Sexual Dysfunctions – Difficulties During Sexual Intercourse

Typically, sexual intercourse (when it is free and consensual) is an activity that is pleasurable and has positive effects on self-esteem and one's sense of femininity or masculinity. When things don’t go well, however, the consequences can be negative—and since it’s a sensitive topic, even discussing it with a professional can be difficult. Let’s take a closer look at difficulties during sexual intercourse.

When a woman experiences pain during intercourse, the first natural response is to avoid sexual activity altogether. But it often extends further—even avoiding gynecological exams. It can almost resemble a phobia of penetration.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Genito-Pelvic Pain/Penetration Disorder is characterized by:

• Recurrent or persistent difficulties in at least one of the following situations: vaginal penetration during intercourse, marked pain during sexual intercourse, fear or anxiety about experiencing pain during intercourse, and marked tension of the pelvic floor muscles during intercourse
• Symptoms must last for at least 6 months and cause clinically significant distress
• The symptoms cannot be better explained by another condition

In men, difficulty during intercourse often presents as the inability to achieve or maintain a satisfactory erection. For those experiencing it, this often results in the feeling of being unable to experience or provide pleasure. Low self-esteem, reduced sense of masculinity, and feelings of depression are common consequences.

According to the DSM-5, Erectile Disorder is characterized by:

• In most sexual encounters, there is difficulty achieving or maintaining an erection
• Symptoms must last for at least 6 months and cause clinically significant distress
• The symptoms cannot be better explained by another condition.

Sources:

• American Psychiatric Association (2013) – Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
• Bernhill, J. W. (2014) – DSM-5 Clinical Cases

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