Sexual Dysfunction and Infertility

  • Narayana Reddy
  • Varsha Swamy
  • N. Pandiyan
  • Shah Dupesh


Human sexuality is influenced by one’s cultural, societal, religious and personal beliefs. Importantly, sexuality influences ones sexual behaviour. Sexual dysfunctions can affect either the male or the female partner in a couple. A sexual dysfunction is said to occur when there is a problem affecting any one of the phases of desire, arousal, orgasm and resolution, in the human sexual response cycle. This chapter briefly describes the various causes of sexual dysfunctions afflicting both male and female, commonly encountered in an infertility setting. While giving an in-depth review of the different sexual dysfunctions is beyond the scope of this chapter, the aim of this chapter is to briefly describe management strategies for the various dysfunctions which can be used at a primary care level.


Erectile Dysfunction Sexual Function Sexual Dysfunction Premature Ejaculation Sexual History 


  1. Abramson PR, Pinkerton SD. With pleasure: thoughts on the nature of human sexuality. New York: Oxford University Press; 2002.Google Scholar
  2. American Psychiatric Association. Task force on sexually dangerous offenders. Dangerous sex offenders: a task force report of the American Psychiatric Association. Washington, D.C: American Psychiatric Pub; 1999.Google Scholar
  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington, DC: American Psychiatric Publication; 2013.CrossRefGoogle Scholar
  4. Aydin S, Odabas Ö, Ercan M, Kara H, Agargün MY. Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction. Br J Urol. 1996;77(2):256–60.Google Scholar
  5. Basson R, Rees P, Wang R, Montejo AL, Incrocci L. Sexual function in chronic illness. J Sex Med. 2010;7(1pt2):374–88.CrossRefPubMedGoogle Scholar
  6. Buffum J. Pharmacosexology: the effects of drugs on sexual function–a review. J Psychoactive Drugs. 1982;14(1–2):5–44.CrossRefPubMedGoogle Scholar
  7. Connolly KJ, Edelmann RJ, Cooke ID. Distress and marital problems associated with infertility. J Reprod Infant Psychol. 1987;5(1):49–57.CrossRefGoogle Scholar
  8. DeBusk R, Drory Y, Goldstein I, Jackson G, Kaul S, Kimmel SE, Kostis JB, Kloner RA, Lakin M, Meston CM, Mittleman M. Management of sexual dysfunction in patients with cardiovascular disease: recommendations of the Princeton Consensus Panel. Am J Cardiol. 2000;86(2):62–8.CrossRefGoogle Scholar
  9. Dunn ME, Trost JE. Male multiple orgasms: a descriptive study. Arch Sex Behav. 1989;18:377–87.CrossRefPubMedGoogle Scholar
  10. Elia G, Bergman A. Pelvic muscle exercises: when do they work? Obstetrics Gynecol. 1993;81(2):283–6.Google Scholar
  11. Epstein N. Cognitive therapy with couples. Springer, Pennsylvania; 1983.Google Scholar
  12. Frank E, Anderson C, Rubinstein D. Frequency of sexual dysfunction in normal couples. N Engl J Med. 1978;299(3):111–5.CrossRefPubMedGoogle Scholar
  13. Goldstein I, Young JM, Fischer J, Bangerter K, Segerson T, Taylor T. Vardenafil, a new phosphodiesterase type 5 inhibitor, in the treatment of erectile dysfunction in men with diabetes a multicenter double-blind placebo-controlled fixed-dose study. Diabetes Care. 2003;26(3):777–83.CrossRefPubMedGoogle Scholar
  14. Gratzke C, et al. Anatomy, physiology, and patho-physiology of erectile dysfunction. J Sex Med. 2010;7(1 Pt 2):445–75.CrossRefPubMedGoogle Scholar
  15. Grenier G, Byers ES. The relationships among ejaculatory control, ejaculatory latency, and attempts to prolong heterosexual intercourse. Arch Sex Behav. 1997;26(1):27–47.CrossRefPubMedGoogle Scholar
  16. Habke AM, Hewitt PL, Flett GL. Perfectionism and sexual satisfaction in intimate relationships. J Psychopathol Beha Asses. 1999;21(4):307–22.CrossRefGoogle Scholar
  17. Halvorsen JG, Metz ME. Sexual dysfunction, part II: diagnosis, management, and prognosis. J Am Board Fam Pract. 1992;5(2):177–92.PubMedGoogle Scholar
  18. Horowitz JD, Goble AJ. Drugs and impaired male sexual function. Drugs. 1979;18(3):206–17.CrossRefPubMedGoogle Scholar
  19. Kaplan HS. The evaluation of sexual disorders: psychological and medical aspects. New York: Psychology Press; 1983.Google Scholar
  20. Kaplan HS. The new sex therapy. Springer, New York; 1980.Google Scholar
  21. Khan SD, Pandiyan N. Ejaculatory dysfunction—a mini review. Adv SexMed. 2015;5(02):39.Google Scholar
  22. Laan E, van Lunsen RH. Hormones and sexuality in postmenopausal women: a psychophysiological study. J Psychosom Obstet Gynecol. 1997;18:126–33.CrossRefGoogle Scholar
  23. Laumann EO, et al. The epidemiology of erectile dysfunction: results from the national health and social life survey. Int J Impot Res. 1999;11 Suppl 1:S60–4.CrossRefPubMedGoogle Scholar
  24. Malavige LS, Levy JC. Erectile dysfunction in diabetes mellitus. J Sex Med. 2009;6(5):1232–47.CrossRefPubMedGoogle Scholar
  25. Masters WH, Masters VJ. Human sexual response. New York: Bantam Books; 1986.Google Scholar
