Download Medical sexology

MEDICAL SEXOLOGY
doc.MUDr.Alexandra Žourková,CSc.
Dept. of Psychiatry,
Masaryk University, Brno
BASED ON EDUCATION IN
- GYNECOLOGY
- PSYCHIATRY
- ENDOCRINOLOGY
- UROLOGY
SEXOLOGICAL
EXAMINATION
- SEXUAL HISTORY
- CURRENT FUNCTIONING
- SOMATIC EXAMINATION
- PLETHYSMOGRAPHY
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
SEXUAL DISORDER
DESIRE
- 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
SEXUAL DISORDER
ORGASM
- 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
PREMATURE
EJACULATION
DEFINITION
INABILITY TO EXPERT
VOLUNTARY CONTROL
OVER THE EJACULATORY
REFLECT
TYPES OF SEXUAL
DYSFUNCTIONS MALE
TYPE
MALE ORGASMIC
DISORDER
- LIFELONG
- ACQUIRED
DEFINITION
INHIBITION OF THE
EJACULATORY REFLEX
NEVER EJACULATED WITH
PARTNER
EJACULATED NORMALY
IN THE PAST BUT
SUBSEQUENTLY DEVELOPED
THIS DIFFICULTY
TYPES OF SEXUAL
DYSFUNCTIONS FEMALE
TYPE
DEFINITION
FEMALE SEXUAL
INABILITY TO DERIVE
AROUSAL DISORDER
EROTIC PLEASURE FROM
SEXUAL STIMULATION
TYPES OF SEXUAL
DYSFUNCTIONS FEMALE
TYPE
ORGASMIC
DISORDER
- LIFELONG
- ACQUIRED
DEFINITION
SPECIFIC DIFFICULTY
IN REACHING ORGASM
NEVER EXPERIENCED
ORGASM BY ANY MEANS
OF STIMULATION
EXPERIENCED ORGASM
BUT SUBSEQUENTLY
DEVELOPMENTS THIS
DIFFICULTY
TYPES OF SEXUAL
DYSFUNCTIONS FEMALE
TYPE
DEFINITION
VAGINISM
IMPENETRABILITY OF THE
VAGINA BECAUSE OF
INVOLUNTARY SPASM OF
THE VAGINAL MUSCLES
DYSPAREUNIA
PAIN ON INTERCOURSE
PARAPHILIAS
COMPONENT OF
SEXUAL MOTIVATION
SEXUAL IDENTIFICATION
GENDER IDENTITY
SEXUAL ORIENTATION
SEXUAL BEHAVIOR
SEXUAL DEVIATION
TRANSSEXUALISM
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
TRANSVESTIC
FETHISISM
DEFINITION
DRESING IN CLOTHES
APPROPRIATE TO THE
OPPOSITE SEX FOR
PURPOSES OF AROUSAL
TYPES OF SEXUAL DEVIATIONS
TYPE
FETHISISM
PEDOPHILIA
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
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 Sadock´s synopsis of
psychiatry, Baltimore: Williams and
Wilkins, 1997