Brief info about Primary, Secondary, and Other Sexual Problems

Dr. Sunil Dubey recognized as the leading sexologist doctor in Patna, Bihar India shares his daily experience about sexual problems and their classification for safe and effective treatment plan...

Hello friends, welcome to Dr. Sunil Dubey (Dubey Clinic), the leading Ayurveda and Sexual Medicine clinic in Patna, Bihar, India. In today's session, this world-renowned Ayurvedacharya has shared his research, studies and daily practice experiences to understand the sexual problems treated in this clinic.

Brief info about Sexual problems

Sexual problems, also known as sexual dysfunction, interfere with human sexuality. In fact, it disrupts the sexual response cycle where a person struggles with his desire, climax, arousal and destination. These are classified into four main categories: desire disorders, arousal disorders, sexual climax disorders and pain disorders. These categories are based on the specific stage of the sexual response cycle affected. Below is given brief information about these sexual problems.

Desire Disorder (HSDD)

This disorder is characterized by a decrease or absence of sexual desire or sexual interest. It can affect both men and women in their different stages of life. For example, hypoactive sexual desire disorder (HSDD) is a common diagnosis in this category.

Arousal Disorder (ED or FSIAD)

Sexual arousal disorder, also known as excitement disorder, is the inability to achieve orgasm despite sexual desire or interest. In the medical terminology of sexology, sexual arousal disorder is the inability to become physically or mentally aroused during sexual activity. In men, it often manifests as erectile dysfunction, i.e., the inability to achieve or maintain a firm erection for penetrative intercourse. In women, it is associated with a lack of vaginal lubrication (vaginal dryness) or a lack of physical or mental arousal for sexual activity.

Orgasm Disorder (DE or FOD)

Sexual orgasm disorder, also known as anorgasmia, refers to the difficulty experiencing or achieving orgasm during sexual activity. In men, this sexual problem often manifests as delayed ejaculation or premature ejaculation or a complete inability to achieve orgasm despite sexual arousal and stimulation. In women, anorgasmia or female orgasmic dysfunction often manifests as complete difficulty in achieving orgasm, the third stage of the sexual response cycle.

Pain Disorder (GPPPD or Dyspareunia)

Sexual pain disorder, often known as dyspareunia, is a condition in which there is pain during sexual activity. Both men and women can experience this sexual problem at some point in their sexual lives, although it is most common in women. In the case of women, both dyspareunia (painful intercourse) and vaginismus (involuntary contractions of the vaginal muscles) cause problems with intercourse that lead to pain.

Dissertation on sexual problems: Dr. Sunil Dubey

World famous Ayurvedacharya Dr. Sunil Dubey, who is one of the best sexologists in Patna, Bihar, has done his research on various sexual problems in men and women. Actually, he has been associated with the profession of Ayurveda and sexology medical science for a long time, where he has successfully treated millions of people at Dubey Clinic. During his dissertation and research of sexual problems, he has divided them into three categories, which are listed below.
1.Primary Sexual Problems
2.Secondary Sexual Problems
3.Other Sexual Problems
Now let us know all those sexual problems in detail...

Primary Sexual Problems (PSPs)

Our world renowned Ayurvedacharya and researcher Dr. Sunil Dubey says that primary sexual problem is permanent and is not new in sexual life. In contrast, "secondary" sexual problems develop after a certain period of normal sexual activity. He says that primary sexual problems can be classified into four main groups similar to general sexual dysfunction, but the difference lies in their lifelong nature. Now, we will know about the "Primary Sexual Problems" in an individual.

Common primary sexual problems (PSPs)

Primary erectile dysfunction (in men): Primary erectile dysfunction (ED) is associated with a man who has never been able to get or maintain an erection strong enough for sexual intercourse throughout his life. It is less common than secondary erectile dysfunction, which develops later in life.
Primary Anorgasmia (in women): Most cases of primary anorgasmia are seen in women with a history of sexual dysfunction. It is the inability to achieve orgasm throughout life, despite adequate sexual arousal and desire.
Vaginismus (in women): It is a condition in which the vaginal muscles involuntarily tighten or harden, making any type of vaginal penetration (including intercourse, tampons, or medical tests) difficult or impossible. In many cases, vaginismus is a primary condition, meaning it is present from the female's first attempt at penetration.
Lifelong hypoactive sexual desire disorder (HSDD): It is a persistent low or absent sexual desire that the person has experienced throughout their life, not a recent change.

