Talking about sexual dysfunction can be embarrassing, but this is an issue that is quite common among both men and women seeking substance abuse treatment.
If you’re experiencing difficulties, it’s important to keep in mind that the condition is likely only temporary and can be helped with the same strategies used to promote long-term sobriety.
Types of Sexual Dysfunction
The term sexual dysfunction is used to refer to problems that a person may have during the various stages of sexual activity. There are four general types of sexual dysfunction.
- Sexual Desire Disorder: This type of sexual dysfunction is marked by a noted decrease in libido. People with this type of disorder have little to no desire or interest in sexual activity.
- Sexual Arousal Disorder: Being unable to become aroused or excited during sexual activity is a sign of a sexual arousal disorder. In men, this may present itself as erectile dysfunction.
- Orgasm Disorder: The inability to have an orgasm is sometimes called anorgasmia. This condition can have physical, pharmacological, or psychological origins.
- Sexual Pain Disorder: Pain during intercourse mostly affects women. The medical term for this is either dyspareunia (painful intercourse) or vaginismus (involuntary painful spasms of the vaginal wall).
Sexual dysfunction is more common in people over 40, due to the various hormone, neurological, and circulatory changes that occur as people age. For example, diabetes and hypertension—two conditions that become more common as people age—are both linked to sexual dysfunction.
Sex addiction, a condition where someone compulsively engages in sexual activity despite negative consequences, is not considered a type of sexual dysfunction. It is most often grouped under the broad umbrella of process addictions, such as gambling addiction and food addiction. Process addictions are thought to be linked to dopamine levels in the brain, similar to the increase that occurs when abusing drugs or alcohol.
How Substance Use Causes Sexual Dysfunction
Although pop culture often portrays drug and alcohol use as a libido enhancer, the opposite is true for people who frequently use addictive substances. For example:
- Cocaine use can cause delayed or impaired ejaculation in men.
- Heroin use can make it difficult for women to reach orgasm.
- Marijuana can lead to erectile dysfunction by decreasing the sensation in certain stimulation receptors within the penis.
- Alcohol reduces inhibitions, but lowers the physiological signs of arousal. This can cause decreased arousal, diminished intensity of orgasm, and difficulty attaining orgasm.
When detox is completed and withdrawal symptoms have diminished, sexual function is often restored. The length of time this takes varies according to past substance use patterns and the specific details of your sexual dysfunction, but the majority of people report normal sexual function returns within one year of sobriety.
Psychological Causes of Sexual Dysfunction
Sometimes, sexual dysfunction that presents itself in addiction treatment is related to the psychological issues that led to a person’s drug or alcohol condition. For example:
- Someone with severe depression may have a markedly decreased libido.
- A person with anxiety may find it hard to relax long enough to enjoy sexual activity.
- A victim of sexual abuse may unconsciously associate sexual activity with pain.
Intensive counseling can help address psychological issues related to sexual dysfunction, thus making it possible for a person to enjoy healthy sexual activity once more. This counseling can be incorporated into an addiction treatment program, if needed.
If a person with a substance use disorder is married or in a long-term committed relationship, sexual dysfunction may be linked to feelings of guilt or shame regarding previous actions while under the influence. Substance abuse can create a great deal of tension in romantic relationships, which makes it difficult to enjoy healthy sexual activity. In this case, both partners need counseling to help build a stronger relationship.
Sexual Dysfunction as a Side Effect of Treatment Medications
In treatment, some medications can cause sexual dysfunction as a side effect. For example, many types of antidepressants are linked to sexual dysfunction. This side effect may diminish as the body adjusts to the medication, but you should discuss concerns with your care provider. He or she may be able to recommend a suitable alternative medication or suggest a lower dosage. Under no circumstances should you stop taking prescribed medication without consulting your care provider.
Patience Is Key
As you progress through your recovery journey, you’ll learn that patience is a virtue. Most causes of sexual dysfunction in people with substance use disorders are only temporary, so you can expect that you will be able to enjoy sexual activity once your condition stabilizes and your body adjusts to functioning without addictive substances.