MEDICAL SEXOLOGY
Ahmed Alabwabi Abdelwahab
MD. Psychiatry SMSB
BASED ON EDUCATION IN
- GYNECOLOGY - PSYCHIATRY - ENDOCRINOLOGY - UROLOGY
SEXOLOGICAL EXAMINATION
- SEXUAL HISTORY - CURRENT FUNCTIONING - SOMATIC EXAMINATION - PLETHYSMOGRAPHY
Sexual Arousal Cycle Masters & Johnson
SEXUAL RESPONSE CYCLE
DESIRE FANTASIES ABOUT SEXUAL ACTIVITY AND THE DESIRE TO HAVE SEXUAL ACTIVITY
EXCITEMENT PSYCHOLOGICAL AND/OR PHYSICAL STIMULATION ERECTION OF THE PENIS LUBRICATION IN THE VAGINA
SEXUAL RESPONSE CYCLE
ORGASM INVOLUNTARY CONTRACTIONS (URETHRA, MUSCLES OF THE PENIS,LOWER THIRD OF THE VAGINA EMOTIONS RESOLUTION A SUBJECTIVE SENSE OF WELL-BEING
DSM-IV SEXUAL DISORDERS RELATED TO A SEXUAL RESPONSE PHASE
PHASE OF SEXUAL RESPONSE CYCLE DESIRE SEXUAL DISORDER
- HYPOACTIVE SEXUAL DESIRE DISORDER - SEXUAL AVERSION DISORDER
DSM-IV SEXUAL DISORDERS RELATED TO A SEXUAL RESPONSE PHASE
PHASE OF SEXUAL RESPONSE CYCLE EXCITEMENT SEXUAL DISORDER
- FEMALE SEXUAL AROUSALDISORDER - MALE ERECTILE DISORDER
DSM-IV SEXUAL DISORDERS RELATED TO A SEXUAL RESPONSE PHASE
PHASE OF SEXUAL RESPONSE CYCLE ORGASM
SEXUAL DISORDER
- FEMALE ORGASMIC DISORDER - MALE ORGASMIC DISORDER - PREMATURE EJACULATION
TYPES OF SEXUAL DYSFUNCTIONS MALE
TYPE IMPOTENCE (MALE ERECTILE DISORDER) - LIFELONG - SECONDARY DEFINITION IMPAIRMENT OF PENILE ERECTION THAT IS RECCURENT AND PERSISTENT NEVER POTENT WITH A PARTNER POTENT IN PAST BUT SUBSEQUENTLY DEVELOPMENT ERECTILE DISORDER
TYPES OF SEXUAL DYSFUNCTIONS MALE
TYPE DEFINITION
PREMATURE EJACULATION
INABILITY TO EXPERT VOLUNTARY CONTROL OVER THE EJACULATORY REFLECT
TYPES OF SEXUAL DYSFUNCTIONS MALE
TYPE
MALE ORGASMIC DISORDER - LIFELONG DEFINITION INHIBITION OF THE EJACULATORY REFLEX NEVER EJACULATED WITH PARTNER EJACULATED NORMALY IN THE PAST BUT SUBSEQUENTLY DEVELOPED THIS DIFFICULTY
- ACQUIRED
TYPES OF SEXUAL DYSFUNCTIONS FEMALE
TYPE DEFINITION
FEMALE SEXUAL AROUSAL DISORDER
INABILITY TO DERIVE EROTIC PLEASURE FROM SEXUAL STIMULATION
TYPES OF SEXUAL DYSFUNCTIONS FEMALE
TYPE ORGASMIC DISORDER - LIFELONG DEFINITION SPECIFIC DIFFICULTY IN REACHING ORGASM NEVER EXPERIENCED ORGASM BY ANY MEANS OF STIMULATION EXPERIENCED ORGASM BUT SUBSEQUENTLY DEVELOPMENTS THIS DIFFICULTY
- ACQUIRED
TYPES OF SEXUAL DYSFUNCTIONS FEMALE
TYPE VAGINISM DEFINITION