Causes of primary sexual problems (PSPs)

The causes of primary sexual problems are often different from those of secondary problems, which may be linked to physical or psychological changes later in life. Primary problems are mostly linked to the following factors:

Psychological (mental health) factors: This is a major cause of primary sexual problems in an individual. It can arise from a variety of issues, including:
Sexual trauma or abuse: Past experiences impact mental health and can lead to long-term psychological disturbances.
Rigid cultural or religious upbringing: A person's beliefs and attitudes towards sexual relationships may be highly restrictive, leading to lifelong sexual difficulties. Rigid upbringing is the most common cause of these cultural or religious beliefs in which there can be the lack of sexual education.
Performance anxiety: Fear and anxiety about sexual performance can become a significant and lasting barrier to a person's sexual life.
Poor body image: Negative feelings about one's body can interfere with sexual desire and response.

Physiological factors: Although less common than psychological causes, some primary sexual problems may be linked to physical problems present from birth or early development. Such as-
Congenital or neurological conditions: Certain birth defects or neurological disorders can affect the nerves or blood vessels needed for sexual function. It is present from the primary phase of sexual life.
Hormonal imbalance: Hormonal problems present from an early age can affect sexual development and function in male or female.

Secondary Sexual Problems (SSPs)

Dr. Sunil Dubey, a leading senior clinical sexologist from Bihar, India, says that secondary sexual problems (SSPs) are conditions that develop after a certain period of normal sexual functioning. While primary problems have always been present, secondary problems arise later in a person's life and are often linked to specific physical, psychological or conditional causes. There are four main categories of sexual dysfunction, all of which may be secondary.
Secondary erectile dysfunction: A man who was previously able to get and maintain an erection but is now having difficulty doing so. Usually, this is seen in men after the age of 30.
Secondary anorgasmia: A man who was previously able to achieve orgasm but has now lost the ability and capacity to do so. This is most commonly seen in men after 40.
Secondary hypoactive sexual desire disorder (HSDD): A man who had a normal or high sexual desire but now has a significant decrease in desire and avoid any form (activity, desire, scene, images) of sexual activity.
Secondary dyspareunia (painful intercourse): A woman who experiences pain during intercourse after some time of painless intercourse. This may be due to physical problems, such as vaginal dryness due to menopause or hormonal imbalances, or psychological reasons. This sexual problem develops in women after the age of a certain period of life.

Causes of Secondary SSPs

Secondary sexual problems are usually the result of one identifiable factor or a combination of factors. The good news is that this sexual problem is treatable and Ayurveda has a completely safe and personalized treatment for it.

Medical conditions: A variety of physical health problems can affect sexual function and health. Some common underlying medical condition is listed below.
Vascular diseases such as heart disease, high blood pressure (hypertension), and high cholesterol can impair blood flow to the genitals and pelvic area, causing erectile dysfunction in men or decreased arousal in women.
Diabetes can damage nerves and blood vessels, causing both erectile dysfunction and decreased sensation or libido in men.
Neurological disorders such as multiple sclerosis (MS) or Parkinson's disease can disrupt nerve signals needed for sexual response and activity.
Hormonal imbalances caused by conditions such as thyroid problems or low testosterone can significantly decrease libido and sexual function.

Medications: There are lots of common prescribed and over-the-counter medications that have sexual side effects on body and affects sexual functions.
Antidepressants, especially SSRIs, are a known cause of decreased libido, delayed orgasm, and anorgasmia in both male and female.
Blood pressure medications (e.g., diuretics and beta-blockers) can cause erectile dysfunction in different ages of men.
Antihistamines and opioid painkillers can also have a negative impact on sexual function. As a side-effect, these drugs can have a negative impact on sexual health.

