Sexual Disorder
Sexuality is an important component of emotional and physical intimacy that most men and women desire to experience throughout their lives.
Sexual functioning is a complex combination of bio-psycho-social process which is coordinated by neurological, vascular and endocrine systems and any approach to the study of human sexuality that stresses only in one dimension is counter-productive.
Sexual function and activity are closely linked with physical health.
Despite the importance of sexual function, sexual problems are highly prevalent yet frequently under-recognized and under diagnosed in clinical practice.
Classification
Sexual Disorders can be classified into 4 main types
Sexual Dysfunction, not caused by organic disorder or disease
Gender Identity Disorder
Psychological and behavioural disorders associated with sexual development and maturation
Paraphilias (Disorders of Sexual Preference)
Sexual Dysfunction
– The essential features of sexual dysfunctions are an inability to respond to sexual stimulation, or experience of pain during the sexual act.
– Dysfunctions can be defined by disturbance in the subjective sense of pleasure or desire usually associated with sex, or by the objective performance.
– Sexual dysfunctions can be life-long or acquired, generalized or situational and result from psychological factor, physiological factor, combined factors and numerous stressor including prohibitive cultural mores, health and partner issues, and relationship conflicts.
Sexual Dysfunction includes:
-Lack or loss of sexualdesire (Loss of LIBIDO, Frigidity)
-Sexual Aversion and lack of sexual enjoyment
-Failure of genital response (Erectile Dysfunction, Psychogenic Impotence, Female sexual arousal disorder)
-Orgasmic dysfunction (nhibited Orgasm)
-Premature ejaculation (PME)
-Nonorganic vaginismus
-Nonorganic dyspareunia
-Excessive sexualdrive (Nymphomaniac, Satyriasis)
-Other sexual dysfunction, not caused by organic disorders or disease
-Unspecified sexual dysfunction, not caused by organic disorder or disease
DIAGNOSIS:
-Diagnosis is clinical, a detailed physical examination and lab investigation (blood counts, blood sugar, LFT, Thyroid profile, Hormonal profile) coupled with a good history is a must in every patient to rule out an underlying physical cause.
-Certain lab techniques (Penile Plethysmograph) may help in differentiating organic an nonorganic sexual dysfunction.
-A large majority of dysfunctions are psychosexual in nature. A detailed sexual and personal history is important in finding out the underlying causes.
-It should be specified whether the sexual dysfunction is psychogenic alone or biogenic factor co-exist, whether the dysfunction is lifelong or acquired and whether the dysfunction is situational or generalized.
MANAGEMENT Of Sexual Dysfunction
1.Psychoanalysis
2. Behavioral Exercises
3.Drug Therapy
4.Integrated Sex Therapy
5.Hormone Therapy
6.Surgical Treatment
Gender Identity Disorder
– This disorder is characterized by disturbance in gender identity: the sense of one’s masculinity or femininity is disturbed.
– This group includes
1. Transsexualism
2. Dual-role transvestism
3. Gender identity disorder of childhood
4. Other gender identity disorders
5. Gender Identity disorder, unspecified
Disorders Of Sexual Preference (Paraphilias)
These are disorders of sexual preference in which sexual arousal occurs persistently and significantly in response to objects which are not a part of normal sexual arousal Includes:
-Fetishism
-Fetishistic Transvestism
-Exhibitionism
-Voyeurism
-Pedophilia
-Sadomasochism
-Multiple disorders of sexual preference
-Other disorders of sexual preference
-Disorder of sexual preference unspecified
Psychological and Behavioural disorders associated with Sexual Development & Orientation
– Sexual Maturation Disorder
– Egodystonic Sexual Orientation
– Sexual Relationship Disorder