IMPENETRABILITY OF THE VAGINA BECAUSE OF INVOLUNTARY SPASM OF THE VAGINAL MUSCLES
PAIN ON INTERCOURSE
DYSPAREUNIA
PARAPHILIAS
COMPONENT OF SEXUAL MOTIVATION SEXUAL DEVIATION TRANSSEXUALISM
SEXUAL IDENTIFICATION GENDER IDENTITY SEXUAL ORIENTATION
SEXUAL BEHAVIOR
PEDOPHILIA FETHISISM TRANSVESTIC FETHISISM EXHIBITIONISM VOYERISM, SADISM MASOCHISM
TYPES OF SEXUAL DEVIATIONS
TYPE DEFINITION
GENDER IDENTITY PERSISTENT SENSE OF DISCOMFORT ABOUT DISORDER (TRANSSEXUALISM) ONE`S ANATOMICAL SEX AND STRONG DESIRE TO CHANGE ONE`S GENITALS AND SECONDARY SEX CHARACTERISTICS
TYPES OF SEXUAL DEVIATIONS
TYPE DEFINITION
TRANSVESTIC FETHISISM
DRESING IN CLOTHES APPROPRIATE TO THE OPPOSITE SEX FOR PURPOSES OF AROUSAL
TYPES OF SEXUAL DEVIATIONS
TYPE DEFINITION USE OF A NONHUMAN OBJECTS AS THE PREFERRED METHOD TO ACHIEVE SEXUAL EXCITEMENT HAVING SEXUAL CONTACT WITH PREPUBERTAL CHILDREN AS THE PREFERRED MEANS TO ACHIEVE SEXUAL EXCITEMENT
FETHISISM
PEDOPHILIA
TYPES OF SEXUAL DEVIATIONS
TYPE DEFINITION EXHIBITIONISM EXPOSURE OF THE GENITALS IN PUBLIC TO UNSUSPECTING STRANGERS TO ACHIEVE SEXUAL EXCITIMENT
VOYEURISM
REPEATEDLY LOOKING AT UNSUSPECTING PEOPLE WHO ARE DISROBING OR ENGANGING IN SEXUAL ACTIVITY
TYPES OF SEXUAL DEVIATIONS
TYPE SEXUAL MASOCHISM DEFINITION
OBTAINING SEXUAL GRATIFICATION TROUGH EXPERIENCING MENTAL SUFFERING OR BODILY PAIN SEXUAL SADISM INFLICTING PHYSICAL OR PSYCHOLOGICAL PAIN ON ANOTHER TO ACHIEVE SEXUAL EXCITEMENT
TREATMENT OF PARAPHILIAS
1. P S Y C H O T H E R A P Y
TO HELP PATIENTS IDENTIFY THE FEELINGS AND PHANTASIES THAT PROMPT DEVIANT SEXUAL BEHAVIOR
TO FIND MORE ACCEPTABLE MEANS OF OBTAINING SEXUAL GRATIFICATION
TREATMENT OF PARAPHILIAS
2. BIOLOGICAL THERAPY A REVERSIBLE HORMONAL (CYPROTERON ACETATE ANDROCUR MEDROXYPROGESTERONACETATE DEPO PROVERA
TREATMENT OF PARAPHILIAS
2. BIOLOGICAL THERAPY A REVERSIBLE NEUROLEPTICS (DEPOT FORMS) THYMOPROPHYLACTIS (LITHIUM, CARBAMAZEPINE) SSRI (EXPERIMENTAL)
TREATMENT OF PARAPHILIAS
2. BIOLOGICAL THERAPY B IRREVERSIBLE - SURGICAL
CASTRATION STEREOTACTIC NEUROSURGERY (ONLY ON REQUEST AND INFORMAL CONSENT)
References :
Waldinger R.J.: Psychiatry for medical students, Washington, DC : American Psychiatric Press, 1997 Kaplan HI, Sadock BJ, Grebb JA.: Kaplan and Sadocks synopsis of psychiatry, Baltimore: Williams and Wilkins, 1997
