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.
|Sexual dysfunction, not
caused by organic
disorder or disease
|Gender identity disorders||Disorders of sexual preference||Psychological &
with sexual development
|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
|Orgasmic dysfunction||Gender identity disorder, unspecified||Paedophilia||Psychosexual development disorder, unspecified|
|Non-organic vaginismus||Multiple disorders of sexual preference|
|Non-organic dyspareunia||Other disorders of sexual preference|
|Excessive sexual drive||Disorder of sexual preference, unspecified|
dysfunction, not caused by organic
disorder or disease
|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|
|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.