SEXUAL DISORDERS

Mr. Jijo Devasi

Asst.Professor
Sexual dysfunctions are listed
under behavioral syndromes
associated with physiological
disturbances and physical
factors(F5).
 CLASSIFICATION

 Gender Identity Disorders

 Psychological and behavioral disorders
associated with sexual development and
maturation
 Disorders of
sexual
preference(Paraphilias)
 Sexual Dysfunctions
Gender identity disorder
(Transsexualism)

 Gender Identity Disorder is a conflict

between a person’s actual physical
gender and the one they actually
identify him or herself as
 For example a person identified as a
boy may actually feel and act like a
girl.
 RISK FACTORS
 People with gender identity disorder may act
and present themselves as members of the
opposite sex.
 This disorder may affect:

 Choice of sexual partners

 Display of feminine or masculine
mannerism, behaviors and dress
 Self concept
The cause is unknown, but hormones in the
womb, genes, and environmental factors
(such as parenting) may be involved.
 Types
Gender Identity disorder include:

 Transsexualism
 Gender Identity disorder of childhood
 Dual role transvestism
 Intersexuality
 Transsexualism

 In this, there is a persistent and significant

sense of discomfort regarding one’s
anatomic sex and a feeling that is
inappropriate to one’s perceived gender.
 The person will be preoccupied with the
wish to get rid of one’s genitals and
secondary sex characteristics and to adopt
the sex characteristics of other sex.
Treatment

 Counseling to help the individaul

reconcile with the anatomic sex
 Sex change to the desired gender
(sex reassignment surgery) in
selected cases.
Gender Identity disorder of
childhood
This disorder is similar to transsexualism with
a very early age of onset.

Dual role transvestism

Characterized by wearing clothes of the
opposite sex in order to enjoy the temporary
experience of membership of the opposite sex
but without any desire for permanent sex
change.
Intersexuality
The patients have gross anatomical or
physiological features of the other sex.
Psychological and behavioral disorders
associated with sexual development and
maturation (F6)
Homosexuality
 Sexual relationships are maintained between
persons of the same sex.
 Female homosexuals are called as ‘lesbians’
and male homosexuals are called ‘gay’.
Treatment
Behavior Therapy
Supportive Psychotherapy
Psychoanalytic Psychotherapy
Disorders of sexual preference or
paraphilias
In paraphilias sexual arousal occurs
persistently and significantly in response to objects,
which are not a part of normal sexual arousal .

Disorder of sexual object

Paraphilias

Disorder of sexual act

 Disorders of sexual object
 Fetishism – Sexual arousal occurs with a non-
living object which is usually intimately
associated with the human body.
The fetish object may include bras,
underpants, shoes, gloves , etc.
 Transvestism- The recurrent wearing of
clothes of the opposite sex is carried out to
achieve sexual excitement.
 Zoophilia(Beastiality)- Involving in sexual
activity with animals.
 Pedophilia– It is characterized
by persistent recurrent
involvement of an adult in sexual
activity with pre pubertal
children.
 Disorders of sexual act
 Exhibitionism– Repeated exposure of the
genitals to an unsuspecting stranger is used
to achieve sexual excitement.
 Voyeurism- This is a persistent and
recurrent tendency to observe
unsuspecting persons naked (Usually of the
other sex) and engaged in sexual activity.
 Sexual Masochism- The person is sexually
aroused by physical or psychological injury
inflicted on self by others.
 Sexual sadism – The individual achieves
sexual excitement by inflicting suffering
up on other person.
 Frotteurism – This is a persistent or
recurrent involvement in the act of
touching and rubbing against an
unsuspecting, non consenting person.
TREATMENT
 Behavior Therapy : Aversion Therapy
 Psycho analysis
 Drug Therapy : Antipsychotics have
been used for severe aggression
associated with paraphilias.
 Sexual dysfunction

Sexual dysfunction is a significant

disturbance in the sexual response
cycle, which is not due to an
underlying organic cause.
 Classification of sexual dysfunctions
Sexual desire disorder:
 Hypoactive sexual desire disorder
It is characterized by a persistent or
recurrent deficiency or absence of
sexual fantasies and desire for sexual
activity. The complaint is more
common in women than men
Sexual aversion disorder
This disorder is characterized by a persistent or
extreme aversion to, and avoidance of all
genital sexual contact with a sexual partner.
Sexual Arousal Disorder
 Female Sexual arousal disorder
It is characterized by lack of sexual arousal in
the form of lack of lubrication or vaginal
dryness.
 Male erectile disorder(Impotence)
It is characterized by the recurrent and persistent,
partial or complete failure to attain or maintain an
erection to perform the sex act.
Primary erectile dysfunctions refers to cases in
which the man has never been able to have
intercourse.
Secondary erectile dysfunctions refers to case in
which the man has difficult getting or maintaining
an erection but has been able to have vaginal or
anal intercourse at least once.
Orgasmic disorder
Female Orgasmic Disorder
It is characterized by persistent or recurrent
delay in, or absence of , orgasm following a
normal sexual excitement phase. In short, a
women’s inability to achieve organism by
masturbation or coitus.
Male orgasmic Disorder
Characterized by persistent or recurrent delay
in, or absence of orgasm following a normal
sexual excitement phase. It is sometimes called
retarded ejaculation.
 a. Female Orgasmic Disorder
It is characterized by persistent or recurrent delay in, or
absence of , orgasm following a normal sexual
excitement phase. In short, a women’s inability to
achieve organism by masturbation or coitus.

b. Male orgasmic Disorder

Characterized by persistent or recurrent delay in, or
absence of orgasm following a normal sexual excitement
phase. It is sometimes called retarded ejaculation.
 C. Premature ejaculation
Characterized by ejaculation before the completion of
satisfactory sexual activity for both partners
35-40% of men treated for sexual disorders have
premature ejaculation as chief complaint.
4.Sexual pain disorder

a.Dyspareunia
Recurrent or persistent genital pain either men or
women during intercourse.

b.Vaginismus
It is an involuntary constriction of the outer one
third of the vagina that prevents penile insertion and
intercourse.
5. Sexual dysfunction due to general medical condition
and substance induced sexual dysfunction.

 Neurological (Multiple Sclerosis,neuropathy)

 Endocrine (Diabetes Mellitus, Thyroid dysfunction)
 Vascular
 Genitourinary
 Substances
Etiology

 Psychological causes
Stress, anxiety, conflicts between partners,
depression ,previous traumatic sexual or physical
experience, body image problem and problem in self
esteem.
 Physical causes
Diabetes Mellitus, heart diseases ,liver diseases, pelvic
surgery, pelvic injury, neurological disorder, hormonal
changes,alchol and drug abuse.
 Interpersonal relationship
Partner performance, lack of partner relationship
and lack of privacy.

 Social cultural factors

Inadequte education,societal taboos and conflict
with religious, personal or family valves.
Treatment
 Biological treatment
a.Pharmaco Therapy:
For erectile disorder-Sildenafil, phentolamine,
alprostadil
For improve sexual function – Antianxiety
agents,Dopamine agonist, bromocriptine.
 Hormone Therapy
Androgen increases sex drive
Antiandrogen sused to treat compulsive sexual
behavior
Antiestrogens increase libido.
 Hypnotherapy
 Behavior therapy
 Group therapy
 Analytically oriented sex therapy