective.
- Lifestyle Changes: Quitting smoking, reducing alcohol, exercising regularly, and managing chronic illnesses like diabetes, high blood pressure, or heart disease can significantly improve symptoms.
- Improved Communication: Discussing preferences and concerns with partners improves outcomes.
- Addressing Medications: Sometimes changing or adjusting prescription drugs that have sexual side effects can help.
For Women
Medical Options:
- Hormonal Treatments: Vaginal estrogen (cream, tablet, ring), transdermal testosterone (in specific cases), and other hormonal therapies can ease pain and dryness and increase desire, especially after menopause.
- ESWT Shockwave Therapy: A mechanical device that utilizes kinetic and acoustic waves to break up scar tissue and instigate angiogenesis and neovascularization to improve performance.
- PRP or Biologic injections: These utilize a patient’s blood to create increased blood vessels and improve blood flow where needed. Coupled with shockwave therapy, this has proven very successful for FSD and incontinence.
- Prescription Medications:
- Flibanserin (Addyi): FDA approved for low sexual desire in premenopausal women.
- Bremelanotide (Vyleesi): An injectable approved for low desire in premenopausal women.
- Prasterone (Intrarosa): A vaginal insert that can address dryness and pain.
- Ospemifene (Osphena): Oral medication for painful sex after menopause.
- Addressing Underlying Illness: Managing or switching medications for health conditions (like antidepressants, blood pressure medications) that cause sexual side effects can be beneficial.
Lifestyle & Psychological Options:
- Counseling/Sex Therapy: Cognitive behavioral therapy, sex counseling, and mindfulness can address psychological or relationship factors, including performance anxiety and trauma.
- Pelvic Floor Physical Therapy: Especially useful for women with pain during intercourse or pelvic floor dysfunction.
- Education and Skills Training: Learning about sexual health, self-exploration, and use of sexual aides (vibrators, lubricants, dilators) can improve both desire and comfort.
- Partner Communication: Openly discussing needs, preferences, and difficulties improves intimacy and satisfaction.
- Lifestyle Changes: Healthy eating, reducing stress, exercising, and managing chronic health issues have a positive impact.
Additional Integrative or Supportive Practices
- Mindfulness and relaxation exercises.
- Addressing relationship or intimacy issues as a couple.
- Regular medical check-ups for chronic disease management.
When to Seek Professional Help
If symptoms persist for more than a couple of months or if sexual difficulties cause significant distress or problems in a relationship, seeking a healthcare provider or specialist in sexual health is recommended. Management is usually most successful when tailored to the individual’s biological, psychological, and relationship needs, and may involve a combination of therapies.
Summary: Options range from medications and medical therapies to counseling, physical therapy, and lifestyle changes. Both men and women benefit from an individualized, holistic approach that considers physical, psychological, and relationship factors. Consulting with a healthcare professional can help determine the best strategies based on specific needs and causes. Please don’t ignore the problem, live your life to the fullest; call us today.
