Sexual disorders

Note: This section covers both men’s business and women’s business.

Sexual disorders or dysfunction can affect both men and women, and can negatively impact on a person’s quality of life, self-esteem, relationships and sense of identity [1][2].

Sexual disorders that affect both men and women include, but are not limited to:

• infertility
• lack of libido (sexual interest)
• inability to enjoy sex or experience pleasure
• anxiety about performance
• worry about looking unattractive during sex [3].

Other sexual disorders are gender specific.

For males, erectile dysfunction (ED) and premature ejaculation (PE) are common among the general population; both conditions affecting approximately 20% of men at some point in their lives [4][5]. Although ED is more prevalent among older men, younger men are also frequently affected [6]. The prevalence of PE does not increase with age and can affect men of all ages [6].

Among Aboriginal and Torres Strait Islander men, the prevalence of ED increases across age groups, from about 10% in younger men to 28% in older men [7]. ED among Aboriginal and Torres Strait Islander men, particularly those living in a remote location, has been strongly associated with chronic disease [7]. The prevalence of sexual health disorders among Aboriginal and Torres Strait Islander men may correspond to the high rates of CVD, diabetes and other chronic diseases among this population [8].

Other sexual disorders that can be experienced by men include:

• blood in semen
• foreskin problems and circumcision
• prostate enlargement
• testosterone deficiency [5].

Some women may experience sexual disorders throughout their reproductive years including difficulties falling pregnant (infertility) or problems carrying a pregnancy to full-term [9][10]. Aboriginal and Torres Strait Islander women are at higher risk of developing polycystic ovary syndrome (PCOS), a common hormonal condition linked to infertility [11]. Post-menopausal changes in women can also impact sexual function [10].

Other common sexual disorders that affect women include:

• vaginismus (tightening)
• dyspareunia (pain during penetration)
• physiological changes following childbirth
• problems caused by menstruation or menopause [2][4].

There are many factors that contribute to sexual disorders, some of the most common include:

• smoking, alcohol and other drugs
• obesity
• high blood pressure
• injury
• hormone changes
• trauma during childbirth
• anxiety, depression and stress
• chronic diseases
• prolonged use of medication [2][3][7].

Sexual problems are often regarded negatively and cause embarrassment; this is particularly so in Aboriginal and Torres Strait Islander communities where talking about sex or sexual health in general is often considered to be shameful [12]. Shame can be a serious barrier for Aboriginal and Torres Strait Islander people getting access to information about sexual disorders or related medical care and services. There are a growing number of sexual health promotion and awareness initiatives and services across Australia, and many that deal with “men’s business” and “women’s business” in culturally appropriate ways.