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18 Psychosexual disorder

18 Psychosexual disorder

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Published by: api-3703352 on Dec 03, 2009
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03/18/2014

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Psychosexual disorder

Objectives
.overview on normal sexualitycommon 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 desireOften 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 disordersPersistent 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 psychotropicmedications 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 andcan cause significant distress, so ! remember to ask your patients

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