There are many factors which may result in a person experiencing a<unk> . These may result from emotional or physical causes. Emotional factors include interpersonal or psychological problems, which include depression,<unk>  fears or guilt, past<unk>  trauma, and<unk>  disorders.<unk>  is especially common among people who have anxiety disorders. Ordinary anxiety can cause erectile dysfunction in men without psychiatric problems, but clinically diagnosable disorders such as panic disorder commonly cause avoidance of intercourse and premature ejaculation. Pain during intercourse is often a comorbidity of anxiety disorders among women. Physical factors that can lead to<unk> s include the use of drugs, such as alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs. For women, almost any physiological change that affects the reproductive system—premenstrual syndrome, pregnancy and the postpartum period, and menopause—can have an adverse effect on libido. Back injuries may also impact<unk>  activity, as can problems with an enlarged prostate gland, problems with blood supply, or nerve damage (as in<unk>  after spinal cord injuries). Diseases such as diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis may also impact activity, as can the failure of various organ systems (such as the heart and lungs), endocrine disorders (thyroid, pituitary, or adrenal gland problems), hormonal deficiencies (low testosterone, other androgens, or estrogen), and some birth defects. In the context of heterosexual relationships, one of the main reasons for the decline in<unk>  activity among these couples is the male partner experiencing erectile dysfunction. This can be very distressing for the male partner, causing poor body image, and it can also be a major source of low desire for these men. In aging women, it is natural for the vagina to narrow and atrophy. If a woman does not participate in<unk>  activity regularly (in particular, activities involving vaginal penetration), she will not be able to immediately accommodate a penis without risking pain or injury if she decides to engage in penetrative intercourse. This can turn into a vicious cycle that often leads to female<unk> . According to Emily Wentzell, American culture has anti-aging sentiments that have caused<unk>  to become "an illness that needs treatment" instead of viewing it as a natural part of the aging process. Not all cultures seek treatment; for example, a population of men living in Mexico often accept ED as a normal part of their maturing<unk> ity. Pelvic floor dysfunction Pelvic floor dysfunction can be an underlying cause of<unk>  in both women and men, and is treatable by pelvic floor physical therapy, a type of physical therapy designed to restore the health and function of the pelvic floor and surrounding areas. Female<unk>  Several theories have looked at female<unk> , from medical to psychological perspectives. Three social psychological theories include: the self-perception theory, the overjustification hypothesis, and the insufficient justification hypothesis: *Self-perception theory: people make attributions about their own attitudes, feelings, and behaviours by relying on their observations of external behaviours and the circumstances in which those behaviours occur *Overjustification hypothesis: when an external reward is given to a person for performing an intrinsically rewarding activity, the person's intrinsic interest will decrease *Insufficient justification: based on the classic cognitive dissonance theory (inconsistency between two cognitions or between a cognition and a behavior will create discomfort), this theory states that people will alter one of the cognitions or behaviours to restore consistency and reduce distress The importance of how a woman perceives her behavior should not be underestimated. Many women perceive sex as a chore as opposed to a pleasurable experience, and they tend to consider themselves<unk> ly inadequate, which in turn does not motivate them to engage in<unk>  activity. Several factors influence a women's perception of her<unk>  life. These can include race, gender, ethnicity, educational background, socioeconomic status,<unk>  orientation, financial resources, culture, and religion. Cultural differences are also present in how women view menopause and its impact on health, self-image, and<unk> ity. A study found that African American women are the most optimistic about menopausal life; Caucasian women are the most anxious, Asian women are the most inhibited about their symptoms, and Hispanic women are the most stoic. About one-third of the women experienced<unk> , which may lead to these women's loss of confidence in their<unk>  lives. Since these women have<unk>  problems, their<unk>  lives with their partners can become a burden without pleasure, and may eventually lose complete interest in<unk>  activity. Some of the women found it hard to be aroused mentally, while others had physical problems. Several factors can affect female dysfunction, such as situations in which women do not trust their sex partners, the environment where sex occurs being uncomfortable, or an inability to concentrate on the<unk>  activity due to a bad mood or burdens from work. Other factors include physical discomfort or difficulty in achieving arousal, which could be caused by aging or changes in the body's condition.<unk>  assault has been associated with excessive menstrual bleeding, genital burning, and painful intercourse (attributable to disease, injury, or otherwise), medically unexplained dysmenorrhea, menstrual irregularity, and lack of<unk>  pleasure. Physically violent assaults and those committed by strangers were most strongly related to reproductive symptoms. Multiple assaults, assaults accomplished by persuasion, spousal assault, and completed intercourse were most strongly related to<unk>  symptoms. Assault was occasionally associated more strongly with reproductive symptoms among women with lower income or less education, possibly because of economic stress or differences in assault circumstances. Associations with unexplained menstrual irregularity were strongest among African American women; ethnic differences in reported circumstances of assault appeared to account for these differences. Assault was associated with<unk>  indifference only among Latinas. Menopause The most prevalent of female<unk> s that have been linked to menopause include lack of desire and libido; these are predominantly associated with hormonal physiology. Specifically, the decline in serum estrogens causes these changes in<unk>  functioning. Androgen depletion may also play a role, but current knowledge about this is less clear. The hormonal changes that take place during the menopausal transition have been suggested to affect women's<unk>  response through several mechanisms, some more conclusive than others. Aging in women Whether or not aging directly affects women's<unk>  functioning during menopause is controversial. However, many studies, including Hayes and Dennerstein's critical review, have demonstrated that aging has a powerful impact on<unk>  function and dysfunction in women, specifically in the areas of desire,<unk>  interest, and frequency of orgasm. In addition, Dennerstien and colleagues found that the primary predictor of<unk>  response throughout menopause is prior<unk>  functioning, which means that it is important to understand how the physiological changes in men and women can affect<unk>  desire. Despite the apparent negative impact that menopause can have on<unk> ity and<unk>  functioning,<unk>  confidence and well-being can improve with age and menopausal status. The impact that a relationship status can have on quality of life is often underestimated. Testosterone, along with its metabolite dihydrotestosterone, is important to normal<unk>  function in men and women. Dihydrotestosterone is the most prevalent androgen in both men and women. Testosterone levels in women at age 60 are on average about half of what they were before the women were 40. Although this decline is gradual for most women, those who have undergone bilateral oophorectomy experience a sudden drop in testosterone levels, as the ovaries produce 40% of the body's circulating testosterone.<unk>  desire has been related to three separate components: drive, beliefs and values, and motivation. Particularly in postmenopausal women, drive fades and is no longer the initial step in a woman's<unk>  response.
Sexual dysfunction
Irregular menstruation
Ejaculation disorders
Urinary incontinence
Erectile dysfunction
Dyspareunia
Anorectal disorder
Delayed ejaculation