It is important to rule out organic causes of sexual dysfunction in both men and women, as the presenting symptoms are often the same.
In men, psychosexual dysfunction presents with an inability to get and/or maintain an erection, premature ejaculation, inability to ejaculate, and/or decreased libido. In women, psychosexual dysfunction can present as decreased libido, inability to achieve an orgasm, vaginal dryness, and/or vaginismus (involuntary tightness of perivaginal muscles causing pain during sexual intercourse).
In both men and women, psychosexual dysfunction can be caused by major depressive disorder, generalized anxiety disorder, and situational anxiety (including performance anxiety) as well as past traumatic sexual experiences. Negative body image can also play a role.
Fetishism refers to a sexual disorder characterized by obsession of sexual fantasy with inanimate objects. Sexual sadism / masochism refers to a sexual disorder in which pain and sexual arousal are codependent. Voyeurism refers to a sexual disorder in which an individual seeks sexual arousal via observation of other individuals engaging in sexual intercourse.
Patients with this disorder may have an increased risk of various general medical conditions.
R37 – Sexual dysfunction, unspecified
56627002 – Psychosexual disorder
Differential Diagnosis & Pitfalls