Sexual dysfunction

Three years into a marriage everyone called perfect, Kamrul and Ruma have stopped trying. It began with one bad night and became a silence neither knows how to break. He searched online and quietly ordered something from a website. She assumes he no longer finds her attractive. Neither has said a word, at home or anywhere else.

An illustration drawn from common experience. The people are invented; the pattern is not.

Understanding sexual dysfunction

Sexual problems are common in both men and women: low desire, difficulty with arousal or erection, pain, premature or delayed ejaculation, or not reaching orgasm. Causes are often physical, including diabetes, high blood pressure, hormonal changes and some medicines, including some antidepressants. Others are psychological or relational: anxiety about performance, depression, stress, past trauma, conflict, or simply never having been taught much at all.

Signs and symptoms of sexual dysfunction

• A problem that has lasted several months and causes distress
• Avoiding intimacy because of fear of failure or pain
• Tension or distance in the relationship that has grown around it
• Using unregulated products bought online

Treatment for sexual dysfunction

A doctor first checks for physical causes and reviews medicines, because treating diabetes or changing a medicine can sometimes help. Psychosexual therapy, alone or as a couple, works on anxiety, communication and specific techniques, and helps many people with these problems. Everything said stays confidential.

What getting better can look like

Kamrul and Ruma might start with one conversation, in a room where it is ordinary and confidential to have it.

Common questions about sexual dysfunction

Is it safe to buy sex medicines online?

Unregulated medicines bought online can be dangerous, and they skip the step that matters most: finding the cause. Sexual problems often have physical causes, such as diabetes, high blood pressure, hormonal changes or other medicines, which a doctor can check and treat. Talking to a doctor about this is confidential.

Can stress or anxiety cause sexual problems?

Yes. Anxiety about performance, depression, stress, past trauma and conflict in the relationship can all cause or worsen sexual problems in men and women. Psychosexual therapy, alone or as a couple, helps many people, usually after a doctor has checked for physical causes.

When to see a psychiatrist

If a sexual problem is causing distress or putting strain on your relationship, you can talk about it in confidence. Please avoid unregulated medicines bought online; some are dangerous.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.