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Sexual Disorders

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Sexual Disorders Sexual Disorders Presentation Transcript

  • Sexual Disorders
    • Sexual dysfunctions are disorders related to a particular phase of the sexual response cycle. For example, sexual dysfunctions include sexual desire disorders, sexual arousal disorders, orgasm disorders, and sexual pain disorders. If a person has difficulty with some phase of the sexual response cycle or a person experiences pain with sexual intercourse, he/she may have a sexual dysfunction.
  • Examples of sexual dysfunctions include:
    • Hypoactive Sexual Desire Disorder. This disorder may be present when a person has decreased sexual fantasies and a decreased or absent desire for sexual activity. In order to be considered a sexual disorder the decreased desire must cause a problem for the individual. In this situation the person usually does not initiate sexual activity and may be slow to respond to his/her partner's sexual advances. This disorder can be present in adolescents and can persist throughout a person's life. Many times, however, the lowered sexual desire occurs during adulthood, often times following a period of stress.
    • Sexual Aversion Disorder. A person who actively avoids and has a persistent or recurrent extreme aversion to genital sexual contact with a sexual partner may have sexual aversion disorder. In order to be considered a disorder, the aversion to sex must be a cause of difficulty in the person's sexual relationship. The individual with sexual aversion disorder usually reports anxiety, fear, or disgust when given the opportunity to be involved sexually. Touching and kissing may even be avoided. Extreme anxiety such as panic attacks may actually occur. It is not unusual for a person to feel nauseated, dizzy, or faint.
    • Female Sexual Arousal Disorder. Female sexual arousal disorder is described as the inability of a woman to complete sexual activity with adequate lubrication. Swelling of the external genitalia and vaginal lubrication are generally absent. These symptoms must cause problems in the interpersonal relationship to be considered a disorder. It is not unusual for the woman with female sexual arousal disorder to have almost no sense of sexual arousal. Often, these women experience pain with intercourse and avoid sexual contact with their partner.
    • Male Erectile Disorder. If a male is unable to maintain an erection throughout sexual activity, he may have male erectile disorder. This problem must be either persistent or recurrent in nature. Also, the erectile disturbance must cause difficulty in the relationship with the sexual partner to be defined as a disorder. Some males will be unable to obtain any erection. Others will have an adequate erection, but lose the erection during sexual activity. Erectile disorders may accompany a fear of failure. Sometimes this disorder is present throughout life. In many cases the erectile failure is intermittent and sometimes dependent upon the type of partner or the quality of the relationship.
    • Female Orgasmic Disorder. Female orgasmic disorder occurs when there is a significant delay or total absence of orgasm associated with the sexual activity. This condition must cause a problem in the relationship with the sexual partner in order to be defined as a disorder.
    • Male Orgasmic Disorder. When a male experiences significant delay or total absence of orgasm following sexual activity, he may have male orgasmic disorder. In order to be qualified as a disorder, the symptoms must present a significant problem for the individual.
    • Premature Ejaculation. When minimal sexual stimulation causes orgasm and ejaculation on a persistent basis for the male, he is said to have premature ejaculation. The timing of the ejaculation must cause a problem for the person or the relationship in order to be qualified as a disorder. Premature ejaculation is sometimes seen in young men who have experienced premature ejaculation since their first attempt at intercourse.
    • Dyspareunia. Dyspareunia is a sexual pain disorder. Dyspareunia is genital pain that accompanies sexual intercourse. Both males and females can experience this disorder, but the disorder is more common in women. Dyspareunia tends to be chronic in nature.
    • What can people do if they need help? If you, a friend, or a family member would like more information and you have a therapist or a physician, please discuss your concerns with that person.
    • Illness and disease Drugs   -beta blockes
    • Alcoholism (neuropathy) – thiazide diuretics
    • Diabetes mellitus - tricyclic antidepressants
    • Arterial disease eg Leriche syndrome - phenothiazines
    • Renal failure - spironolactone
    • Carcinomatosis -cimetidine
    • Neurosyphilis - cannabis
    • Hypothalamo-pituitary dysfunction
    • Liver failure
    • Multiple sclerosis
    • and many others
    • Physical causes of dyspareunia that would need to be excluded
    • Female 
    • Failure of vaginal lubrication
    • Failure of vasocongestion
    • Failure of uterine elevation and vaginal ballooning during arousal
    • Oestrogen deficiency leading to atrophic vaginitis
    • Radiotherapy for malignancy
    • Vaginal infection e.g. Trichomonas or herpes
    • Vaginal irritation e.g. sensitivity to creams or deodorants
    • Abnormal tone of pelvic floor muscles
    • Scarring after episiotomy or surgery
    • Bartholin's gland cysts/abscess
    • Rigid hymen, small introitus
    • Males
    • Painful retraction of the foreskin
    • Herpetic and other infections
    • Asymmetrical erection due to fibrosis or Peyronie's disease
    • Hypersensitivity of the glans penis
  • What can be done?
    • behavioural psychotherapy and physical
    • Giving and Receiving Partners take turns in giving and then receiving touch and massage, i.e. giving pleasure, without at first touching breast or genital areas. THis giving and receiving exercise is called sensate focus.