Sexual Dysfunctioning; subtypes; Major Sexual Dysfunctioning; delayed ejaculation; erectile dysfunctioning; ED; treatment;

2. Sexual dysfunctions are a heterogeneous
group of disorders that are typically
characterized by a clinically significant
disturbance in a person's ability to respond
sexually or to experience sexual pleasure.

3. • Lifelong refers to a sexual problem that has been
present from first sexual experiences.
• Acquired applies to sexual disorders that develop after
a period of relatively normal sexual function.

4. • Generalized refers to sexual difficulties that are not
limited to certain types of stimulation, situations, or
partners.
• Situational refers to sexual difficulties that only occur
with certain types of stimulation, situations, or partners.

5. • 1) partner factors (e.g., partner's sexual problems; partner's
health status)
• 2) relationship factors (e.g., poor communication;
discrepancies in desire for sexual activity)
3) individual vulnerability factors (e.g., poor body image; history
of sexual or emotional abuse), psychiatric comorbidity (e.g.,
depression, anxiety), or stressors (e.g., job loss, bereavement)
4) cultural or religious factors (e.g., inhibitions related to
prohibitions against sexual activity or pleasure; attitudes
toward sexuality)
5) medical factors relevant to prognosis, course, or treatment.

6. Delayed ejaculation, erectile disorder
Female orgasmic disorder, female sexual interest/arousal
disorder, genito-pelvic pain/penetration disorder,
Male hypoactive sexual desire disorder, premature (early)
ejaculation, substance/medication induced sexual
dysfunction
Other specified sexual dysfunction, and unspecified sexual
dysfunction.

7. Diagnostic Criteria
A. Either of the following symptoms must be
experienced on almost all or all occasions
(approximately 75%-100%) of partnered sexual
activity and without the individual desiring delay.
• 1. Marked delay in ejaculation.
• 2. Marked infrequency or absence of ejaculation.

8. B. The symptoms in Criterion A have persisted for a
minimum duration of approximately 6 months.
C. The symptoms in Criterion A cause clinically
significant distress in the individual.

9. D. The sexual dysfunction is not better explained by a
nonsexual mental disorder or as a
consequence of severe relationship distress or other
significant stressors and is not attributable
to the effects of a substance/medication or another
medical condition.

10. Mild: Evidence of mild distress over the symptoms in
Criterion A.
Moderate: Evidence of moderate distress over the
symptoms in Criterion A.
Severe: Evidence of severe or extreme distress over the
symptoms in Criterion A.

11. Genetic and physiological
Nerves and age-related decreased sex steroid secretion
may be associated with the increase in delayed
ejaculation in men older than 50 years.
Culture-Related Diagnostic issues

12. Substance/medication use.
Pharmacological agents, such as antidepressants,
antipsychotics, alpha sympathetic drugs, and opioid drugs.

13. e.g.,
Men who can ejaculate during sexual activity with one sex
but not the other
Men who can ejaculate with one partner but not another of
the same sex
Men with paraphilic arousal patterns
Men who require highly ritualized activity to ejaculate
during partnered sexual activity.

14. Treatment for delayed ejaculation depends on the cause.
There is no single intervention that works for all patients
and that the key to successful treatment is to identify the
source of the problem.
Some medications may help improve the symptoms of
delayed ejaculation, but none have yet been specifically
approved to treat it.

15. Prevalence is unclear because of the lack of a precise
definition of this syndrome. It is the least common male
sexual complaint.
Less than 1% of men will complain of problems with
reaching ejaculation that last more than 6 months.

16. Diagnostic Criteria
At least one of the three following symptoms must be
experienced on almost all or all (approximately 75%-
100%) occasions of sexual activity.
1. Marked difficulty in obtaining an erection during sexual
activity.
2. Marked difficulty in maintaining an erection until the
completion of sexual activity.
3. Marked decrease in erectile rigidity.

17. Lifelong: The disturbance has been present since the
individual became sexually active.
Acquired: The disturbance began after a period of
relatively normal sexual function.
Generalized : Not limited to certain types of stimulation,
situations, or partners.
Situational : Only occurs with certain types of stimulation,
situations, or partners.

18. Male sexual arousal is a complex process that involves the
brain, hormones, emotions, nerves, muscles and blood
vessels.
Physical causes
• Heart disease
• Diabetes
• Metabolic syndrome — a condition involving increased blood
pressure, high insulin levels, body fat around the waist and
high cholesterol
• Sleep disorders
• Treatments for prostate cancer or enlarged prostate
• Surgeries or injuries that affect the pelvic area or spinal cord

19. Psychological causes
The brain plays a key role in triggering the series of
physical events that cause an erection, starting with
feelings of sexual excitement.
• Depression, anxiety or other mental health conditions
• Stress
• Relationship problems due to stress, poor communication
or other concerns

20. • Age Factor
• Medical conditions
• Tobacco use
• Being overweight
• Certain medical treatments, such as prostate surgery or
radiation treatment for cancer
• Medications, including antidepressants, antihistamines and
medications to treat high blood pressure, pain or prostate
conditions
• Psychological conditions, such as stress, anxiety or
depression
• Drug and alcohol use

21. Drug treatments for erectile dysfunction
PDE-5 (phosphodiesterase-5) inhibitors.
Most of these pills are taken 30-60 minutes before sex - the
best known being the blue-colored pill sildenafil (Viagra).
Other options are:
• Vardenafil (Levitra)
• Tadalafil (taken as a once-daily pill; Cialis)
• Avanafil (Stendra)

22. • Vacuum devices
• Surgical treatments
Penile implants - these are a final option reserved
for men who have not had any success with drug
treatments and other non-invasive options.
Vascular surgery - another surgical option for some
men is vascular surgery, which attempts to correct some
blood vessel causes of erectile dysfunction.

23. Sex therapy and counseling is a specialized area and
access to properly trained counselors.
Treating the couple
Erectile problems are common in men diagnosed with
depression and posttraumatic stress disorder.

24. Approximately 13%-21% of men ages 40-80 years
complain of occasional problems with erections.
Approximately 2% of men younger than age 40-50 years
complain of frequent problems with erections, whereas
40%-50% of men older than 60-70 years may have
significant problems with erections.
About 20% of men fear erectile problems on their first
sexual experience, whereas approximately 8%
experienced erectile problems that hindered
penetration during their first sexual experience.

25. • Presented By Tarun Chauhan