What constitutes a sexual dysfunction? Not being able to get an erection one night? Experiencing difficulties having an orgasm during sexual intercourse? Having no sexual desire for your partner? Do sexual dysfunctions have to happen for extended periods of time, or do they happen only once in a while? There are many types of sexual dysfunc­tions, and they can happen at any point during sexual activity.

Sexual dysfunctions are classified by the Diagnostic and Statistical Manual (DSM), the major diagnostic system used in U. S. research and therapy. The DSM is occasionally up­dated, with the last text revision in 2000 (referred to as the DSM IV-TR; American Psychiatric Association, 2000). The DSM provides diagnostic criteria for the most com­mon sexual dysfunctions including description, diagnosis, treatment, and research findings.

Before we discuss the sexual dysfunctions, it’s important to differentiate between common problems with sexual functioning and true sexual dysfunctions. Common sex­ual problems include things such as insufficient foreplay, lack of enthusiasm for sex, and/or the inability to relax. These problems often occur infrequently and may or may not interfere with overall sexual functioning. Most of us have experienced a problem that has interfered with our sexual functioning at one point or another, but the problem went away without treatment. Even “normal” couples report periodic problems with sex­ual functioning (E. Frank et al., 1978). A sexual dysfunction is characterized by a dis­turbance in the sexual response that typically doesn’t go away by itself—in fact, it may get worse over time.

SEXUAL DYSFUNCTIONS: DEFINITIONS, CAUSES, AND TREATMENT STRATEGIESПодпись: Although our sexual response changes as we age, many older couples still enjoy an active, satisfying sex life.One more point is in need of clarification before moving on—as you will soon real­ize, the DSM classification system for sexual dysfunctions appears rather heterosexist in that often the criteria for diagnosis revolves around an inability to engage in vaginal in-

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