Psychological and emotional factors:
Stress, anxiety and depression are major causes of secondary sexual problems in an individual. Worries about work, economic or other life stresses can interfere with desire and arousal in sexual activity.
Performance anxiety, which is the fear of not being able to perform well sexually, can create a cycle of anxiety and sexual dysfunction in men. It develops after a period of time with newly married life or initial phases of sexual life.
Relationship problems such as poor communication, conflict or lack of emotional intimacy can reduce sexual desire and lead to sexual problems in an individual or couple.

Lifestyle factors:
Excessive consumption of alcohol and drug use can reduce sexual performance and desire. It also affects the sexual health and its function.
Smoking and obesity can negatively impact heart health, which is important for healthy sexual function like arousal and erection.

Other sexual problems (OSPs)

In addition to the primary and secondary categories of sexual dysfunction, there are other types of sexual problems that are more specific in nature and diagnosis. These often involve behavioral patterns, psychological conditions, or relationship dynamics that cause distress or harm sexual or married life.

Paraphilic disorders (PDs)

Paraphilias are recurrent, intense sexual fantasies, impulses, or behaviours involving unusual objects, situations, or people. These are considered paraphilic disorders only when they cause serious distress or harm to the person or when they involve non-consensual or harmful activities of others. Examples include:
Voyeuristic disorder: Deriving sexual arousal from secretly observing strangers who are nude, unclothed or engaged in sexual activity.
Exhibitionistic disorder: Deriving sexual arousal from exposing one's genitals to an unsuspecting stranger.
Frotteuristic disorder: Deriving sexual arousal from touching or rubbing a non-consenting person in a public place.
Paedophilic disorder: Persistent and intense sexual interest in children.

Compulsive sexual behaviour (hypersexuality)

It is also called "sexual addiction", "hypersexuality", or "compulsive sexual behavior disorder". The condition is an obsession with sexual fantasies, desires, and behaviours that are difficult to control and that cause severe distress or negative effects on a person's life (e.g., his or her relationships, career, or financial situation). Unlike sexual dysfunction, which is a loss of function, it is a problem of impulse control.
Key characteristics of compulsive sexual behavior include:
Frequent and intense desires: Feeling driven to engage in sexual behavior.
Loss of control: Inability to stop or reduce the behavior despite negative consequences.
Using sexual activity as an escape: Using sexual activity to cope with stress, anxiety, or depression.
Guilt and shame: Experiencing negative emotions after engaging in the behavior.

Sexual aversion disorder (SAD)

Despite being a type of sexual desire disorder, it is important to distinguish sexual aversion disorder from low desire. It is characterized by extreme repulsion and avoidance from all or almost all genital sexual contact with one's partner. This aversion is often phobic in nature, meaning that the person feels intense fear and disgust related to sexual activity or life, which leads them to actively try to avoid it.

Post-orgasmic disorder (POD)

These are less common but clinically recognized conditions in which negative symptoms occur after climax.
Post-coital sadness (PCS): Feelings of sadness, anxiety, or depression that occur after climax. It can last from a few minutes to hours in a person.
Post-coital illness syndrome (POIS): This is a rare condition in which a man experiences a number of flu-like symptoms (e.g., extreme fatigue, muscle weakness, headache, fever) immediately after ejaculation.

Sexual pain disorder (SPD)

Pain disorders are one category of sexual dysfunction, but some specific conditions also fall into this category. Dyspareunia: Especially in women, painful intercourse. It is often a symptom of other problems (such as lack of lubrication), but it can also be the underlying problem. Vulvodynia: It is persistent pain or discomfort in the vaginal area with no obvious cause. The pain may be constant or worsen with pressure or touch, making intercourse painful or impossible in women. Peyronie's disease (in men): A condition in which fibrous scar tissue develops inside the penile, leading to curvature, pain, and sometimes shortening of the penile.