Sexual Dysfunction Causing Rifts in Relationships – Kathmandu

Radha Baral (name changed), a 42-year-old woman, suffered from weakness, frequent anger, occasional body heat, and constant heaviness in her body. These problems persisted for three years, leading to conflicts between her and her husband. Radha lost interest in physical intimacy, and her husband began accusing her of being involved with someone else. This pushed her into depression. When she consulted a doctor, she learned she was going through menopause.

Similarly, Vishnu Magar (name changed) was diagnosed with diabetes two years ago. Despite the doctor’s advice to take medication, he refused, fearing addiction. As the sole caretaker of his two and five-year-old sons, he had many responsibilities. Over time, diabetes caused him to become more irritable, weak, and physically heavy. Frequent fights with his wife led them to sleep in separate rooms. Only after seeking medical advice did he realize his condition was linked to sexual dysfunction.

These two cases highlight how sexual dysfunction is causing problems in Nepali society.

National Study on Sexual Dysfunction

A 2024 national study conducted by Solid Nepal, the Family Welfare Division, and the United Nations Population Fund found that people with chronic diseases like diabetes and high blood pressure experience higher rates of sexual dysfunction. Obesity also increases the risk.

The study showed:

• 66.8% of people without chronic illnesses reported sexual dysfunction.

• 71.8% of diabetics and 83.2% of those with high blood pressure faced the issue.

• If someone had two or more chronic conditions, the rate rose to 84.6%.

• Weight also played a role, 76.5% of underweight and 71.4% of severely obese individuals reported sexual dysfunction.

Causes of Sexual Dysfunction

Dr. Khem Bahadur Karki, a sexual and reproductive health specialist, explains that sexual dysfunction refers to problems in sexual life. He says, "Sexual dysfunction strains relationships, leading to domestic violence, abuse, and even criminal acts like rape."

Psychologist Sanam Poudel adds that when one partner enjoys intimacy while the other does not, emotional distance grows, often triggering domestic violence.

Menopause is a natural phase where women stop menstruating, often reducing sexual desire. However, husbands sometimes suspect infidelity, worsening family conflicts.

Gender Differences in Sexual Dysfunction

The study found:

• 72% of men and 67% of women over 30 experience sexual dysfunction.

• 5% of affected men have severe issues, while 32% face mild problems.

• 84% of men reported dissatisfaction during intercourse.

• 92% of women said both partners lacked mutual desire.

Psychological and Lifestyle Factors

Dr. Karki states that stress, busy lifestyles, family separation, conflicts, and work-life imbalance contribute to poor sexual health. Infections in reproductive organs also play a role.

Psychological factors affect 90% of cases, including stress, anxiety, depression, and trauma. Dr. Karki explains that dysfunction and mental health issues create a vicious cycle, worsening the problem.

Global Perspective

Though Nepal’s study is the first of its kind, sexual dysfunction is a worldwide issue:

• 49% of women and 43% of men globally face some form of sexual dysfunction.

• In Asia:

  • Malaysia: 27-69%

  • Singapore: 51-73%

  • Hong Kong: 64%

Substance abuse worsens the problem:

• 69% of alcohol users and 80% of long-term smokers who quit reported sexual dysfunction.

The Need for Open Discussion and Policy Changes

Dr. Karki stresses that sexual and reproductive health must be included in policies and programs. He suggests:

• Integrating sexual health counseling, treatment, and violence prevention in healthcare programs.

• Establishing sexual health counseling centers in hospitals.

Psychologist Poudel emphasizes open, respectful communication between partners. She says, "Sexual dysfunction is a common health issue—people should not hesitate to seek proper treatment."

Dr. Karki argues for political action: "Society has created a stigma around this issue. It must become a political agenda for open discussion."

Many avoid talking about sexual dysfunction, leading them to seek unproven treatments before consulting professionals.

Importance of Sex Education

Dr. Karki recommends comprehensive sex education in schools and universities to:

• Promote healthy sexual health among youth.

• Prevent sexual and gender-based violence.

• Stop child marriage and intimate partner violence.

Addressing sexual dysfunction openly can improve relationships and overall well-being in society.