Sexual Problems (Sexual Disorders) : Definition, Classification, & Diagnosis

Sexual Problems (Sexual Disorders) : Definition, Classification, & Diagnosis


  • A sexual problem is, according to the above definition, an obstacle to achieve the individual’s desired sexual experience.
  • Thus, it can be assumed that all human beings at least once during the lifetime have a sexual problem. But when does a problem become a medical issue?


Sexual problems may manifest themselves in different forms and at very different levels:


  • Sexual desire is frustrated and unfulfilled.
  • The body does not function sexually.
  • There is a loss of sexual motivation and interest.
  • The body has sex-specific characteristics (male/female), which are opposite to how the person feels about his or her sex (female/male).
  • The sexual behaviour of the person poses a problem to others or to the society in general.


ICD-10 classification

Sexual dysfunction, not
caused by organic
disorder or disease
Gender identity disorders Disorders of sexual preference Psychological &
disorders associated
with sexual development
and orientation
Lack or loss of sexual desire
Sexual maturation disorder
Sexual aversion Dual-role transvestism Fetishistic transvestism Egodystonic sexual orientation
Lack of sexual enjoyment Gender identity disorder of childhood Exhibitionism Sexual relationship disorder
Failure of genital response Other gender identity disorders Voyeurism Other psychosexual
development disorders
Orgasmic dysfunction Gender identity disorder, unspecified Paedophilia Psychosexual development disorder, unspecified
Premature ejaculation Sadomasochism
Non-organic vaginismus Multiple disorders of sexual preference
Non-organic dyspareunia Other disorders of sexual preference
Excessive sexual drive Disorder of sexual preference, unspecified
Unspecified sexual
dysfunction, not caused by organic
disorder or disease

DSM-5 Classification

Gender dysphoria Paraphilic disorder
Delayed ejaculation Gender dysphoria in children Voyeristic disorder
Erectile disorder Gender dysphoria in adolescents and adults Exhibitionistic disorder
Female orgasmic disorder Other specified gender dysphoria Frotteuristic disorder
Female sexual interest/arousal disorder Unspecified gender dysphoria Sexual masochism disorder
Genito-pelvic pain
Penetration disorder
Sexual sadism disorder
Male hypoactive sexual desire disorder Pedophilic disorder
Premature early ejaculation Fetishistic disorder
Other specified sexual dysfunction Transvestic disorder
Unspecified sexual dysfunction Other specified paraphilic disorders
Unspecified paraphilic disorder


Sexual dysfunctions are the most frequently found sexual problems among patients. The diagnosis of the sexual dysfunctions in practice is performed in three steps.

Step 1: Definition and Descriptive Diagnosis

It is useful to combine the ICD-10 with some additional criteria as defined in DSM-5.

The general characteristics in ICD-10 are:

  • G1. The subject is unable to participate in a sexual relationship as he or she should wish.
  • G2. The dysfunction occurs frequently, but may be absent on some occasions.
  • G3. The dysfunction has been present for at least 6 months.
  • G4. Not entirely attributable to any of the other mental and behavioural disorders in ICD-10, physical disorders
    (such as endocrine disorder) or drug treatment.

The additional criteria taken from the DSM-5 are:

  • Lifelong: The disturbance has been present since the individual became sexually active.
  • Acquired: The disturbance began after a period of relatively normal sexual function.
  • Generalized: Not limited to certain types of stimulation, situations or partners.
  • Situational: Only occurs with certain types of stimulation, situations or partners.
    Mild, moderate or severe distress over the symptoms.

Step 2: The explanatory working hypothesis

Step 3: Comprehensive Diagnosis

Combining the description and the working hypothesis, the health care professional can establish a comprehensive diagnosis which will serve as a basis for developing a therapeutic plan.

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