ABSTRACT
Sexual problems are the major cause of separation and divorce in the first 2 years of marriage. This is a surprise to those who believe the claim that people are having the most exquisitely satisfying sex in the history of the world. Although there is more information and discussion of sexual issues than at any time in human history, this has not translated into healthier sexual functioning or greater sexual satisfaction. Couples are not functioning better sexually than their parents’ generation. What has changed are the types of problems. Sexual dysfunction in the 21st century is less likely to be caused by lack of information or repressive sexual attitudes. Problems of inhibited sexual desire, premature ejaculation, female nonorgasmic response, erectile dysfunction, and painful intercourse are frequent. There is a troubling increase in secondary dysfunction (i.e., the person or couple had been functional, but sex is now problematic), especially inhibited sexual desire. Rates of sexual problems (fifty percent of married couples complain of sexual dysfunction or dissatisfaction) have not changed in 20 years but have shifted to those caused by unrealistic expectations, performance anxiety, and disappointment and alienation.
