05 April 2008

Sexual Disorders

Have you ever had trouble making love to your partner? Was your sexual experience an unpleasant one? Have you ever had embarrassing cravings for unnatural sex? Do you feel ashamed of your own sexual organ?

Many people experience sexual disorders. Still considered a taboo, most people prefer not to discuss their shame and rather opt to suffer in silence. Therefore, allow me to shed some light on this for the good of everyone.

Sexual disorders cover a wide range of aetiological factors and causes, notably the main groups being psychogenic and organic. However, in this article only the psychogenic causes will be discussed.

Part 1: Sexual Dysfunction

Sexual dysfunction covers the various ways in which an individual is unable to participate in a sexual relationship as he or she would wish. There may be lack of interest, lack of enjoyment, failure of the physiological responses necessary for effective sexual interaction (e.g. erection), or inability to control or experience orgasm.

Something keeping you from having good sex?

Lack or loss of sexual desire:
Loss of sexual desire is the principal problem and is not secondary to other sexual difficulties, such as erectile failure or dyspareunia. Lack of sexual desire does not preclude sexual enjoyment or arousal, but makes the initiation of sexual activity less likely. This Includes frigidity (female impotence), and hypoactive sexual desire disorder.

Sexual aversion:
The prospect of sexual interaction with a partner is associated with strong negative feelings and produces sufficient fear or anxiety that sexual activity is avoided.

Lack of sexual enjoyment:
Sexual responses occur normally and orgasm is experienced, but there is a lack of appropriate pleasure. This complaint is much more common in women than in men. This includes anhedonia (absense of sexual pleasure).

Failure of genital response:
In men, the principal problem is erectile dysfunction, i.e. difficulty in developing or maintaining an erection suitable for satisfactory intercourse. If erection occurs normally in certain situations, e.g. during masturbation or sleep or with a different partner, the causation is likely to be psychogenic. Otherwise, the correct diagnosis of nonorganic erectile dysfunction may depend on special investigations (e.g. measurement of nocturnal penile tumescence) or the response to psychological treatment.

In women, the principal problem is vaginal dryness or failure of lubrication. The cause can be psychogenic or pathological (e.g. infection) or estrogen deficiency (e.g. postmenopausal). It is unusual for women to complain primarily of vaginal dryness except as a symptom of postmenopausal estrogen deficiency. This Includes female sexual arousal disorder, male erectile disorder, and psychogenic impotence.

Orgasmic dysfunction:
Orgasm either does not occur or is markedly delayed. This may be situational (i.e. occur only in certain situations), in which case aetiology is likely to be psychogenic, or invariable, when physical or constitutional factors cannot be easily excluded except by a positive response to psychological treatment. Orgasmic dysfunction is more common in women than in men. This Includes inhibited orgasm (for both male and female), and psychogenic anorgasmy.

Premature ejaculation:
The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction. In severe cases, ejaculation may occur before vaginal entry or in the absence of an erection. Premature ejaculation is unlikely to be of organic origin but can occur as a psychological reaction to organic impairment, e.g. erectile failure or pain. Ejaculation may also appear to be premature if erection requires prolonged stimulation, causing the time interval between satisfactory erection and ejaculation to be shortened; the primary problem in such a case is delayed erection.

Nonorganic vaginismus:
Spasm of the muscles that surround the vagina, causing occlusion of the vaginal opening. Penile entry is either impossible or painful. Vaginismus may be a secondary reaction to some local cause of pain, in which case this category should not be used.
This includes psychogenic vaginismus.

Nonorganic dyspareunia:
Dyspareunia (pain during sexual intercourse) occurs in both women and men. It can often be attributed to a local pathological condition and should then be appropriately categorised. In some cases, however, no obvious cause is apparent and emotional factors may be important. This category is to be used only if there is no other more primary sexual dysfunction (e.g. vaginismus or vaginal dryness). This includes psychogenic dyspareunia.

Excessive sexual drive:
Both men and women may occasionally complain of excessive sexual drive as a problem is its own right, usually during late teenage or early adulthood. When the excessive sexual drive is secondary to an affective disorder or when it occurs during the early stages of dementia, the underlying disorder should be coded. This includes nymphomania (excessive sexual impulse in female), and satyriasis (excessive sexual impulse in male).

Part 2: Abnormal Sexual Preference, Paraphilia

Paraphilia is a term that describes a family of persistent, intense fantasies, aberrant urges, or behaviors involving sexual arousal to nonhuman objects, pain or humiliation experienced by oneself or one's partner, children, or nonconsenting individuals or unsuitable partners.

The recurrent urge or behavior to expose one's genitals to an unsuspecting person. Can also be the recurrent urge or behavior to perform sexual acts in a public place, or in view of unsuspecting persons.

Exhibitionism; cartoon of flasher.

The use of inanimate objects to gain sexual excitement. Partialism refers to fetishes specifically involving nonsexual parts of the body.

The recurrent urges of behavior of touching or rubbing against a nonconsenting person.

Frotteurism; man grabbing girl's behind.

The sexual attraction to prepubescent or peripubescent children.

Sexual masochism:
The recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer for sexual pleasure.

Sexual sadism:
The recurrent urge or behavior involving acts in which the pain or humiliation of a person is sexually exciting.

Transvestic fetishism:
A sexual attraction towards the clothing of the opposite gender.

The recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities, or may not be sexual in nature at all.

Other rarer paraphilias include telephone scatalogia (obscene phone calls), necrophilia (corpses), partialism (exclusive focus on one part of the body), zoophilia (animals), coprophilia (feces), klismaphilia (enemas), urophilia (urine), emetophilia (vomit).

Part 3: Sexual Disorientation

Homosexuality refers to erotic attraction, predisposition, or activity, including sexual congress, between individuals of the same sex, including gays and lesbians.

The practice of dressing or masquerading in the clothes of the opposite sex; especially the adoption of feminine mannerisms and costume by a male.

The desire to change one's anatomic sexual characteristics to conform physically with one's perception of self as a member of the opposite sex.

Do you have an identity crisis?

Well, I guess if you suffer from any of the disorders above, my advice is: go see a shrink or psychiatrist, or admit yourself into a mental hospital and get some serious help!

Enjoy sex! Play safe!


Anonymous said...

For your information, APA has removed homosexuality from the category of sexual disorder since long time ago.

wonghongweng said...

I'll look it up again, thanks!

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