Other sexual dysfunctions. Erectile disorder may coexist with premature (early) ejacu- lation and male hypoactive sexual desire disorder.
Erectile disorder can be comorbid with other sexual diagnoses, such as premature (early) ejaculation and male hypoactive sexual desire disorder, as well as with anxiety and de- pressive disorders. Erectile disorder is common in men with lower urinary tract symptoms related to prostatic hypertrophy. Erectile disorder may be comorbid with dyslipidemia, car- diovascular disease, hypogonadism, multiple sclerosis, diabetes mellitus, and other diseases that interfere with the vascular, neurological, or endocrine function necessary for normal erectile function.
Relationship to International Classification of Diseases
Erectile response is coded as failure of genital response in ICD-lO (F22).
Diagnostic Criteria 302.73 (F52.31)
A. Presence of either of the following symptoms and experienced on almost all or all (ap- proximately 75%—100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts): 1. Marked delay in, marked infrequency of, or absence of orgasm.
2. Markedly reduced intensity of orgasmic sensations.
B. The symptoms in Criterion A have persisted tor a minimum duration of approximately 6 months.
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress (e.g., partner violence) or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.
Specify whether:
Lifelong: The disturbance has been present since the individual became sexually active.
Acquired: The disturbance began after a period of relatively normal sexual function.
Specify whether:
Generalized: Not limited to certain types of stimulation, situations, or partners.
Situational: Only occurs with certain types of stimulation, situations, or partners.
Specify it:
Never experienced an orgasm under any situation.
Specify current severity:
Mild: Evidence of mild distress over the symptoms in Criterion A.
Moderate: Evidence of moderate distress over the symptoms in Criterion A.
Severe: Evidence of severe or extreme distress over the symptoms in Criterion A.
Female orgasmic disorder is characterized by difficulty experiencing orgasm and / or markedly reduced intensity of orgasmic sensations (Criterion A). Women show wide vari- ability in the type or intensity of stimulation that elicits orgasm. Similarly, subjective descrip- tions of orgasm are extremely varied, suggesting that it is experienced in very different ways, both across women and on different occasions by the same woman. For a diagnosis of female orgasmic disorder, symptoms must be experienced on almost all or all (approx- imately 75%—100%) occasions of sexual activity (in identified situational contexts or, if generalized, in all contexts) and have a minimum duration of approximately 6 months.
The use of the minimum severity and duration criteria is intended to distinguish transient orgasm difficulties from more persistent orgasmic dysfunction. The inclusion of ”approx- does not meet the recommended 6-month threshold.
For a woman to have a diagnosis of female orgasmic disorder, clinically significant dis- tress must accompany the symptoms (Criterion C). In many cases of orgasm problems, the causes are multifactorial or cannot be determined. If female orgasmic disorder is deemed to be better explained by another mental disorder, the effects of a substance/ medication, or a medical condition, then a diagnosis of female orgasmic disorder would not be made.
Finally, if interpersonal or significant contextual factors, such as severe relationship dis- tress, intimate partner violence, or other significant stressors, are present, then a diagnosis of female orgasmic disorder would not be made.