Patient's question:
Doctor, hello, I have sexual dysfunction.Doctor's answer:
It can be roughly divided into three categories: biological factors, psychological factors, and cultural factors, with psychological factors being particularly important. The more direct psychological factors affecting sexual function mainly include:(1) Incorrect sexual attitudes
Sexual anxiety arising from the fear of sexual failure may be the most common cause of impotence. Inappropriate demands regarding sexual ability or forcing one’s partner to engage in sexual activity are also fundamental causes of sexual dysfunction. Additionally, another significant reason for sexual dysfunction is acting as a "spectator"—when one party is overly anxious and obsessively focused on their partner’s reactions during intercourse, distracting their attention and hindering the establishment of adequate sexual arousal and the attainment of orgasm.
(2) Past sexual experiences
If a person has suffered strict control, harsh treatment, or harm in their past sexual experiences, they may develop lingering psychological trauma and form conditioned reflexes. When faced with sexual situations again, they may unconsciously recall past sexual traumas, leading to sexual dysfunction such as impotence or lack of orgasm.
(3) Interpersonal tension
This primarily refers to conflicts between sexual partners, such as suspicion, jealousy, or distrust. Obviously, one party’s strong disappointment or hostility can provoke a similar response in the other, which is harmful to sexual desire. For example, some women are highly sensitive to being "used," believing their partners are only interested in their bodies and ignore their humanity. Intercourse is perceived as exploitation, domination, or degradation, leading to a lack of sexual response or even aversion to sexual activity.
(4) Various external factors
These can also affect sexual function. The fast-paced modern life, busy work or household chores, interpersonal conflicts, workplace competition, and setbacks, as well as an individual’s education level and social status, can all create psychological stress. Since sexual desire and sexual ability are influenced by psychological factors, these external pressures can contribute to sexual dysfunction.
In addition to the above cases, sexual dysfunction can also have organic causes. When diagnosing sexual dysfunction, it is essential to rule out relevant physical illnesses, such as chronic inflammation of the sexual organs, trauma, or neurological disorders. Certain endocrine diseases, long-term use of certain medications, or mental illnesses like depression or anxiety neurosis may also lead to sexual dysfunction.
(5) Diabetes patients
Chronic diabetes can lead to varying degrees of sexual function decline, with some patients even experiencing complete sexual dysfunction. Diabetic sexual dysfunction has a unique characteristic: conventional aphrodisiacs often have little effect. The most common factors contributing to diabetic sexual dysfunction include:
1. Psychological and behavioral causes
This includes marital disharmony, anxiety, depression, and other psychological factors. Diabetes patients often experience fatigue, peripheral neuropathy, and peripheral neuritis, all of which can affect their mood and contribute to increased sexual dysfunction. This is a case where physiological issues lead to psychological problems, known as psychosomatic disease.
Recommendation: Adjust your mindset, engage in positive social activities, and consult a psychologist if necessary.
2. Hormonal secretion deficiency
Diabetes is an endocrine disorder that some doctors believe can affect the secretion of sexual hormones. However, Nie Wentao argues that if hormonal secretion is insufficient, aphrodisiacs that stimulate hormone secretion may be effective, but this is often ineffective in diabetic patients, suggesting insufficient evidence for hormonal deficiency.
Recommendation: Increase the intake of nutritious foods such as goji berries, Chinese chives, onions, and lamb.
3. Microvascular disease
Both male and female reproductive organs are rich in microvessels. With chronic diabetes, metabolic function gradually declines, and microvascular disease worsens, reducing blood flow to the reproductive organs and lowering sexual arousal. Persistent low sexual arousal can lead to sexual dysfunction.
Recommendation: Reduce social engagements, quit smoking or reduce smoking, avoid excessive alcohol consumption, control diet, and increase grain intake. Consult a doctor if necessary.
4. Nerve receptor damage
Peripheral numbness, a common symptom of advanced diabetes, reduces the sensitivity of nerve receptors. This type of nerve receptor damage is frequent in diabetic patients. Since sexual arousal requires high coordination among various sensory organs (eyes, ears, nose, tongue, body, and mind) and mental focus, the decline in metabolic function and resulting nerve receptor damage in advanced diabetes is a significant cause of sexual dysfunction in diabetic patients.
Recommendation: Follow the treatment methods for diabetic complications.
Sexual dysfunction is often secondary, making it easier to see therapeutic effects.