ABPSYC LT 3

• Sexual dysfunctions


  • Delayed ejaculation
  • Erectile disorder
  • Female orgasmic disorder
  • Female sexual interest/arousal disorder
  • Genito-pelvic pain/penetration disorder
  • Male hypoactive sexual desire disorder
  • Premature (early) ejaculation
  • Substance/medication-induced sexual dysfunction
  • Other specified sexual dysfunction
  • Unspecified sexual dysfunction
• Sexual dysfunctions


  • Heterogeneous group of disorders
  • Clinically significant disturbance in a person's ability to respond sexually or to experience sexual pleasure
  • Individual may have several sexual dysfunctions at the same time
• Clinical judgment should be used to determine if the sexual difficulties are the result of inadequate sexual stimulation; in these cases, there may still be a need for care, but a diagnosis of a sexual dysfunction would not be made
• Subtypes of sexual dysfunctions

  • Lifelong (present from first sexual experiences)
  • Acquired (develop after a period of relatively normal sexual function)
  • Generalized (not limited to certain types of stimulation, situations, or partners)
  • Situational (only occur with certain types of stimulation, situations, or partners)
• Factors to consider during assessment of sexual dysfunction

  • Partner factors (e.g., partner's sexual problems; partner's health status)
  • Relationship factors (e.g., poor communication; discrepancies in desire for sexual activity)
  • Individual vulnerability factors (e.g., poor body image; history of sexual or emotional abuse), psychiatric comorbidity (e.g., depression, anxiety), or stressors (e.g., job loss, bereavement)
  • Cultural or religious factors (e.g., inhibitions related to prohibitions against sexual activity or pleasure; attitudes toward sexuality)
  • Medical factors relevant to prognosis, course, or treatment
• Clinical judgment about the diagnosis of sexual dysfunction should take into consideration cultural factors that may influence expectations or engender prohibitions about the experience of sexual pleasure
• Aging and relationship duration may be associated with a normative decrease in sexual response
• Sexual response


  Involves a complex interaction among biological, sociocultural, and psychological factors
• A sexual dysfunction diagnosis requires ruling out problems that are better explained by a nonsexual mental disorder, by the effects of a substance (e.g., drug or medication), by a medical condition (e.g., due to pelvic nerve damage), or by severe relationship distress, partner violence, or other stressors
• For diagnoses linked to reproductive anatomy (e.g., erectile dysfunction, premature [early] ejaculation, delayed ejaculation, and genito-pelvic pain/penetration disorder), diagnoses should be based on the individual's current anatomy and not on the individual's sex assigned at birth
• If the sexual dysfunction is mostly explainable by another nonsexual mental disorder (e.g., depressive or bipolar disorder, anxiety disorder, posttraumatic stress disorder, psychotic disorder), then only the other mental disorder diagnosis should be made
• If the problem is thought to be better explained by the use/misuse or discontinuation of a drug or substance, it should be diagnosed accordingly as a substance/medication-induced sexual dysfunction
• If the sexual dysfunction is attributable to another medical condition (e.g., peripheral neuropathy), the person would not receive a psychiatric diagnosis
• If severe relationship distress, partner violence, or significant stressors better explain the sexual difficulties, then a sexual dysfunction diagnosis is not made, but an appropriate Z code for the relationship problem or stressor may be listed
• It is possible to have a diagnosis of a sexual dysfunction and a coexisting medical condition, nonsexual mental disorder, or use/misuse or discontinuation of a drug or substance; and it is possible to have one or more diagnoses of sexual dysfunction