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Return to Sexual Problems - Overview

Four of 10 women and three of 10 men experience sexual problems, according to a study in the Journal of the American Medical Association. The most common problems reported by women were low sexual desire (22 percent), problems with arousal (14 percent), and pain during intercourse (7 percent). Men most commonly reported problems with premature ejaculation (21 percent), erectile dysfunction (5 percent) and low desire (5 percent).

Other key findings include the following:

The prevalence of sexual problems in women tends to decrease with increasing age, except for those who report trouble lubricating. As men get older, however, they are more likely to experience sexual problems, such as erectile dysfunction and lack of desire for sex.
Younger women are more likely to experience sexual problems, perhaps due to lack of experience and the greater likelihood that they’re not in a stable relationship (for example single as opposed to married).
Married women and men are at lower risk for sexual problems than their non-married counterparts.
Women and men with lower educational levels report less pleasurable sexual experience and raised levels of sexual anxiety.
Emotional or stress-related problems, as well as financial difficulties, are important risk factors for sexual problems.
Past sexual trauma such as forced sexual contact or sexual assault is associated with long-term sexual problems, whether the person was the victim or aggressor.
Sexual problems are associated with unsatisfying personal experiences and relationships, lack of physical and emotional satisfaction, and low feelings of happiness.
Of course, these results don’t apply to everyone in exactly the same way, but they do create a compelling profile of sexual problems. The authors of the study conclude there is a “strong association between sexual dysfunction and impaired quality of life,” and that sexual dysfunction “warrants recognition as a public health concern.”

Sexual Problems: Why Diagnosis Is Difficult

Return to Sexual Problems - Causes

There is no set definition of what a “normal” sex life is. Individuals and couples vary widely in terms of how often they have sex and what that encounter involves. For some couples, once a week or month or even a few times a year may be perfectly normal. A sexual encounter may not always include intercourse, and each partner may not have an orgasm every time. And nearly everyone goes through periods when interest in sex or the ability to perform is hindered. This lack of a clear standard can make it difficult to diagnose whether or not someone has a “problem.”

The Merck Manual of Diagnosis and Therapy uses three phrases that can be helpful in judging whether a difficulty you’re experiencing is actually a problem with sex:

Persistent or recurrent: It isn’t an isolated or occasional event but persists a long time.
Causes personal distress: It upsets you and causes unusual anxiety.
Causes interpersonal problems: It hurts your relationship with your sexual partner.
The latter two categories are the most important. Many people may experience levels of desire or changes in function that don’t cause distress and do not impact their relationships. These changes would not then be considered a problem. However, these same changes may be very stressful for other people or couples and would be considered a sexual problem. Problems vary from person to person.

Another complicating factor is that most sexual problems cannot be traced to one specific cause. Rather, they result from a combination of the physical and the psychological. Proper sexual functioning depends on the sexual response cycle, which includes:

An initial mindset or state of desire.
The flow of blood to the genital areas (erection in men and swelling and lubrication in women) in response to arousal.
Orgasm.
Resolution, or a general sense of pleasure and well-being.
A breakdown in one of the cycle’s phases can be responsible for a sexual problem, and that breakdown can stem from a variety of causes.

Role of diabetes, smoking and other problems

According to the American Medical Association, sexual problems often result from physical conditions such as:

Diabetes
Heart disease
Neurological disorders (such as stroke, brain or spinal cord injury, or multiple sclerosis)
Pelvic surgery or trauma
Side effects of medications
Chronic disease such as kidney or liver failure
Hormonal imbalances
Alcoholism and drug abuse
Heavy smoking
The effects of aging
Psychological causes might include:

Stress or anxiety at work
Concern about performance, marital or relationship problems
Underlying mental disorders such as depression and anxiety
Previous traumatic sexual experience
These sets of causes often “play off” one another. Certain illnesses or diseases can cause people to feel anxious about their sexual performance, which, in turn, can make the problem worse.

When doctors suspect a sexual problem, they usually run a series of diagnostic tests to see if there is any physical cause such as a certain medication, hormonal imbalance, neurological problem or other illness or some other mental disorder such as depression, anxiety or trauma. If any of these causes are found, then treatment will begin. If such underlying problems are ruled out, then the nature of the relationship between the two people must be considered. A sexual problem may be “situational.” That is, the issues are specific to encounters with a certain person in a particular situation. In such cases, therapy is usually recommended for the couple.

ED and Levitra

Erectile dysfunction (ED,buy levitra ) — the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual performance(5) — is a common health condition among men that is largely untreated. It is estimated that some degree of ED affects more than one half of all men over the age of 40(6) — 152 million men worldwide(7) and 30 million men in the United States alone.(8) Despite the high prevalence of sexual problems, nine out of 10 men in the U.S. have not yet sought treatment from a physician. (9)(buy levitra)

Bayer and GlaxoSmithKline signed a worldwide co-promotion and co-development agreement for Levitra in November 2001. To date, Levitra has received regulatory approval for the treatment of ED in more than 50 countries. It was launched in major European (levitra order) markets beginning on March 7, 2003.

As previously disclosed, Pfizer has filed suit in the United States alleging that one of its patents would be infringed by the sale of Levitra. The case is in its early stages.

REFERENCES:

1. Package insert.

2. Valiquette L, Hellstrom W, Gittelman M, et al. Vardenafil provides reliable efficacy over time in men with erectile dysfunction. Presented at the 10th World Congress of the International Society for Sexual and Impotence Research, September 24, 2002, Montreal, Quebec, Canada.

3. Saenz de Tejada I, Glina S, Becher E, Ulbrich E, Vardenafil Study Group. Vardenafil exhibits long-term efficacy and safety for up to 52 weeks. Presented at the V Congress of the European Society for Sexual and Impotence Research (ESSIR,order levitra), December 3, 2002, in Hamburg, Germany.

4. Padma-Nathan H, Kaufman J, Taylor T. Earliest time of onset of erections with vardenafil determined in an at-home setting. Presented at a satellite symposium at the 2003 Annual Meeting of the American Urological Association, April 25, 2003, Chicago.

5. Jardin A, Wagner G, Khoury S, et al. Recommendations of the 1st International Consultation on Erectile Dysfunction. Co-sponsored by the World Health Organization (WHO), International Consultation on Urological Diseases (ICUD,order levitra) and Societe Internationale d’Urologie (SIU,order levitra) and held July 1-3, 1999, Paris. 2000, p. 713.

6. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994;151:54-61.

7. Aytac IA, McKinlay JB, Krane RI. The likely worldwide increase of erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999;84:50-56.
8. National Institutes of Health, Consensus Development Conference Statement, December 7-9, 1992.

9. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537-544.

How should I take levitra?

Take levitra exactly as it was prescribed for you. Do not take it in larger doses or for longer than recommended by your doctor.

Take each dose with a full glass of water.
• levitra can be taken with or without food.
• levitra is usually taken only when needed, about 60 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor’s instructions.
Do not take levitra more than once a day. Allow 24 hours to pass between doses.Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism,Order Levitra) can damage the penis.Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?
• Since levitra is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine.
• Overdose symptoms may include back pain, muscle pain, or vision problems.

What should I avoid while taking levitra?

Avoid drinking alcohol, which can increase some of the side effects of levitra.
• Grapefruit and grapefruit juice may interact with levitra. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
Do not use any other drug to treat impotence, such as alprostadil (Caverject, Muse, Edex,Order Levitra) or yohimbine (Yocon, Yodoxin, others,Order Levitra), unless your doctor tells you to.