Causes of Sexual Dysfunctions

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Biology 202
2002 First Paper
On Serendip

Causes of Sexual Dysfunctions

Lauren Welsh

"Sexual dysfunctions are an important public health concern, to which general health and emotional problems contribute" (10). What is a sexual dysfunction? A sexual dysfunction is any condition that inhibits someone's ability to enjoy sex. Some common sexual dysfunctions are: hypoactive desire disorder (low sex drive), hyperactive sexual disorder (high sex drive), sexual aversion disorder, lack of lubrication (females), impotence (male erectile disorder), premature ejaculation, vaginismus (prolonged contractions of the vaginal wall that cause painful intercourse), or failure to orgasm during sex (8). In a study of happily married couples, 14% of men and 15% of women reported that they were either not very satisfied or not at all satisfied with their sex lives. In another study by Laumann in 1992, it was found that the prevalence of sexual dysfunction is 43% in women and 31% in men (10). Are these numbers surprising? What is causing this lack of sexual fulfillment?

Did you ever wonder why sexual desire varies from person to person? Or why and how your sexual drive can change over time? Did you ever wonder what causes things to go wrong sexually - sexual dysfunctions? What is controlling YOUR sexual desire?

Innervations of the organs of sexuality are mediated primarily through the autonomic nervous system (12). The autonomic nervous system is the part of the vertebrate nervous system that regulates involuntary action, as of the intestines, heart, and glands, and that is divided into the sympathetic nervous system and the parasympathetic nervous system (1). It is generally assumed that the parasympathetic system activates the process of erection via impulses that pass through the pelvic splanchnic nerves (S2, S3, S4), which cause the smooth muscles of the penile arteries to dilate. The sympathetic (adrenergic/adrenalin) system is responsible for ejaculation. Similarly for women, the sympathic system facilitates smooth muscle contraction of the vagina, urethra, and uterus that occurs during orgasm.

"The autonomic nervous system functions outside of voluntary control and is influenced by external events (for example, stress, drugs) and internal events (hypothalamic, limbic, and cortical stimuli)" (12). So, it is not surprising, therefore, that erection and orgasm are so vulnerable to dysfunction.

There are many possible psychological disorders that could cause a person to be sexually unsatisfied. If a person has a psychological disorder such as bi-polar disorder, schizophrenia, epilepsy, or depression - they tend to enter states of extreme fear, paranoia, or anxiety more often than a person without their disorder. These states are not normal states of consciousness for a healthy person, and many of these abnormal states of consciousness inhibit sexual interest (9). For example, a bi-polar person experiences non-normal states of extreme bliss or extreme depression. During each non-normal state of consciousness, the bi-polar person will be too consumed by either their elation or their depression to feel any sexual desire. Therefore, a person's sexual desire is related to the amount of time spent in non-normal states of consciousness.

Not only the psychological disorder itself can cause abnormalities in sexual desire, but so can the treatment of the disease. Drugs used to treat some psychological disorders - such as depression - can alter sexual desires by disturbing the normal processes in the brain that deal with desire and sexual arousal. Certain chemical agents such as antihypertensive, anticonvulsant, serotoninergic antidepressant and neuroleptic drugs may cause a loss of libido - sex drive (12). These drugs alter the production and uptake of certain chemicals called neurotransmitters in the brain that have been found to alter sexual desire/performance. Some of these neurotransmitters are: dopamine, epinephrine, norepinephrine, and serotonin. All have effects on sexual function. For example, an increase in dopamine is presumed to increase libido. Serotonin produced in the upper pons and mid-brain is presumed to have an inhibitory effect on sexual function (12).

There are other medical conditions in addition to psychological disorders that can be the cause sexual problems. In the U.S. there are two million men who are "impotent because they suffer from diabetes mellitus; an additional 300,000 are impotent because of other endocrine diseases; 1.5 million are impotent as a result of vascular disease; 180,000 because of multiple sclerosis; 400,000 because of traumas and fractures leading to pelvic fractures or spinal cord injuries; and another 650,000 as a result of radical surgery, including prostatectomies, colostomies, and cystectomies" (12). Some of the injuries are of the abdomen, lower spinal cord, or pelvic vascular areas, which can compromise circulation to the genitalia or sensory nerves to/from the genitalia - producing impotence or other changes in normal sexual responses.

In addition to psychological disorders, drugs, and varying medical conditions being the cause of sexual dysfunction, injury and/or brain surgery can also cause a range of affects on a person's libido (4). Examining the outcome of damage to certain, specific areas of the brain can help us understand the roles that those parts of the brain play in sexual drive/performance.

