Abstract
Anxiety is an important maintaining factor in sexual problems, so it is not a surprise that anxiety disorders have the highest prevalence of comorbid sexual problems among all the mental disorders.
Some sexual problems are specific for a specific anxiety disorder. Men with panic disorder have a high prevalence of erectile dysfunction, while women with the same anxiety disorder have high rates of orgasmic disorders. Obsessive-compulsive disorder (OCD) is tightly connected with sexuality as in many patients with OCD, their obsessions have sexual content. One of the prevalent obsessions is about sexual orientation. Also, many OCD patients consider sexuality as an anxiety-provoking subject, so their OCD symptoms worsen after masturbation or when fantasizing about sex. Patients with social phobia have problems in dating and finding a partner as they fear social situations. People suffering from post traumatic stress disorder (PTSD) have high comorbidity of erectile dysfunction and may have communication problems and intimacy concerns. The pathophysiology of sexual problems in anxiety disorders can be explained also by the fact that both share some brain structures (i.e., amygdala), neurotransmitter systems (e.g., noradrenergic activity), and the importance of hypothalamic-pituitary-adrenal axis.
The treatment of sexual problems in anxiety disorder patients should be adjusted to their anxiety symptoms, and anxiety-reducing techniques should be an integral part of the therapy. Emotions connected to sexuality should be explored and normalized, and when sexual symptoms are just symptoms of their anxiety disorder, this should be clearly explained to the patient.
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References
Brotto L, Atallah S, Johnson-Aqbakwu C, et al. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2016;13(4):538–71.
Telch MJ, Pujols Y. The erectile performance anxiety index: scale development and psychometric properties. J Sex Med. 2013;10(12):3019–28.
Seligman LD, Hovey JD, Chacon K, et al. Dental anxiety: an understudied problem in youth. Clin Psychol Rev. 2017;55:25–40.
American Psychiatric Association. Diagnostic and statistical manual of Mental Disorders, fifth edition (DSM-5). Washington, DC: American Psychiatric Association; 2013.
Fontenelle LF, de Souza WF, de Menezes GB, et al. Sexual function and dysfunction in Brazilian patients with obsessive-compulsive disorder and social anxiety disorder. J Nerv Ment Disord. 2007;195(3):254–7.
Minnen AV, Kampman M. The interaction between anxiety and sexual functioning: a controlled study of sexual functioning in women with anxiety disorders. Sex Relatsh Ther. 2000;15:47–57.
Aksoy UM, Aksoy SG, Maner F, et al. Sexual dysfunction in obsessive compulsive disorder and panic disorder. Psychiatr Danub. 2012;24(4):381–5.
Munoz V, Stravynski A. Social phobia and sexual problems: a comparison of social phobic, sexually dysfunctional and normal individuals. Br J Clin Psychol. 2010;49:53–66.
Blumentals WA, Gomez-Caminero A, Brown RR, et al. A case-control study of erectile dysfunction among men diagnosed with panic disorder. Int J Impot Res. 2004;16:299–302.
Mercan S, Karamustafalioglu O, Ayaydin EB, et al. Sexual dysfunction in female patients with panic disorder alone or with accompanying depression. Int J Psychiatry Clin Pract. 2006;10(4):235–40.
Aksaray G, Yelken B, Kaptanogllu C, et al. Sexuality in women with obsessive compulsive disorder. J Sex Marital Therapy. 2001;27(3):273–7.
Hahn AM, Tirabassi CK, Simons RM, et al. Military sexual trauma, combat exposure, and negative urgency, as independent predictors of PTSD and subsequent alcohol problems among OEF/OIF veterans. Psychol Serv. 2015;12(4):378–83.
Tran JK. Sexual dysfunction in veterans with post-traumatic stress disorder. J Sex Med. 2015;12(4):847–55.
Arbanas G. Does post-traumatic stress disorder carry a higher risk of sexual dysfunctions? J Sex Med. 2010;7(5):1816–21.
Badour CL, Gros DF, Szafranski DD, et al. Sexual problems predict PTSD and depression symptom change among male OEF/OIF veterans completing exposure therapy. Psychiatry. 2016;79(4):403–17.
Anticevic V, Britvic D. Sexual functioning in war veterans with posttraumatic stress disorder. Croat Med J. 2008;49(4):499–505.
Sobot V, Ivanovic-Kovacevic S, Markovic J, et al. Role of sexual abuse in development of conversion disorder: case report. Eur Rev Med Pharmacol Sci. 2012;16:276–9.
Farina B, Mazzotti E, Pasquini P, et al. Somatoform and psychoform dissociation among women with orgasmic and sexual pain disorders. J Trauma Dissociation. 2011;12:526–34.
Bandini E, Corona G, Ricca V, et al. Hysterical traits are not from the uterus but from the testis: a study in men with sexual dysfunction. J Sex Med. 2009;6:2321–31.
Cogan R, Cochran BS, Velarde LC, et al. Sexual fantasies, sexual functioning, and hysteria among women. Psychoanal Psychol. 2007;24(4):697–700.
Corretti G, Pierucci S, Nisita C, et al. Hysteria-like symptoms and sexual disorders: a study in 175 sexological patients. Theol Sex. 2004;38:31–4.
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Arbanas, G. (2021). Anxiety and Somatoform Disorders. In: Lew-Starowicz, M., Giraldi, A., Krüger, T. (eds) Psychiatry and Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-52298-8_18
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DOI: https://doi.org/10.1007/978-3-030-52298-8_18
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