Sexual dysfunction

Domain 8. Sexuality
Class 2. Sexual function
Diagnostic Code: 00059
Nanda label: Sexual dysfunction
Diagnostic focus: Sexual function

Sexual dysfunction is considered a nursing diagnosis, meaning it is an illness or health condition that nurses are prepared to treat. It is the health concern of pain or disruption in a patient’s ability to engage in a pleasurable and satisfying sexual experience. The nurse is responsible for caring for and promoting the physical, mental, and emotional well-being of the patient which includes assessing and treating sexual dysfunction.

NANDA Nursing Diagnosis Definition

The NANDA-International definition of Nursing Diagnosis: Sexual Dysfunction refers to an alteration in an individual’s normal pattern of sexual arousal, including the perception and expression of his or her own sexuality. It may be associated with physical, psychological, social and spiritual factors.

Defining Characteristics

For a definitive diagnosis, the following characteristics must be present:

Subjective Characteristics

• Verbal statements or reports of diminished or lack of sexual desire
• Verbal statements or reports of difficulty or inability to reach orgasm
• Verbal statements or reports of difficulty maintaining erections
• Verbal statements expressing hesitance towards sexual activities
• Decreased lubrication or self-lubrication
• Feelings of anxiety related to anticipated sexual activity

Objective Characteristics

• Diminished frequency of or complete lack of sexual activity
• Diminished or complete lack of sexual interest
• Changes in body language that suggest avoidance of sexual activities and/or topics
• Inability to maintain erection

Related Factors

There are several underlying factors that may contribute to a patient experiencing sexual dysfunction.

• Physical: Certain medical conditions such as heart and vascular diseases and diabetes, certain medications, the presence of pelvic organs and hormones, urinary incontinence and pain disorders.
• Psychological: Anxiety, depression, poor self-esteem, unresolved issues from the past, relationship problems, stress, insufficient knowledge/skills.
• Social: Cultural norms and taboos, access to resources (education & care), substance involvement, fear of intimacy, experience of abuse and trauma or gender identity.
• Spiritual: Negative perceptions about sex, inadequate relationship with God or faith tradition.

At Risk Population

While any individual can have sexual dysfunction, some populations are more likely to experience them than others. These populations include:

• Women: Women may be at risk of experiencing or exacerbating sexual dysfunction due to the hormonal changes associated with pregnancy, breastfeeding and menopause. Additionally, women are more likely to be prescribed major tranquilizers or other drugs that may cause sexual side effects.
• Older Adults: As we age, our bodies and minds change. This can lead to a decrease in sexual desire, erectile dysfunction, and vaginal dryness. Many medications used in chronic illnesses like high blood pressure and diabetes also cause sexual issues.
• LGBTQ+ Community: People who are part of the lesbian, gay, bisexual, transsexual, Queer or questioning communities may find that their cultural or religious views conflict with their sexuality. They may also face discrimination and stigma which can lead to difficulty with forming meaningful relationships or engaging in sexual activity.
• Individuals Living with Serious Illness: Chronic illness can have a significant impact on a person’s physical and emotional health. This can make participation in intimate relationships or engaging in sexual activity difficult.

Associated Conditions

There are many potential associated conditions that can affect sexual dysfunction. These include, but not limited to:

• Pain Disorders: Chronic pain can be both a symptom and cause of sexual dysfunction. High levels of stress can worsen these conditions and lead to decreased libido or difficulty experiencing pleasure.
• Substance Abuse: Some substances, such as alcohol, opiates and stimulants, can impair sexual performance by reducing sensations, inhibiting arousal and delaying ejaculation. Other drugs can lead to erectile dysfunction or difficulty attaining orgasm.
• Chronic Diseases: Many chronic diseases, such as diabetes and cystic fibrosis can affect sexual functioning. Hormonal changes, nerve damage, and reduced circulation all can contribute to low libido and erectile dysfunction.
• Mental Illness: Mental illness, such as depression and anxiety, can cause a decrease in libido or an inability to get aroused. Additionally, those taking antidepressant or antipsychotic medications often experience problems with sexual arousal or orgasm.

Suggested Use

The primary goal for the treatment of sexual dysfunction is to maximize the patient’s ability to engage in a pleasurable and satisfying sexual experience. Various techniques and therapies have been used to help alleviate symptoms and improve functioning.