There are 4000 serious head injuries that occur each year in the U.S., of which about 100 are survivors. The disturbance of sexual functioning in these head injury survivors is the rule rather than the exception (4). Sexual drive, having to do with structures deep in the brain, are rarely disturbed by non-penetrating head injury. It is sexual motivation and initiation that are damaged by blunt frontal lobe trauma.

Experimentation with animals has demonstrated that the limbic system is directly involved with elements of sexual functioning. In all mammals the limbic system is involved in behavior required for self-preservation and the preservation of the species (12). The limbic system is the "link between higher cortical activity and the lower systems that control behavior" (3). It controls the neuroendocrine system, autonomic system, olfactory sensory processing, emotions and motivation, and memory. The limbic system is interconnected nuclei of the olfactory bulb and orbitofrontal cortex, amygdala, hippocampal formation, hypothalamus, anterior and mediodorsal nuclei of thalamus, septal nuclei, and the Limbic ring of neocortex (7).

Kluver and Bucy proved that the limbic system is involved with sexual functioning in their experiment with monkeys. The monkeys in their experiment were aggressive and raging prior to the operation. The operation consisted of the removal of the monkey's temporal lobe. After the operation the monkeys were docile, orally fixated, and had increased compulsive and sexual behaviors (2). Their findings led to the so-called Kluver-Bucy Syndrome. Humans can get Kuver-Bucy Syndrome when their temporal lobes get damaged from such things as tumors or surgery. Humans with this disorder also experience a disturbance in sexual function just as the monkeys did (3).

Temporal lobe epilepsy is another way in which the temporal lobe might function inadequately and cause sexual dysfunction. There is a high frequency of sexual disturbance in patients with temporal lobe epilepsy. Gastaut and Collomb (1954) were the first to draw attention to hyposexuality after specific inquiry in 36 patients with temporal lobe epilepsy. More than two-thirds showed marked diminution or absence of interest, appetite or sexual activity. Other forms of focal and generalized epilepsy appeared to be unassociated with such problems. Frequently, there was "a remarkable lack of sexual curiosity, fantasies or erotic dreams, yet little to suggest inhibition since the patients talked easily and without reserve about such matters" (12).

The amygdala has a large number of sexual phenomena associated with it. One of the more interesting is the observation that gay men have more connections between the amygdala on each side of the brain than straight men (9). The amygdala manages our emotions and helps to manage our states of consciousness (9). These normal and non-normal states of consciousness have a lot to do with sexual dysfunction (e.g. hyposexuality) as was discussed previously with psychological disorders.

Physiological disorders, medications, certain medical conditions, injury and/or brain surgery are only some of the causes of sexual dysfunction. Examining the neurological causes of sexual dysfunction will allow us to better understand the workings in our brain that have to do with sexual desire - and with this knowledge and better understanding we can hopefully help the many people in our society that suffer from sexual dysfunctions.

References

1)Online Dictionary

2)Brain and physiology of emotion

3)Neuroscience of emotions and sexuality

4) HEAD INJURY AND SEXUALITY

5)EMOTIONAL MEMORY AND THE AMYGDALA

6)Kluver-Bucy Syndrome

7)Limbic System

8)Sexual Dysfunction

9)Sex and states of consciousness

10)Sexual Dysfunction Secondary to Depressive Disorders

11)What causes behavior?

12)Sexual Dysfunction Following Injury:Time for Enlightenment and Understanding

 

 

Continuing conversation
(to contribute your own observations/thoughts, post a comment below)

09/22/2005, from a Reader on the Web

I read your atricles on line about neuroscience and sexuality and also about the anygdala and sexuality. I am 24 male and I have suffered with a complete lack of desire for the last 3 years after having taken a drug called Propecia (for 5 months) for male pattern baldness. The drug inhibits the production of DHT in the body which can help to stop balding, but is known to also affect libido & impotency in some men. I was late going through puberty when I was younger so even though I took Propecia when I was 21, I think I had the pubertal stage of a 17 yr old. I have been to just about every hormonal expert in America and I do not seem to have a problem nor do I respond at all to Testosterone injections. I had a very normal libido before I took the drug and now I have next to nothing, a sexual thought has not crossed my mind in years without me forcing it. I also have next to no visual stimulation at all and I fell very numbed emotionally (especially romantically obviously) as well a I have also seen a number of sexual psychologists ( Dr Perelman, if you have heard of him) who seem to think that I may have caused some neurological damage and there does not seem to be any significant emotional problem which could have caused this. I believe after speaking with a number of doctors (yet no neurologists) that the lack of DHT at stage when my brain was still developing sexually may have caused some neurological deformation or damage, potentially to the amygdala. I was wondering if you could refer me to or tell me of a neurologist (preferrably in NYC) who may be at least willing to check if I have experienced any neurological damage or anything like that. I am not concerned about the potential costs involved, this has been incredibly devastating to my life and I am willing to do just about anything to get to the bottom of it. I might also add that I know of hundreds of other men who have experienced the side effects of this drug permanently after stopping up to 7 years ago. We are trying to get attention for the issue, but it is a difficult problem to trace. Thank you for your time.

