India is still a conservative society, where sex is generally considered as a taboo subject. Many sexual health issues or problems therefore remain under-recognized despite high prevalence. In consequence, there are several misconceptions and myths surrounding sex and sex-related disorders. As a result, people fall into the hands of quacks, which at times may have a disastrous consequence.
Sexual problems cause distress to the affected person, both emotional and physical distress and affect their quality of life. Hence, they need to be addressed and managed.
Family therapists are the first point of contact for patients. In this capacity, they can help a person with a sexual disorder.
In this Course on “Sexual Health”, Dr Reshma Agarwal, a well-known psychiatrist DGO, DNB (Psychiatry) Consultant, Holistic Wellness Former Senior CMO, Dept. of Psychiatry GB Pant Hospital, New Delhi elaborates on various common sex-related disorders and dispels many associated myths.
It will enable Family therapists to learn about some common sexual disorders so as to diagnose them and then to treat them, which also includes timely referral to psychiatrist for evaluation and management.
- Learn about the four phases of normal sexual response
- Learn the truth about some myths associated with sexuality such as:
- Small penis size affects sexuality
- Small penis size affects sexuality
- Testosterone is a sex tonic
- Circumcision affects sexuality
- Homosexuality is a perversion
- Most people are ignorant about paraphilias being a disorder.
- Various types of paraphilias include voyeurism, frotteurism, exhibitionism, zooophilia, among several others.
- They begin in adolescence; their onset in middle age is rare.
- Paraphilias are difficult to manage – they are controllable and not curable. Medications have limited role.
- Referral to psychiatrist is a must as lifetime therapy is needed.
- Transsexualism causes severe distress to the individual and the family due to ignorance about the condition.
- Gender identity disorder is not homosexuality.
- Early intervention can prevent transsexual behavior later in life.
- All patients must be referred to psychiatrist for thorough evaluation as management is complicated and multidisciplinary.
- Sexual arousal is the 2nd phase of normal sexual response
- Sexual arousal disorder is much more common in men, but is also seen in women
- To make a diagnosis, other differential diagnoses such as dyspareunia or lack of arousal, medical causes especially hormonal, other psychiatric disorders such as anxiety, depression, or prescribed medications must be ruled out
- Several disorders are associated with the last phase of the sexual cycle
- Two common disorders of the resolution phase are postcoital dysphoria, postcoital headache
- These disorders often remain undiagnosed and lead to interpersonal difficulties.
- The first phase of normal sex response is desire.
- There is a common myth that aphrodisiacs increase sexual desire or performance.
- Sexual dysfunction disorders associated with desire are: Low desire, sexual anhedonia, sex phobia, sexual addiction.
- Orgasm is an individual’s unique perception of peak physical reaction and release.
- Masturbation and premature ejaculation are common orgasm-related disorders.
- Inhibited orgasm is also a disorder in both men and women.
- Counsel and reassure the patient.
- Psychiatrist referral is needed in managing such cases.
- Orgasm is the third phase of the normal sexual cycle after arousal.
- Some common myths associated with orgasm are:
- Orgasm is same as ejaculation.
- Larger ejaculated means more pleasurable orgasm.
- Coitus necessarily means orgasm.
- Multiple orgasms are common in a man at the same time
- Masturbation is a normal human behaviour, but there are many myths surrounding it.
- Masturbation is healthy and harmless except when out of control or preferred to a partner who is available.
- Women do masturbate.
- Genital self stimulation is seen in babies especially 15-19 months of age.
- Erectile dysfunction or impotence is a very common but poorly understood condition.
- Hence, it is often mismanaged.
- ED is treatable in almost all cases today.
- Medications are useful.
- Mechanical devices and surgery are indicated in selective cases.
- All cases need psychological treatment.