Suggested Alternative NANDA Nursing Diagnosis

In addition to the diagnosis of Sexual Dysfunction, there are several other NANDA Nursing Diagnoses that can be applicable in the care of a patient experiencing difficulties with sexual functioning. These include:

• Impaired Comfort: related to pain or sensation causing interruption of regular activity.
• Disturbed Body Image: related to impaired appearance secondary to physical or emotional condition.
• Sexuality Pattern, Ineffective: related to absent or altered patterns of sexual response.
• Readiness for Enhanced Sexuality: related to client’s recognition of abilities and desires that remain dormant or that require improvement.

Usage Tips

When treating a patient with sexual dysfunction, healthcare professionals should consider the following tips:

• Talk openly and honestly with the patient to discuss their feelings and experiences regarding their sex life.
• Reduce stress levels (if possible) by addressing issues that could be contributing to the dysfunction.
• Develop a safe, nonjudgmental environment where the patient can feel comfortable discussing their concerns.
• Encourage positive communication between the patient and their partner, if applicable.
• Provide education on healthy sexual practices and how to optimally engage in intimacy.
• Refer the patient to a specialist, if necessary.

NOC Outcomes

The NOC outcomes for a patient seeking treatment of sexual dysfunction are as follows:

• Sexual Desire: increases the expression and pleasure of initiating and participating in sexual activity.
• Sexual Response: demonstrates appropriate responses during intimacy to achieve mutual pleasure.
• Sexual Orientation: expresses knowledge of sexual identity and owns acceptability of one’s sex and gender role.
• Risk -Taking Ability: accepts risk associated with sexual activities with informed consent.
• Health Beliefs: perceives satisfaction with sexual activity as positive health behavior.

Evaluation Objectives and Criteria

In order to assess whether the interventions have been successful, the following objectives and criteria should be observed:

• The patient is able to recognize their own sexual response pattern.
• The patient is capable of having a pleasurable sexual experience.
• The patient maintains an acceptable level of functioning with regards to sexual activity.
• The patient is able to engage in mutual, consensual sexual activity.

NIC Interventions

NIC interventions that would be useful in treating sexual dysfunction are as follows:

• Sexual Counseling: Includes individual and/or couples counseling to assist the patient in developing and/or improving skills to enhance intimate relationships.
• Rehabilitative Care: Addresses physical and psychological aspects of treating sexual dysfunction, including exercise, nutrition, lifestyle modifications, and psychotherapeutic counseling to enhance self-esteem and improve body image.
• Education: Offer evidence based information about anatomy and physiology, sexuality, contraception, sexual health, and sexually transmitted infections to the patient and their partner.
• Pharmacological Management: Uses medications to treat underlying medical conditions, reduce anxiety, correct hormonal imbalances and treat erectile dysfunction.

Nursing Activities

Nurses caring for a patient experiencing sexual dysfunction will need to perform a variety of activities. These may include:

• Assess the patient’s sexual health history, including previous sexual experiences and current sex life.
• Monitor patient response to interventions.
• Provide emotional support and recognize the patient’s feelings.
• Encourage healthy communication between patient and loved ones.
• Educate the patient on sexual health including anatomy and physiology.
• Refer the patient to necessary specialists, if applicable.

Conclusion

In conclusion, Nurses play an important role in caring for patients experiencing sexual dysfunction. Through proper assessment, education and interventions, nurses can ensure the patient’s physical, mental and emotional wellbeing is supported.

FAQs

• What is sexual dysfunction? Sexual dysfunction is a health concern of pain or disruption in a patient’s ability to engage in a pleasurable and satisfying sexual experience.
• What are some associated conditions that can lead to sexual dysfunction? Associated conditions include chronic pain, substance abuse, chronic diseases and mental illness.
• What is the primary goal for the treatment of sexual dysfunction? The primary goal for the treatment of sexual dysfunction is to maximize the patient’s ability to engage in a pleasurable and satisfying sexual experience.
• What types of activities should nurses perform when caring for a patient with sexual dysfunction? Activities may include assessing the patient’s sexual health history, providing emotional support and recognizing the patient’s feelings, providing education on sexual health, and referring the patient to necessary specialists.
• What are suggested alternative NANDA Nursing Diagnosis that can be used to care for a patient encountering sexual dysfunction? Suggested alternative NANDA Nursing Diagnosis include Impaired Comfort, Disturbed Body Image, Sexuality Pattern, Ineffective, and Readiness for Enhanced Sexuality.