Male sexual problems

- Summary of sexual disorders in men

- Male Hypoactive Sexual Desire Disorder

- Erectile Disorder

- Marked difficulty in obtaining erection during sexual activity

- Mainting an erection

- Decrease in rigidity

- Factors affecting:

- Physical markers: age, smoking, drugs, etc

- Social/cultural: "erotophobia": learned negative attitudes towards sexuality, + religion + poor interpersonal relationship

- Psychological: episode related to stress

- Treatment:

- Surgical options : blow up dick

- Medicine: viagra

- Sex counselling: education and relaxation

- Delayed Ejaculation (can't come OR anorgasmia)

- Marked delay in ejaculation, Infrequency or absecne of ejaculation on 75% on more of occasions

- Causes:

- Physical (like neurological diseases)

- Psychogenic

- Ethological factors: less knwolesdged about high levels of sexual arousal, absence or inhibition (due to performance aniexty and selective attention) of sexual arousal

- Treatments

- Aim: increase and focus on sexual arousal

- Clear goals, prohibition to ejaculate during intercourse, masturbation training

- Premature Ejaculation

- Ejaculation within 1 minute and before the individual wishes it

- Average: 5.4 min after penetration

- Treatement? possible side effect from pharmacological treatment

- Antidepressants

- Dapoxetine

- Local anesthetic cream

- Sex therapy: interventions and techniques

- Discuss goals and do exercises

- Others Specified Sexual Dysfunctions

- Sexual aversion: averision and or avoidance of almost all genital sexual contact

- Hyperactive Sexual Desire

- Unspecified Sexual Dysfunction

- Body Dysmorphic Disorder

- Diagnosis

- DSM V criteria

- Must cause distress, to the individual or their sexual partner

- must occur over 75% of the time

- Lifelong vs acquired

- Generalised vs situational

- Physical examination and lab tests

- Life style

- Hormonal inbalance

- Individual's history (anamnesis)

- Psychiatric co-morbidity

- Negative sexual expereinces

- Intrest in sexual stimuli

- Relational factors

- Treatment options

- Testosterone supplements

- Sex Counselling

- Life style changes: loss weight and exercise

- Brea the pattern of avoidance behaviour (look for positive sexual cues)

- Cognitive restructuring (rational emotive therapy)

Couple therapy: such as open conversations bout sex

- Combination

- Different Cases

- Case 1 john

- Minimum amount of testosterone is needed in order to functionvc sexually

- Make the system ready for sexual activty

- Produced in the leydig cells of testes and is regulated by the pituitary gland

- Diagnosis

- Normal levels of testosterone and weight

- Just autistic