Patient's question:
Doctor, hello. I have sexual dysfunction. My wife is about to divorce me because of this reason.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 during sexual intercourse becomes anxious and obsessively focuses on their partner’s reactions, causing distraction and hindering the establishment of moderate sexual arousal and the attainment of orgasm.
(2) Past sexual experiences
If a person has been subjected to strict control, harsh treatment, or harm during past sexual experiences, it may leave them with difficult-to-heal psychological trauma, easily forming conditioned reflexes. Once they are faced with sexual situations again, they may unconsciously recall past sexual traumas, leading to impotence, lack of sexual climax, and other sexual dysfunctions.
(3) Interpersonal tension
This primarily refers to interpersonal conflicts between sexual partners, such as suspicion, jealousy, and distrust. Obviously, one party’s strong disappointment or hostility can trigger a similar response in the other, which is harmful to sexual desire. For example, women are very sensitive to being "used," believing that their partners are only interested in their bodies and ignore their humanity. They may view sexual intercourse as exploitation, domination, or degradation, leading to a lack of sexual response or even aversion to sexual life.
(4) Various external factors
These can also affect sexual function. The fast-paced modern life, busy work or household chores, interpersonal disharmony, competition and frustration at work, as well as an individual’s education level and social status, can all create psychological pressure. 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 necessary to rule out relevant physical illnesses, such as chronic inflammation of the sexual organs, trauma, or related neurological disorders. Certain endocrine diseases, long-term use of certain medications, or mental illnesses such as depression or anxiety neurosis may also lead to sexual dysfunction.
(5) Diabetes patients
With prolonged diabetes, sexual function may decline to varying degrees, and some patients may even experience complete loss of sexual function. Diabetes-related sexual dysfunction has a unique characteristic: traditional aphrodisiacs often have little effect. The most common factors contributing to diabetes-related sexual dysfunction include:
1. Psychological and behavioral causes
This includes disharmony between partners, anxiety, depression, and other psychological factors. Diabetes patients often experience fatigue, peripheral neuropathy, and peripheral neuritis, all of which can affect their mood and lead to increased sexual dysfunction. This is a psychological problem caused by physiological factors, known as psychosomatic disease.
Suggestion: Adjust your mood, 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. However, these are often ineffective for diabetes patients, suggesting that insufficient hormonal secretion may not be a significant factor.
Suggestion: 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 prolonged diabetes, metabolic function gradually declines, and microvascular disease worsens, affecting blood flow to the reproductive organs and reducing sexual arousal. Chronic reduced sexual arousal can lead to sexual dysfunction.
Suggestion: Reduce social engagements, quit smoking or reduce smoking, avoid excessive alcohol consumption, control your diet, and increase grain intake. Consult a doctor if necessary.
4. Nerve receptor damage
In the later stages of diabetes, limb numbness often occurs, reducing the sensitivity of nerve receptors. This type of nerve receptor damage is common in diabetes patients. Since sexual arousal requires high coordination among various senses (eyes, ears, nose, tongue, body, and mind) and mental focus, the decline in metabolic function in the later stages of diabetes leading to nerve receptor damage is a significant cause of sexual dysfunction in these patients.
Suggestion: Treat according to the methods for managing diabetes complications.
Dysfunction is often secondary, making it easier to see therapeutic effects.