 

Comments

michael tyndall's picture

limbic system sexual dysfunction after bacterial meningitis

I am 35 yrs old. I had a bacterial meningitis at 23 and lost sensation to the penis. For years i had no physical ability for erection or orgasm but a few years ago i used an Erchonia Cold Laser on my sacral nerve roots to restore balance to the parasympathetic nervous system. Long stort short, i received about 30% restoration the the penis but still have no ability to think and become aroused or see and become aroused. It's like the whole mental connection to the physical process of arousal has been lost. I have been seeing a Chiropractic.Neurologist and he says my nerves are not damage but that my limibic system is off and needs restoration. I am trying to heal myself and be involved in a relationship, and hopefully a marriage. I have much more information but i don't know how much is valid for sharing here. I just wanted to see if there is anyone with any insight to this particular situation. Thanks!

Serendip Visitor's picture

Lack of sexual desire

I was interested to read your response to this as I suffered a Viral meningitis a couple of weeks ago, and all of a sudden I seem to have no sexual desire...I was happy to read that im not completely alone, but obviously my heart goes out to you for the suffering you have endured. My girlfriend is convinced its her but when I tell her its me, I seem to get into trouble for not making her feel loved. She has a very high sex drive, of which we both used to share...now I cant even seem to "get it up" for her which is very embarrassing and also frustrating for both of us. She believes she is unattractive to me now which is definitely not the case...I just don't seem to work down there like I used to. Again, thank you for sharing this, ive been trawling the net for hours trying to find someone with the same problem as me.

Serendip Visitor's picture

Our attitudes

Our attitudes towards sex are our biggest dysfunction. Is it any wonder that a clinical psychologist salary is so high with the sheer number of mentally challenged individuals pushing their so called moralities that they themselves only regurgitate.

Serendip Visitor's picture

Post Propecia Syndrome

To the reader above that mentioned Propecia:
I am not a doctor, just someone who speaks from personal experienced and after critically reading the literature. Unfortunately the drug is usually prescribed by dermatologists, so most endocrinologists and neurologists are unfamiliar with it and when some superficial labwork seems normal, they think the problem is in the patient's head. It is in his head, but it is not psychological. Propecia can cause sexual dysfunction in many different ways:
-Inhibition of the enzyme 5-alpha-reductase-2, which is present in the brain and other organs. Important neurosteroids (Allopregnanolone, Tetrahydrodeoxycorticosterone, etc) with anxiolytic, antidepressant and anticonvulsant properties, depend on this enzyme.
http://en.wikipedia.org/wiki/5-alpha-reductase_inhibitor
http://meridianvalleylab.com/5-alpha-reductase-over-inhibition/
-Androgen resistance. Most endocrinologists will naively think that if your testosterone levels are within range, you do not have a problem. But Finastride may make the androgen receptors in the brain, genitalia etc, insensitive to androgens. This means that you could require testosterone much higher than normal to achieve normal sexual function. I personally experienced this and Dr John Crisler claims to have seen it in a lot of patients.
-Epigenetic side effects
http://www.ncbi.nlm.nih.gov/pubmed/19501473
A neuroendocrinologist is probably the best doctor to consult. The website propeciahelp.com has information about the (very few) doctors that acknowledge the condition, and may be able to offer partial relief. Some names include Alan Jacobs, MD (neuroendocrinologist in NYC) and John Crisler, DO (in Michigan).

Bill B's picture

Sex Drive and Monogamous Relationships

I am a monogamist when in a committed relationship. I also have a moderately high sex drive. These two types of behavior together can often be self destructive. If I am in a relationship with someone whose sex drive is lower than mine or someone whose sex drive diminishes over time, I am left with no possible means of having my needs met. When at this point I bring up this problem in conversation with my lover, she then feels pressured to have sex. This preserved pressure will almost always result in distancing and less sexual desire on her part. Thus causing a downward spiral where my choices get limited to, live in frustration or dissolve the relationship.
Where as the simple solution of open communication sounds good, in reality it does not work. The solution of an open relationship does not fulfill my true desire to be monogamous.
So I am currently again seeking a committed relationship. As I see it my only choice is to find a woman with the same issue. A woman with only a high sex drive will often cheat (I’ve been there and done that). A woman simply devoted to the committed relationship will make us both miserable over time.(I did that for 20years)
So I will have to choose a partner based more on sex drive than other seemingly more important character traits.

