Sexual Behavior and Related Dysfunctions

Sexual Behavior

Warning on Inappropriate Behavior

• Inappropriate behavior can lead to harassment claims.
• Reminder to engage in appropriate actions (e.g., shaking hands under the mistletoe).

Normal Sexual Behavior

• Functions of sexual behavior:
  • Reproductive purposes: Ensures species continuation.
  • Intimacy: Strengthens emotional connections between partners.
  • Pleasure: Contributes to overall well-being and happiness.

Brain and Sexual Behavior

• The limbic system plays a crucial role in sexual functioning and is involved in:
  • Self-preservation and species preservation.
  • Key components include:
  • Thalamus
  • Hypothalamus
  • Amygdala
  • Hippocampus
• Limbic Functions:
  • Olfaction
  • Feeding behavior
  • Sexual behavior (including parenting)
  • Emotions
  • Motivation
  • Learning & memory

Brain Neurotransmitters and Sexual Functioning

1. Dopamine: Associated with increased libido.
2. Serotonin: Might have an inhibitory effect on sexual function.
3. Cholinergic innervation: Mediates erection, while ejaculation is mediated by alpha-1 adrenergic fibers.
4. Uterine innervation: Involves both adrenergic and cholinergic fibers.

Male Libido

• Testosterone Levels:
  • Strong correlation between testosterone (T) and libido.
  • When T decreases, estrogen (E) levels decrease as well, impacting sexual drive.
• Castration: Results in decreased sexual abilities and potentially impotence.
• Psychological aspects: Anticipation of sex can trigger hormone release, indicating a learned component to libido.
• Environmental Influence: Culture plays a role in shaping libido.

Female Libido

• Hormonal Influence:
  • Lower androgen levels correlate with decreased sexual function in women.
  • Testosterone treatment has shown modest improvements in sexual function for postmenopausal women not taking estrogen therapy.
• Menstrual Cycle Impact:
  • Women often experience heightened sexual desire around ovulation, linked to rising testosterone levels.
  • Interest in sex may decline post-ovulation as estrogen levels fluctuate.

Aging and Sexual Health

• Sexual capacity in older adults has been historically neglected in research.
• Recent studies show that maintaining a sexual life correlates with better health and happiness in older adults.
• Aging may change sexual functions, but this is increasingly viewed as requiring medical attention rather than normal aging processes.

Differing Viewpoints on Sexual Health

• Sexual health in aging men is perceived as an early indicator of overall health. Sexual dysfunction is increasingly linked to risks such as heart disease.
• The pharmaceutical industry sees significant market potential in treating sexual dysfunction in both men and women.

Common Sexual Dysfunctions

1. Erectile Dysfunction (ED):
   • Difficulties with achieving or maintaining an erection, common in older men.
2. Premature Ejaculation (PE):
   • Characterized by ejaculation occurring with minimal stimulation and lack of control. Rates suggest 1 in 10 men experience this issue.

Treatment Approaches for Dysfunctions

• ED Treatments:
  • Medications including PDE-5 inhibitors (e.g., Viagra).
  • Lifestyle changes and psychological counseling may help.
• PE Management:
  • Different approaches based on psychological and biological factors.
  • Involves behavioral therapy and potential medications.
• Female Sexual Dysfunction:
  • The existence of hypoactive sexual desire disorder (HSDD) has been highlighted, with a notable lack of available treatments compared to male counterparts.

Future of Drug Development

• New drugs like flibanserin targeting HSDD have been developed, although not yet approved in many regions due to side effects.
• Ongoing research aims to create medications catering to the different physiological and psychological needs of both genders regarding sexual dysfunction.