Sex is a natural and pleasurable part of a healthy lifestyle, so when interest wanes or sexual difficulties occur, it can be confronting and uncomfortable for both you and your partner.
Defining sexual dysfunction is tricky, because each of us has different feelings and expectations regarding what’s ‘normal’ for us, ranging from being highly sexual to rarely interested.
However, issues may occur when your own level of sexual interest and function changes, or isn’t aligned with that of your partner.
Sexual difficulties take several different forms, including:
Some people also experience pain during intercourse. If you’re affected, talk to your healthcare professional to arrange further investigation and treatment if necessary.
Among other factors, your libido and sexual performance are likely to reflect your personal preferences, relationship status and any other issues occurring in your life - including your physical health and emotional wellbeing.
Consequently, when sexual dysfunction occurs, the causes may be physical, psychological or both.
In addition, many people are sexually dissatisfied for reasons that are not considered dysfunctional but are instead an appropriate consequence of their personal circumstances. (For example, relationship issues between you and your partner may understandably contribute to lowered sex drive, performance difficulties or reduced arousal).
In men, sexual performance problems are often caused by low testosterone levels, which are commonly associated with weight problems and poor blood sugar balance.
Together, these issues have detrimental effects on the structure and function of the blood vessels, including those supplying the penis. As a result, they can lead to symptoms of erectile dysfunction, which may present as problems achieving an erection, sustaining an erection for long enough to participate in sexual activity, and/or premature ejaculation.
Benign prostatic hypertrophy (BPH) and other conditions affecting the male genitourinary tract may also contribute to sexual problems.
In women, hormonal imbalances strongly influence libido, sensitivity and sexual performance. For example, a woman’s libido may peak during times when her testosterone levels are high (for example, prior to ovulation each month) and drop when they are low (for example, while breastfeeding).
Low oestrogen levels may also have an impact. For example, the decline in oestrogen that women experience during menopause may cause vaginal dryness, making sex less pleasurable than it had been previously.
Other issues that may cause or contribute to low libido and sexual dysfunction in both men and women include:
In traditional Chinese medicine (TCM), low libido and poor sexual function are often seen as an imbalance of Yin (female energies) and Yang (male energies), particularly as they relate to the Kidney organ-meridian system (which in TCM includes not only the kidneys themselves, but also the sexual organs and hormones).
When the functioning of the Kidney organ-meridian, Kidney Yin and Kidney Yang are healthy and in balance, sexual vitality and performance are also likely to be strong.
However, deficiency of Kidney Yang may dampen sex drive, and low levels of Kidney Yin may decrease stamina and performance (even if the desire for sex remains).
The herbs Tribulus and Horny Goat Weed have traditionally been regarded as rejuvenating aphrodisiac tonics. They are suitable for use by both men and women, and may help to enhance sex drive, stamina and performance.
They are often combined with other Chinese herbs that strengthen and anchor Yang, help promote its balance with Yin, and support the functioning of the Kidney organ-meridian system, such as Morinda, Curculigo and Schisandra.
The Western herb Serenoa supports men's reproductive functioning, including helping to maintain normal hormonal balance and the health of the sex organs and prostate gland.
It’s often taken with Chinese male tonic herbs traditionally regarded as having the ability to strengthen Yang and act as tonics for the Kidney organ-meridian, including Morinda, Psoralea, Cuscuta and Horny Goat Weed.
The antioxidant nutrients zinc, selenium and lycopene may provide additional benefit by helping regulate testosterone levels and support healthy sperm production and function.
For women, herbs that help to regulate the menstrual cycle and support healthy female reproductive function include Peony and Dong Quai.
They are often taken with female reproductive tonics traditionally used to tone and preserve the Yin (such as Rehmannia, Chinese Licorice and Ginger) and promote the flow of Qi (energy) and Blood to the ovaries, uterus and pelvis (such as Cyperus and Ligusticum).