How to last longer in bed's picture

Most of male sexual problems

Most of male sexual problems are caused by psychological issues such as stress and anxiety. The age is also ahuge factor when it comes to Erection Disfucntion. So much huge companies are making a lot of money by offering medical solution for every of these issues when it actually can be solved naturally without involving any drugs.

Serendip Visitor's picture

sexual damage from acupuncture

I read online that acupuncture could help with erections but the acupuncture procedure caused me damage and gave me a severe sexual problem with erections that I did not have prior to the procedure. I live in New Jersey. What should I do?

Serendip Visitor's picture

Too bad you've got the same

Too bad you've got the same bad experience i had with acupuncture...erection difficulty and before you start any acupuncture corrective measures which the acupuncturist will always claim can be done to reverse the sad situation, check your heart rate; that is the number of your heart beat per minute to be sure the acupuncture has not caused your heart rate to slow down to bradycardia which is defined as heart slowness or a resting heart rate of under 60 beats per minute. If your heart rate has slowed to bradycardia, it's likely that the vagus nerve was stimulated. You may check your heart rate and write back.

Too young to die's picture

Sexual Dysfunctions

I am a 45 and my husband is 53 in which I think that we both are too young to loose sexual desires for each other. Unfortunately this is what has happened. I must admit that my husband is a diabetic and also has high blood pressure and is on medication for it. On the other hand I am healthy and is on no medication at this time. My complaint is our sex life. I seem to not be interested in making out with me which is cause me to loose my sex drive because I'm thinking that I do not want to do it with anyone who doesn't want to do it with me. Because of this I am suffering sexually. I desire to have one really really good intimate night until I just about to go and cheat just so I can feel again. I am a christian woman and do not want to do this but at some point, if I do not find an answer to his lack of sexual activity with me, I fear that our marriage could be damage. For now, I am trying to cope with it by thinking that his sexualy dysfunction can be solved but I need some answers now before I go sexually crazy.

Teb.'s picture

little or no sexual desire.

Hello,
Thanks a lot for your effort in putting up this page with very helpful medical informtion. I stumbled upon this page in an effort to seek information concerning an unfortunate medical situation in my sexual life. I'm male, 39 years old and living in China, though I'm not Chinese. My problem is that i'm experiencing sexual dysfunction, needless talking about its devastating effects on my life; but i will just go on to explain how it came about. I visited an acupuncturist here in China for my painful knees as a result of treading at the gym. The acupuncturist did cure the pain by inserting acupuncture needles at certain points he called Acupoints on my knees. Those needles had to touch the tendons or muscles and produce a sharp sensation. The acupuncture treatment as he explained, was to facilitate blood circulation and has no bad effects. The acupuncture did work very well and i really appreciated his great skills. From there we started talking much about the acupuncture treatment and since i had constipation and some bowel problems, i asked him if acupuncture can be done on such a bowel problem and he answered yes. He did acupuncture on my stomach on three occasions, though the bowel problem was never solved. He located an Acupoint on my lower abdomen closer to my navel, others on both sides of my stomach and others on my legs and explained that all those Acupoints are for the stomach. They were not as comfortable as the Acupoints he located on my knees and at one moment i felt a very brief and sharp reflexive burning sensation that tended to produce an internal dehydration effect on my body. There were also sharp pains on those Acupoints on the abdomen and both sides of the stomach and all with suffocating feelings that i could not even cough when the urge to cough came. He was to do the acupuncture for five days but i had to stop on the third day because i felt he was doing the wrong acupuncture. 4 days later, i felt my nervous system was so slackened or loosened and i felt like my muscles were shrinking especially my penis and i had virtually no emotional energy so to speak of. No sexual desire at all, no libido. I called him and talked to him and he told me acupuncture has no bad effects and that my situation could not have arisen from the acupuncture he did on me. He asked me to show my tongue to him and after examing it with his naked eyes, he told me he will prescribe some medicine for me to change the function of my spleen; that my spleen doesn't function well and that after taking the medicine all those sexual problems will regularized themselves. I took the medicine and the situation seemed to have improved just a little. Before this problem, my sexual life was very healthy, just a mere thought of a girl will produce an instant erection or just eating an apple or drinking enough water or sitting in some way will incite sexual desires. But now forceful romantic thoughts or chatting with my girl friend have virtually no romantic effect on my mind. Before, i used to have very stiff erections in the early mornings even when i'm asleep but now my penis sleeps more than me. The reason i have written all these is to solicit help from any angle and to let others be aware of the dangers of wrong acupuncture, though it is "believed" acupuncture has no bad effects. I don't know exactly what i should do. Any help will be highly appreciated. Thank you.

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