A Q and A on Sexual Function
Sexual Function: straight answers to the questions people actually ask, with the figures behind them.
Difficulties with desire, arousal, pain or orgasm, in any gender.
Key takeaways
- Common contributors: medication, depression, relationship factors, hormonal change
- Antidepressants: a very common and often reversible cause
- Most useful single change: Raise it with your doctor; it is a common concern and they will have heard it.
- Commonest mistake: Buying sexual enhancement products online; FDA has found many contain hidden drugs.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
What is Sexual Function?
Difficulties with desire, arousal, pain or orgasm, in any gender.
Why does it matter?
These are common, frequently have a physical or medication cause, and are rarely raised in appointments.
Common contributors for Sexual Function?
Medication, depression, relationship factors, hormonal change.
Erectile dysfunction for Sexual Function?
Can be an early sign of heart disease or diabetes.
Painful sex for Sexual Function?
Always warrants assessment; it is not something to tolerate.
What is the single most useful thing to do?
Raise it with your doctor; it is a common concern and they will have heard it.
What is the most common mistake?
Buying sexual enhancement products online; FDA has found many contain hidden drugs.
When should I see a doctor?
See your doctor for painful sex, which always warrants assessment, or for new erectile dysfunction, which can be an early sign of heart disease or diabetes. Never take PDE5 inhibitors such as sildenafil with nitrate medicines. Go to the emergency room for an erection lasting more than four hours, and call 911 for chest pain during or after sex.
More questions, answered
Is it normal for desire to change over time?
Yes. Desire naturally varies with age, stress, health, hormones and relationship stage. For many people, desire becomes more responsive, appearing after intimacy begins rather than before. It becomes a problem worth addressing only when the change distresses you or your partner.
Can antidepressants cause sexual problems?
Yes. Some antidepressants commonly reduce desire, delay orgasm or affect arousal. Options include adjusting the dose, switching to a medicine with fewer sexual effects, or adding treatment. Talk to your prescriber rather than stopping, because stopping suddenly can cause withdrawal symptoms and relapse.
Is it safe to buy erectile dysfunction pills online?
Only from a licensed US pharmacy with a valid prescription. FDA has found many supplements and online products marketed for sexual enhancement contain hidden prescription drugs or harmful ingredients, which can dangerously lower blood pressure, especially with nitrate medicines. If you see a product that promises fast results, treat that as a warning sign.
Why does sex hurt after menopause?
Lower estrogen thins and dries the tissues of the vagina and vulva, making them more fragile and less elastic. This is called genitourinary syndrome of menopause, and it tends to worsen without treatment. Lubricants, moisturizers and low-dose vaginal estrogen help many people.
Can stress alone cause erectile problems?
Stress and performance anxiety can certainly cause erectile difficulties, especially when erections are normal in other situations. However, it is worth having a physical assessment, because physical and psychological causes often coexist and erectile changes can signal heart disease. A simple checkup can rule this out.
Is it safe to have sex with heart disease?
For most people with stable heart disease, sex is safe. Your doctor can tell you when it is safe to resume after a heart attack or procedure, often based on your ability to do moderate activity. Report chest pain, unusual breathlessness or palpitations during sex.
Related topics
- Erectile Dysfunction: Sorting the Evidence From the Noise (Men's Health)
- Pelvic Floor: What the Evidence Actually Says (Women's Health)
- The Evidence on Stress, Without the Hype (Mental Health)
- What the Guidance Really Says About Mental Health and Long-Term Illness (Long-Term Conditions)
Where to go next
- The First Steps With Sexual Function
- The Short Guide to Sexual Function
- Sexual Function — the reference entry
- Sexual Health: The Complete Guide
- Sexual Health Services: What Published Guidance Supports
- Menstrual Cycle Tracking: What Published Guidance Supports
When to speak to a doctor
See your doctor for painful sex, which always warrants assessment, or for new erectile dysfunction, which can be an early sign of heart disease or diabetes. Never take PDE5 inhibitors such as sildenafil with nitrate medicines. Go to the emergency room for an erection lasting more than four hours, and call 911 for chest pain during or after sex.
Where this comes from
- National Institute of Diabetes and Digestive and Kidney Diseases — Erectile Dysfunction (ED)
- FDA — Tainted Sexual Enhancement Products
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.
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