  26. McCarthy BW, Fucito LM. Integrating medication, realistic expectations, and therapeutic interventions in the treatment of male sexual dysfunction. J Sex Marital Ther. 2005;31(4):319–28.CrossRefPubMedGoogle Scholar
  27. McMahon CG, Althof SE, Waldinger MD, Porst H, Dean J, Sharlip ID, Adaikan PG, Becher E, Broderick GA, Buvat J, Dabees K. REPORT: an evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) Ad Hoc committee for the definition of premature ejaculation. J Sex Med. 2008;5(7):1590–606.Google Scholar
  28. Meston CM, Buss DM. Why humans have sex. Arch Sex Beha. 2007;36(4):477–507.CrossRefGoogle Scholar
  29. Meston CM, Hull E, Levin RJ, Sipski M. Disorders of orgasm in women. J Sex Med. 2004;1(1):66–8.CrossRefPubMedGoogle Scholar
  30. Metz ME, McCarthy BW. The “Good-Enough Sex” model for couple sexual satisfaction. Sex Relation Therapy. 2007;22(3):351–62.CrossRefGoogle Scholar
  31. Metz ME, Pryor JL, Nesvacil LJ, Abuzzahab Sr F, Koznar J. Premature ejaculation: a psychophysiological review. J Sex Marital Ther. 1997;23(1):3–23.CrossRefPubMedGoogle Scholar
  32. Millheiser LS, Helmer AE, Quintero RB, Westphal LM, Milki AA, Lathi RB. Is infertility a risk factor for female sexual dysfunction? A case–control study. Fertil Steril. 2010;94(6):2022–5.CrossRefPubMedGoogle Scholar
  33. Miner M, et al. Cardiometabolic risk and female sexual health: the Princeton III summary. J Sex Med. 2012;9(3):641–51.CrossRefPubMedGoogle Scholar
  34. Morales A, Gingell C, Collins M, Wicker PA, Osterloh IH, Montorsi F, Wagner G. Clinical safety of oral sildenafil citrate (ViagraTM) in the treatment of erectile dysfunction. Int J Impot Res. 1998;10(2):69–74.CrossRefPubMedGoogle Scholar
  35. Padma-Nathan H, Steers WD, Wicker PA. Efficacy and safety of oral sildenafil in the treatment of erectile dysfunction: a double-blind, placebo-controlled study of 329 patients. Sildenafil Study Group. Int J Clin Pract. 1998;52(6):375–9.PubMedGoogle Scholar
  36. Phillips NA. The clinical evaluation of dyspareunia. Int J Impot Res. 1998;10 Suppl 2:S117–20.PubMedGoogle Scholar
  37. Phillips NA. Female sexual dysfunction: evaluation and treatment. Am Fam Physician. 2000;62(1):127–48.PubMedGoogle Scholar
  38. Ramezanzadeh F, Aghssa MM, Jafarabadi M, Zayeri F. Alterations of sexual desire and satisfaction in male partners of infertile couples. Fertil Steril. 2006;85(1):139–43.CrossRefPubMedGoogle Scholar
  39. Read S, King M, Watson J. Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner. J Public Health. 1997;19(4):387–91.CrossRefGoogle Scholar
  40. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, O’Leary MP, Puppo P, Robertson C, Giuliano F. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003;44(6):637–49.CrossRefPubMedGoogle Scholar
  41. Segraves RT, Madsen R, Carter CS, Davis JM. Erectile dysfunction associated with pharmacological agents. In: Diagnosis and treatment of erectile disturbances. Springer, New york; 1985. p. 23–63.Google Scholar
  42. Simon JA, Kingsberg SA, Shumel B, Hanes V, Garcia Jr M, Sand M. Efficacy and safety of flibanserin in postmenopausal women with hypoactive sexual desire disorder: results of the SNOWDROP trial. Menopause. 2014;21:633–40.CrossRefPubMedGoogle Scholar
  43. Smith JF, Walsh TJ, Shindel AW, Turek PJ, Wing H, Pasch L, Katz PP. Sexual, marital, and social impact of a man’s perceived infertility diagnosis. J Sex Med. 2009;6(9):2505–15.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Striar S, Bartlik B. Stimulation of the libido: the use of erotica in sex therapy. Psychiatric Anna. 1999;29(1):60–2.CrossRefGoogle Scholar
  45. Taylor B, Davis S. Using the extended PLISSIT model to address sexual healthcare needs. Nurs Stand. 2006;21(11):35–40.CrossRefPubMedGoogle Scholar
  46. Thranov I, Klee M. Sexuality among gynaecologic cancer patients—a cross-sectional study. Gynecol Oncol. 1994;52:14–9.CrossRefPubMedGoogle Scholar
  47. Weiner DN, Rosen RC. Medications and their impact. In: Sipski ML, Alexander CJ, editors. Sexual function in people with disability and chronic illness: a health professional’s guide. Gaithersburg: Aspen; 1997.Google Scholar

Copyright information

© Springer India 2017

Authors and Affiliations

  • Narayana Reddy
    • 1
  • Varsha Swamy
    • 2
  • N. Pandiyan
    • 3
  • Shah Dupesh
    • 4
    • 5
  1. 1.(University of Madras), AASECT (American Association of Sexuality Educators Counsellors and Therapists), Dega Institute of Sexual MedicineT-NagarIndia
  2. 2.Bloom Fertility CenterVelacheryIndia
  3. 3.Department of Reproductive MedicineChettinad Hospital and Research Institute, International Academic Affiliations, Chettinad UniversityKelambakkamIndia
  4. 4.Centre of Excellence for Men’s health, The Women’s Infertility Clinic, Women’s centreT NagarIndia
  5. 5.Fortis Healthcare, Fortis Malar HospitalsAdyarIndia

Personalised recommendations