Psychological causes and classification of sexual dysfunction and the etiology of erectile dysfunction

Sexual dysfunction

In medicine, sexual dysfunction refers to the inability to engage in normal sexual activity or to achieve satisfaction during normal sexual activity. Most cases of sexual dysfunction are not caused by organic lesions, meaning there are no abnormalities or diseases in the sexual organs, but rather by psychological factors. Therefore, in sexology, it is often referred to as psychosexual dysfunction.

Psychological causes of sexual dysfunction

The psychological causes of sexual dysfunction are complex. They are mostly related to the patient's life experiences and environment. Traditional Chinese families have historically avoided discussing sex, leading to a delay in sex education and thus having a certain psychological impact on young people. These psychological factors mainly include the following aspects.

1. An "incorrect" attitude

Sexual anxiety stemming from fear of sexual failure can be a common direct cause of erectile dysfunction or frigidity. Inappropriate or excessive demands from one's partner regarding sexual ability can also be a fundamental cause of sexual dysfunction. Furthermore, another important factor contributing to sexual dysfunction is acting as a "spectator," where one partner anxiously and compulsively focuses on their partner's reactions during intercourse. This spectator role leads to distraction, hindering the establishment of an adequate sexual response and the attainment of orgasm.

2. The experience was "too bumpy".

Experts believe that underlying conflicts, primarily related to past sexual experiences, are a deep-seated cause of sexual dysfunction. If these conflicts control a person's sex life to some extent, sexual dysfunction may occur. Examples include unpleasant experiences with sex during childhood, or confusion caused by a failed first sexual encounter.

3. Suspicion and jealousy

Suspicion and jealousy are often significant causes of sexual dysfunction. When suspicion and distrust arise between sexual partners, there are generally two reasons: first, a lack of understanding leading to distrust and unease; second, closed-mindedness stemming from a lack of understanding of the root cause and communication, with judgments based solely on one's own logic. Many jealous husbands suffer from this problem. They constantly suspect their wives of infidelity, and this intense jealousy and suspicion cause them to experience sexual dysfunction. The more dysfunction they experience, the more they suspect their wives seeking compensation outside the home, creating a vicious cycle.

There is no need to worry too much about functional disorders caused by sexual psychological disorders, because there is no organic lesion. As long as you pay attention to adjusting your mindset and eliminating anxiety, the psychological disorder will be gone, and the functional disorder will naturally disappear as well.

Basic information about male sexual dysfunction

In the overall process of normal male sexual function (including five stages: sexual arousal, penile erection, penile penetration, orgasm-ejaculation, and sexual satisfaction), any disruption in any stage is called a sexual dysfunction, such as impotence, premature ejaculation, anejaculation, retrograde ejaculation, hypoactive male libido, and hyperactive male libido. It can be further divided into erectile dysfunction (including impotence and priapism), ejaculatory dysfunction (including premature ejaculation, anejaculation, and retrograde ejaculation), male sexual dysfunction (hypoactive libido, sexual aversion, hyperactive libido, and paraphilia), and sexual sensation disorders (dyspareunia and orgasmic disorders).

The basic conditions required for men to maintain normal sexual function mainly include the following aspects:

1. A healthy nervous system is required, including the nerve control centers such as the cerebral cortex, diencephalon, hypothalamus, subcortical centers, and spinal cord;

2. A normal endocrine system is present, the most important of which is the male gonad (testes). In addition, the thyroid and adrenal glands are also important.

3. Has a normal cardiovascular system;

4. Has a normal reproductive system;

5. Has a normal mental and psychological state;

6. Possess correct sexual knowledge and attitudes;

7. There is appropriate sexual stimulation.

Problems with any of these seven aspects can affect normal sexual function.

The occurrence of male sexual dysfunction is a complex psychological and physiological change and reaction, including the understanding of sex, the depth of feelings between partners, the magnitude and appropriateness of sexual stimulation, and is also influenced by family, society, environment and interpersonal relationships.

Classification of male sexual dysfunction

There are three main classification methods.

1. Classification by etiology

It is divided into two types: organic and functional (non-organic, psychological).

Organic sexual dysfunction refers to sexual dysfunction caused by pathological changes in a certain organ or system of the body, such as brain tumors, spinal fractures, paraplegia, arteriosclerosis, testicular hypoplasia, hypogonadism, hyperthyroidism or hypothyroidism, severe hypospadias or epispadias, and the use of some neurodepressant drugs.

