Chapter 58 - Sexual Function and Dysfunction in Men and Women

Abstract

Sexual dysfunction is a highly prevalent, but often underdiagnosed condition affecting both men and women. It is recognized that risk factors for erectile dysfunction (ED) include diabetes mellitus, increasing age, cardiovascular disease, tobacco use, and decreased physical activity. Therefore, sexual dysfunction can be a sign and symptom of possible underlying disease and pathology—penile health reflects overall health. Beyond the obvious impact sexual dysfunction can have on an individual personally, emotionally, and socially, this dysfunction can be viewed as an opportunity to address even greater co-morbid disease. Sexual dysfunction in men includes ED, problems with ejaculation including premature ejaculation (PE) and anejaculation, anorgasmia, decreased libido, hypogonadism, and sexual pain disorders. Female sexual dysfunction (FSD) includes disorders of sexual desire, disorders of sexual arousal, and sexual pain. In comparison, the female sexual response is still not completely understood or agreed upon. Although similarities exist in the physiology and pathophysiology of male and female sexual function, the differences help explain why finding effective treatments for women pose such a challenge. Female sexuality is much less well understood, in part because of the emotional and psychological influences on the female sexual response. Pharmacotherapy, growth factor therapy, gene therapy, and regenerative medicine exist as the exciting therapeutic advances in development. It is with these novel new approaches to the treatment of sexual dysfunction under investigation that we are hopeful for improved future success and cure.