Enjoying Better Sex

One of the more distressing and interesting pieces of information to emerge from the study of sexual dysfunction in recent years has been the discovery that erectile dysfunction is becoming more common in young men.

It turns out that although erectile dysfunction is more common in older men – as you might expect – it’s also surprisingly common in younger men. About 40% of men in their 40s have erectile dysfunction – an astonishingly high number.

Yet a study in the Journal of Sexual Medicine suggests that almost 26% of men under 40 have erectile dysfunction – and half of them have it in a very severe form.

This is quite amazing! We think of young men are sexually potent, constantly looking for sex, constantly needing sexual outlets, and always ready with an erection.

Yet if the data in this study is to be believed, then this fundamental problem needs to be addressed for the sake of the emotional and mental health of the young men concerned.

But why should this be so? Why should there be such a high predominance of erectile dysfunction in young men?

Assuming that causes of erectile dysfunction like diabetes which occur in older men are going to be less predominant in younger men, we are forced back to the conclusion that in fact, this epidemic of erectile dysfunction in young men must be caused by psychological issues.

It seems obvious to me that we are living in a society which is much more stressful than it used to be. It’s also possible that there is much more drug abuse than they used to be in society. In any event, both stress and drug abuse are recognized causes of erectile dysfunction, so if younger men are more predominantly stressed or more frequent users of drugs per capita of population than older men, then that could well be part of an explanation.

And yet, and yet… There’s no problem without a solution, and nowhere is that more true than in the arena of sexual dysfunction, where so much time and effort – let alone money – has been spent on remedies for sexual dysfunctions of all kinds that a solution, no matter how difficult the problem, is within almost everybody’s grasp.

The interesting thing about erectile dysfunction is that about 20% of the 18 million men in America currently affected by erectile dysfunction take prescription drugs – and of course these are well-known as a very effective treatment.

The most common are Viagra and Cialis. But the interesting thing is that a very significant minority of men who take these drugs still don’t get an erection. And when you look into this, it turns out this is because the fundamental basis of the erectile mechanism is psychological rather than physical.

Having said that, the experts also found that men are physically active have better erectile function: a calorie restricted diet and greater physical activity have been found to restore erectile function in even severe cases of ED.

Having said all of that, what about women? Surely there level of sexual dysfunction must also reflect the stress which society inflicts on us all these days?

For women, it turns out that low libido, or low sex drive, is the predominant sexual dysfunction. In fairness, it should be mentioned that there are plenty of sex experts who think low libido for women is perfectly normal, and not in actual fact any kind dysfunction at all.

The viewpoint that low sexual desire is a problem which needs to be solved with a medical solution is a reflection of how sexual activity can be medicalized. (What that broadly means is that drug companies and the medical profession can take ownership of psychological and sexual issues – mostly because there is profit to be made, rather than suffering to be averted.)

But there is a real problem here: in 2008, in a survey of over 30,000 women in the United States aged 18 or over, almost half of the women reported sexual problems. A full 10% of them complained about low sexual desire (aka hypoactive sexual desire disorder or HSDD) needless to say, one doctor described this as “a real diagnosis”.

In the sense that millions of women who go through the menopause may experience low sexual desire, I believe we are all less likely to think of young women as possibly subject to sexual dysfunction of this kind.

Yet women’s libido is a complicated issue. I think we all know that, both men and women alike! And Women Come First, a book by Ian Kerner, suggests that men can do a lot to get women in the mood by spending adequate time on foreplay. That in fact, low sexual drive in women may not be a problem. It may merely be a symptom – of inadequate sexual attention from men!

And interestingly enough, when you dig down into this, you’ll find that sometimes it isn’t the lack of sexual desire that’s the problem, but it’s about the women’s anxiety – their emotional response to the fact that they don’t feel much sexual desire.

Interestingly enough, however, almost 40% of women diagnosed with HSDD report depression. The question that would occur to most therapists here is – well, which came first, the depression or the low sex drive? In actual fact, the two probably go together in a feedback loop which ensures constant reinforcement.

We also recognize these days that contraceptive pills can cause low sex drive. In general, it’s probably much more functional to ask a woman what she needs to become orgasmic than to start offering medicalized solutions which do little to address the specific problems of an individual, but much to address the profits of the doctors or drug companies.

Yet it’s a common complaint among experts in the field that the pharmaceutical companies are producing diagnostic tools for “low sex drive” because they want to medicalize what might actually be a normal human condition.

As one therapist rightly observed, many people today – both male and female – feel a lot of pressure to be sexually active, perhaps too much pressure, leading them to a place of false expectation. Indeed, it could be that what we are expecting women to experience as a normal sex drive is in fact in reality hypersexualisation.

In other words, it’s possible that women are just being pressured into expectations about sex that are completely unrealistic. Combine those unrealistic expectations with hard, possibly stressful jobs, and you begin to build up a very different picture. “A lot of women say the best part of traveling is the hotel room with the giant bed and the clean sheets and no children crying and a husband who wants something from them,” said Steinhart. “Truthfully, women have always been this way.”

And there is now a widespread recognition that stress – that’s to say, the stress of working longer hours, and the threat of job insecurity – is exhausting for people. And why wouldn’t it be? It makes people – both men and women – feel older than their age, it diminishes libido, and in the end people under this much pressure are probably too tired to care whether they have sex anyway.

The good news, of course, is that such a reduction in sex drive doesn’t need to be permanent. We all recognize that our sexual drive and sexual energy tends to fluctuate throughout our lives.

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