Psychosexual disorder

Objectives

.overview on normal sexuality-

common types of psychosexual-

.disorders

.Main outlines of the management-

Normal sexuality
:It depends on four interrelated factors
(.Sexual identity: genotype (XY or XX- 1
Gender identity: firm conviction of maleness or- 2
.femaleness
Gender role: behaviour that is build up- 3
cumulatively through experiences and
.learning
Sexual Orientation: describes that object of- 4
person’s sexual impulses (hetero, homo, or bi-
(.sexual
Four-phase response cycle
Desire: fantasies and desire to have sexual- 1
.activity
Excitement: brought by psychological and- 2
.physiological stimulation
Orgasm: peaking of sexual pleasure with- 3
contraction of the perineal muscles and pelvic
.reproductive organs
Resolution: brings body back to its resting- 4
state. (sense of well-being and muscular
(.relaxation
Sexual dysfunction is defined as a
disturbance in the sexual response cycle
.or as pain with sexual intercourse

:Sexual dysfunction can be

.Psychogenic-
.Due to substance abuse-
.Due to general medical condition-
Common types

:Hypoactive desire-
Often use inhibition of desire in a
defensive way to protect against
.unconscious fears about sex
Clinician should make the diagnosis taking
into account age and baseline of sexual
.interrest
:Sexual arousal disorders-
Persistent and recurrent inability to attain or
, maintain until completion of sexual activity
.lubrication in female or erection in male

Impotence is the chief complaint of more than

50% of all men complaining of sexual
.disorders
Sexual pain disorder

Dyspareunia: recurrent genital pain

occuring before, during, or after
.intercourse

Vaginismus: involuntary muscle

constriction of the outer third of the
vagina that interferes with penile
.insertion
Paraphilias

Abnormal expression of sexuality. They

can range from nearly normal behaviour
.to behaviour that is destructive or hurtful

Paraphiliac urges may occure rarely,

. intermittently, or compulsivly
: Pedophilia
recurrent intense sexual urges toward or
arousal by children 13 years of age or
.younger
.Most common paraphillia
.Perpetrator is usually a relative
.of victims are boys 60%
Masochism: aroused by being humiliated,
.beaten, or made to suffer

Sadism: aroused by psychologically and

physically dominating somebody else.
.Causing pain
.Fetishism: aroused by nonliving objects

Exhibitionism: aroused by exposing one’s

.genitals to an unsuspecting stranger

Voyeurism: observing people who are

.naked or engaged in sexual activity
Transvestic fetishism: dress in opposite-
.gender clothing

Telephone scatologia – intenet sex

Management

Psychotherapy is almost always treatment of

choice for sexual dysfunction disorder. There
is a sufficient evidence for specific
psychotherapy remedies to be used in certain
( psychosexual disorder (e.g couple therapy
Psychotropic medications, however, can play a
role in alleviating accompanied symptoms like
.anxiety and depression
Remember that psychotropic-
medications usually have sexual side
effects, most frequently loss of libido and
.delayed ejaculation
Remember to interview the sexual-
.partner
Finally, sexual disorders are not rare and-
can cause significant distress, so
! remember to ask your patients