What it means: It’s known as erectile problem, and manifests as an inability to achieve or sustain an erection long or strong enough for penetration. It also covers the inability to ejaculate. In women, sexual dysfunction is characterised by low libido (low or no desire to have sex). It could also mean that the woman cannot stay aroused all through intercourse; or is unable to arouse herself, despite wanting to have sex. If you cannot reach an orgasm, or you find intercourse painful, that too can be classified as sexual dysfunction. This lot of men and women can still have a baby through assisted reproductive procedures or what’s now known as In Vitro Fertilisation (IVF), where the egg is fertilised by the sperm outside the body, and then transferred into the woman’s uterus.
How it happens: In men, it’s psychological triggers like stress, anxiety and exhaustion that lead to erectile dysfunction. Diabetes, excess intake of alcohol and the use of antidepressants for long are add-ons. In women, the causes could be hormonal as lower oestrogen levels change genital tissues and affect sexual responsiveness. This tends to happen after pregnancy, during breast-feeding and menopause. During menopause, the vaginal lining becomes thinner, drier and less elastic, making intercourse painful, and arousal tough to achieve. For many women, the impending fear of pain during the first intercourse is a major inhibiting factor.
How to tackle it: Men must change their lifestyle; cut down on alcohol, tobacco and nicotine. Then address stress and anxiety, and hone interpersonal relationship skills. In women, hormones are the first in line for interrogation. Counselling is often advised to deal with fear of penetration and grim idea-associations with the sexual act.
What it means: It’s the inability to have children despite trying for an extended period of time. For a woman under 32, this period can be up to two years; for someone older, it would be a year.
How it happens: In women, there could be problems with ovulation; too little or too many eggs are produced. There could be mechanical problems with the uterus such as fibroids, an enlargement or an abnormally shaped uterus. Infections like tuberculosis could also affect the fallopian tubes.
Among men, problems with sperm count (concentration of sperm in a man’s ejaculate), motility (ability of sperm to move towards an egg) and morphology (the size and shape of sperm) can inhibit conception. And this may be genetic. Performance anxiety and lack of libido bring down sperm motility, as would a block in the sperm passage. Smoking and higher than desired temperature around the sperm sac can also lower sperm count.
How to tackle it: Medical and surgical intervention is possible in all cases. Hormone supplements, IVF and Intracytoplasmic sperm injection (sperm is injected into the egg) can be discussed for each case.