Sexual health problems where the mind is at play

1. Erectile Dysfunction
   ED is defined as the inability to get or keep an erection firm enough for a certain period of time required for healthy sexual functioning. Studies show that it affects 50 percent of men above forty and around 10 percent of men below the age of forty. Although physical causes like diabetes, heart disease, obesity or lifestyle choices – like excessive smoking and consumption of alcohol – can be contributing factors, almost 99.9 percent of the people suffering from ED also complain of stress or mental/emotional pressure. All these factors need to be addressed for any effective treatment of ED. 
2. Vaginismus
   Clinically identified as a sexual disorder, vaginismus is a condition which woman are unlikely to be aware of till they have their first sexual intercourse. Vaginismus leads to an involuntary spasm of muscles surrounding the outer layer of vagina when the body senses an impending penetration. This makes sex very painful and sometimes, the partner cannot penetrate at all because the pain is way too much. Such an issue requires detailed and long term behavioural therapy to figure out what might be causing the body to respond in such a way. 
3. Dysmenorrhea
   Quite common amongst adolescent women and teenagers, dysmenorrhea is a medical condition characterized by severe uterine pain during menstruation.The most common reason for it is the increased muscular activity during menstruation, but studies do suggest that there may be psychological or behavioral roots attached to this problem. Most gynecologists in India tell patients that the pain may go away after one gets married – in other words, when a woman goes through intercourse and pregnancy, leading to maximum uterine contraction. But dysmenorrhea may still continue as pain associated with it could be due to emotions and an individual's feelings around sex. Fear due to sex because of lack of sex education can also be one of the reason 
4. Dhat Syndrome
   In this condition, seen mostly in the Indian subcontinent, men with a history of premature ejaculation or impotence, may complain of passage of semen in the urine, mostly while sleeping in the night. This issue has no known physical, pathological or organic cause related to it. Men may not know that they are passing semen, but may complain of passing whitish fluid during urination. In the local culture, where a lot of anxiety and phobia surround masturbation  – and the resultant loss of 'vital' fluids  – the Dhat Syndrome is considered an unconscious symptom of the same. Cognitive Behaviour Therapy (CBT) is considered very effective in treating this syndrome.
5. Anorgasmia
   As the name suggests, anorgasmia is the inability to achieve orgasm despite adequate stimulation. In males, it can present as delayed ejaculation and total the lack of a clitoral or vaginal orgasm in women. In fact it is more common in women than in men; more so in post-menopausal women. Although the condition is known to be caused by a variety of factors such as like diabetic neuropathy, multiple sclerosis, genital mutilations or pelvic trauma, there also exist many strong psychological reasons. Thus, besides large-scale medication behavioural sex therapy is also often recommended for anorgasmia.

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