Sexual Dysfunction

Sexual dysfunctions cover a wide variety of disorders, including male impotence, premature ejaculation in males, spasms of the vagina, pain with sexual intercourse, and problems with sexual desire (libido) and response. Men over age 65 are at increased risk for impotence. Impotence, however, is not a normal part of aging. The causes of sexual disorders vary, and include psychological causes and some medical conditions, such as illness or injury.

Signs and Symptoms

What Causes It?

What to Expect at Your Provider's Office

Your health care provider will do a physical examination. He or she may ask about your ethnic, cultural, religious, and social background, which can influence your sexual desires, expectations, and attitudes. Blood tests can help distinguish between psychological and physical causes for sexual dysfunctions. Other tests for men may include penile tumescence measurements, which are done while you are sleeping to determine whether an impotence problem is psychological or physical.

Treatment Options

Antidepressants can be taken by men and women whose sexual dysfunction is related to depression. Vasodilators administered by injection are sometimes used for impotence. Viagra (sildenafil citrate), a drug for treating impotence, can have serious side effects in some men. Over-the-counter products are available as creams or gels for women whose bodies produce inadequate lubrication.

A variety of psychological, behavioral, and interpersonal therapies are also available for many sexual disorders.

Surgery on the veins in the penis can be performed in severe cases, but this treatment is still considered experimental. An implant in the penis may help impotence if the problem does not respond to other treatment.

Complementary and Alternative Therapies

Sexual dysfunction secondary to decreased circulation, hormonal imbalance, depression, or anxiety may be reduced with alternative therapies.

Nutrition Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

For sexual dysfunction related to poor circulation: For sexual dysfunction secondary to hormonal imbalance: For sexual dysfunction associated with depression or anxiety:

St. John's wort (Hypericum perforatum), kava kava (Piper methysticum), skullcap (Scutellaria lateriflora), lemon balm (Melissa officinalis), passionflower (Passiflora incarnata), and gotu kola (Centella asiatica). Combine equal parts in a tea (1 cup twice a day) or tincture (20 to 30 drops twice a day). May take six weeks for results.

Physical Medicine
Contrast sitz baths promote circulation. You will need two basins that you can comfortably sit in. Sit in hot water for three minutes, then in cold water for one minute. Repeat this three times to complete one set. Do one to two sets per day three to four days per week.

Therapeutic massage can reduce the effects of stress.

Following Up

Most sexual dysfunctions are long-term and require professional care.

Special Considerations

Certain drugs and herbs used for treating these psychological or physical disorders may have serious side effects. Marital counseling and other forms of interpersonal therapy are also important.


American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:383.

Conn RB, Borer WZ, Snyder JW. Current Diagnosis (No. 9). Philadelphia, Pa: WB Saunders, Co; 1996:9.

Erectile Dysfunction. MedlinePlus. Accessed at on August 23, 2018.

Erectile Dysfunction (ED). University of Wisconsin Hospitals and Clinics Authority. Accessed at on August 23, 2018.

Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble Books; 1995:195.

Impotence. NMIHI. Accessed at on August 23, 2018.

Murray MT. The Healing Power of Herbs: The Enlightened Person's Guide to the Wonders of Medicinal Plants. Rocklin, Calif: Prima Publishing; 1995:127, 149-150.

Sildenafil. NMIHI. Accessed at on August 23, 2018.

Scalzo R. Naturopathic Handbook of Herbal Formulas. 2nd ed. Durango, Colo: Kivaki Press; 1994:66.

Tadalafil. NMIHI. Accessed at on August 23, 2018.

Vardenafil. NMIHI. Accessed at on August 23, 2018.

What is sildenafil? Accessed at on August 23, 2018.