Functional sexual dysfunction refers to erectile dysfunction in which no organic lesions can be found in the body. Sexual dysfunction is often caused by insufficient sexual knowledge, psychological trauma, disharmony in marital relationship, inappropriate environment, or iatrogenic reasons, such as erectile dysfunction caused by accidental failure of intercourse and being misdiagnosed as impotence by a doctor, which aggravates the psychological burden.

2. Classification by the time of onset of sexual dysfunction

It is divided into primary sexual dysfunction (sexual dysfunction that begins from the first sexual contact) and secondary sexual dysfunction (sexual dysfunction that occurs later in the past when sexual function was good).

3. Situational sexual dysfunction

Sexual dysfunction may occur in one person or under certain circumstances, while sexual function remains completely normal in others or under different circumstances. This is due to psychological factors. Human sexual activity involves complex psychological and physiological processes, often involving the interaction of psychological and organic factors. Psychological sexual dysfunction, of course, requires psychological analysis, counseling, and sex education based on its underlying causes. Similarly, treating only the organic lesions while neglecting psychological and mental support will not yield the desired therapeutic effect for organic sexual dysfunction.

Erectile dysfunction-the most common male sexual dysfunction

Erectile dysfunction (ED) is one of the most common male sexual dysfunctions. It refers to the inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse when a man experiences sexual stimulation and desire. However, due to its high incidence, complex causes, and difficulty in treatment, how to treat ED has become a major concern for many men.

Causes of erectile dysfunction

1. Western medical etiology

There are many causes of erectile dysfunction, which can be broadly categorized into two types: psychological and organic.

Psychological factors contributing to erectile dysfunction: Each person's environment, experiences, psychological state, and personality traits differ, leading to varying reactions to the same mental and social factors. What may not cause psychological distress for most people can become a contributing factor to erectile dysfunction for some. Common psychological factors affecting erectile function include: influences during development; the impact of disharmonious interpersonal relationships; emotional factors; and differences in understanding of sex.

Organic factors that cause erectile dysfunction: There are many factors, with different causes and different pathologies. The main factors include endocrine diseases, neurological diseases, vascular diseases, urogenital diseases, certain internal diseases, trauma and surgical trauma, old age and physical weakness, and the effects of drugs.

2. Etiology in Traditional Chinese Medicine

The causes of erectile dysfunction are complex, and can be either singular or mixed. Generally speaking, they can be mainly divided into the following aspects:

Emotional factors: The emotional causes of erectile dysfunction mainly lie in three aspects: fright, depression, and anxiety. Sudden fright can disrupt the flow of Qi; excessive tension can cause mental and physical instability, both of which can easily lead to impotence. Excessive depression or grief, lack of affection between spouses, disharmony in the family, and setbacks in one's career can all easily lead to stagnation of liver Qi, resulting in impotence. Excessive anxiety, over time, gradually damages the heart and spleen, Qi and blood. Qi deficiency leads to insufficient propulsion, and blood deficiency leads to impaired nourishment, ultimately resulting in impotence.

Lifestyle factors: (1) Excessive sexual activity: Unrestrained and excessive sexual activity damages kidney essence, leading to physical weakness and eventually impotence. (2) Dietary habits and hobbies: Improper diet over time damages the spleen and stomach. Weakness of the spleen and stomach over time leads to insufficient production of qi and blood, resulting in impotence due to lack of nourishment of the reproductive organs. (3) Overwork: Excessive mental and physical labor consumes a lot of physical strength, leading to impotence due to liver and kidney deficiency over time.

Unhealthy Habits and Behaviors: Certain unhealthy habits and behaviors in men can easily induce erectile dysfunction. These mainly include extramarital or unsafe sexual behavior, and smoking and drinking habits. In 1986, the University of Pridonia in South Africa conducted a survey of 116 men with erectile dysfunction and found that 108 of them were drug addicts. A survey of 440 men with erectile dysfunction in a city hospital in my country found that 64% were smokers.

Why does smoking lead to erectile dysfunction? A Canadian research laboratory found that one-quarter of smokers experienced poor penile blood circulation, compared to only one-twenty-one in the control group-a five-fold difference. Pathologists believe that nicotine causes vasoconstriction. Smoking is a major contributing factor to arteriosclerosis, and when the small arteries supplying blood to the penis harden to a considerable extent, it inevitably leads to reduced blood flow to the penis (especially during erection), and erectile dysfunction is one of its consequences. Researchers also found that the proportion of smokers with poor penile erection strength was significantly higher than that of non-smoking men.