423Sexual
 Dysfunctions
Sexual dysfunctions  include delayed ejaculation, er ectile disorder, female orgasmic
disorder, female sexual intere st/arousal disorder, genito-pelvic pain/penetration disorder,
male hypoactive sexual desire disorder, premature (early) ejac ulation, substance/medication-
induced sexual dysfunction, other specified se xual dysfunction, and unspecified sexual dys-
function. Sexual dysfunctions ar e a heterogeneous group of disorders that are typically char-
acterized by a clinically significant disturbance in a person’s ability to respond sexually or to
experience sexual pleasure. An individual may have several sexual dysfunctions at the same
time. In such cases, all of the dysfunctions should be diagnosed. 
Clinical judgment should be used to determin e if the sexual difficulties are the result of
inadequate sexual stimulation; in these cases,  there may still be a need for care, but a di-
agnosis of a sexual dysfunctio n would not be made. These cases may include, but are not
limited to, conditions in which lack of know ledge about effective stimulation prevents the
experience of arousal or orgasm.
Subtypes are used to designate the onset of  the difficulty. In many individuals with
sexual dysfunctions, the time of onset may in dicate different etiolo gies and interventions.
Lifelong  refers to a sexual problem that has been present from first sexu al experiences, and
acquired  applies to sexual disorders that develop after a period of relatively normal sexual
function. Generalized  refers to sexual difficulties that  are not limited to certain types of
stimulation, situatio ns, or partners, and situational  refers to sexual difficulties that only oc-
cur with certain types of stimul ation, situations, or partners.
In addition to the lifelong/ acquired and generalized/situational subtypes, a number