Sexual Disorders

🔴 Sexual Disorders

📍Sex cycle
1-Arousal or thinking about sex
2-Excitement
3-Orgasm
4-Resolution (loss of erection)

*Male & female equally experience the first 3 stages but the male have rapid resolution (rapid decline) while female have gradual decline

*We need 5-30 minutes to get another erection (refractory period)

*This refractory period depends on :
-age
-psychological state
-experience
-body health

-other factors

✅ Disorders of sexual orientation

📍Homosexual

*Preserved gender identity

✅ Sexual dysfunction

📍Sexual desire disorder
-Hypoactive sexual disorder
*Deficiency or absence of sexual fantasies & desire

-Sexual aversion disorder
*more in women
*Rx by psychotherapy

📍Sexual arousal disorder
-Female sexual arousal disorder
*Persistent or recurrent partial or complete failure
*There is thinking about sex but the body does not response

-Male erectile disorder

📍Orgasmic disorder
-Female orgasmic disorder
*Called also (inhibited female orgasm or anorgasmia)
*It is a recurrent or persistent inhibition of female orgasm

-Male orgasmic disorder
*Called also (inhibited orgasm or retarded ejaculation)
*The ejaculation occurs with greater difficulty (if at all)
*A man with lifelong orgasmic disorder has never been able to ejaculate during coitus

-Premature ejaculation
*Persistent or recurrent achievement of orgasm & ejaculation before the pt wish to
*Usually occur before or immediately after entering the vagina
*More in college-educated men
*In 35-40% of men treated for sexual disorders

💡Consider a man a premature ejaculator if he could not satisfy his partner in at least half their episides of coitus 
 *Rx : by squeeze technique exercise, sex therapy, SSRI & TCA (by their side effects)

📍Sexual pain disorder
-Dyspareunia
*Occur in both male & female
*But more common in female
*You should exclude PID

-Vaginismus
*Involuntary contraction of the outer 1\3 of vagina
*Prevents penis penetration
*Rx by graduated dilators

💡Both dyspareunia & vaginismus are treated by use of excessive lubricants

📍Sexual dysfunction due to general medical condition or medication or substance side effects

💡General Rx of sexual dysfunction :
-dual-sex therapy
-group therapy
-pharmacotherapy
-mechanical Rx

-vascular surgery

✅ Abnormality of sexual preference (paraphilia)

📍Exhibitionism
-recurrent urge to expose the genitalia to a stranger
-exclusive to the male
-has 2 types = erectile & non-erectile
-another classification = married or single
-masturbating during or after the event

📍Fetishism
-prefer non-living things of the partner (shoes, gloves, pantyhose, stoking, …)

📍Transvestic fetishism
-wear the partner clothes or put her make up
-occurs in both male & female

📍Sexual masochism
-more common in men
-gaining pleasure from experience of physical or psychological pain

📍Sexual sadism
-usually starts before age of 18 yrs
-most of them are men
-gaining pleasure from apply physical or psychological pain on other

💡combined sadism & masochism —> lead to increase risk of death (sexual death)

📍Frotturism
-exclusive to the male
-rubbing his genitalia on the buttocks or other parts of the victim
-usually in crowded places

📍Voyeurism (scopophilia)
-enjoy by observing

📍Pedophilia
-prefer sex with child
-for children 13 yrs or younger
-over a period of at least 6 months
-now not regarded as disorder

📍Paraphilia NOS
-Necrophilia
-Zoophilia
-Coprophilia (linked to feces)
-Klismaphilia (anal injections)
-Urophilia

-Hypoxyphilia

✅ Disorders of gender identity (transsexualism)
(See the picture 👇)

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