x. Aetiology dysf.

Sexual dysfunction are often seen in combination with physical conditions and disabilities which themselves can have a direct or indirect influence on sexual functioning. At the time of the patient’s initial presentation, it may no longer be possible to identify any causal relationship between conditions, since various other factors will have taken a hand in the meantime. For example, a man who experienced erectile dysfunction when taking beta blockers for hypertension may have developed a negative self-image and fear of failure, whereupon the erectile dysfunction persists even when the medication is discontinued. In this context, both patient’s delay and doctor’s delay are significant. Where either party defers a frank discussion of sexual problems, those problems are likely to worsen unnecessarily.
Sexual dysfunctions can also co-exist with psychological problems, psychiatric conditions – such as mood, anxiety or personality disorders – and the use of psycho pharmaceuticals. Examination by a psychologist and/or psychiatrist is then required to identify the underlying problems, arrive at an accurate diagnosis and determine the most appropriate treatment. If, for example, loss of libido is further to clinical depression, it will be included within the diagnosis of depression. In some cases however, psychological problems are the result of a sexual dysfunction, as in low self-esteem caused by the inability to achieve or sustain an erection. Although there is seldom a clear causal relationship, some biological risk factors for sexual dysfunctions can be distinguished, such as: