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Osmosis: The Cure for Sexual Dysfunction

Are you struggling with sexual dysfunctions? Check out our latest post on Osmosis to learn more about this psychiatric clinical practice.

Sexual Dysfunctions (Psychiatric Clinical Practice)

Sexual dysfunctions are one of the most common psychiatric disorders. It is important to remember that all psychiatric disorders are heterogeneous, and that sexual dysfunctions can be found in different types of patients. There are four main types of sexual dysfunctions:

  • Hypoactive sexual desire disorder: This is the most common type of sexual dysfunction. Patients with this disorder have a reduced interest in sex. They may also have a reduced number of sexual fantasies and a reduced sexual arousal.
  • Sexual aversion disorder: Patients with this disorder have a strong aversion to sexual activity. They may also have a fear of sexual activity.
  • Female sexual arousal disorder: This disorder is characterized by a lack of sexual arousal in women. Women with this disorder may have a reduced number of sexual fantasies and a reduced sexual desire.
  • Male erectile disorder: This disorder is characterized by a lack of erection in men. Men with this disorder may have a reduced sexual desire and a reduced number of sexual fantasies.

Sexual dysfunctions can be caused by a variety of factors. These factors can be divided into three main categories:

  1. Biological factors: These factors include diseases, injuries, and medications.
  2. Psychological factors: These factors include anxiety, depression, and stress.
  3. Social factors: These factors include cultural and religious beliefs, and relationship problems.

Treatment

The treatment of sexual dysfunctions depends on the underlying causes. If the cause is biological, then the treatment may involve medications or surgery. If the cause is psychological, then the treatment may involve psychotherapy or counseling. If the cause is social, then the treatment may involve education or relationship counseling.

Ok, quick recap. Delayed ejaculation causes either a marked delay in ejaculation, marked infrequency of ejaculation, or absence of ejaculation.

In erectile disorder, there’s marked difficulty in having an erection during sex; difficulty in maintaining an erection until the end; and a decrease in erectile rigidity.

In male hypoactive sexual desire disorder there are few or no sexual thoughts or fantasies and low or absent desire for sexual activity.

Next is premature ejaculation, where ejaculation occurs approximately 1 minute after vaginal penetration and before the individual wishes it.

In female orgasmic disorder, individuals have a delay in, infrequency of, or absence of orgasm, or alternatively, the orgasmic sensations are reduced or absent.

In female sexual interest or arousal disorder, there’s a lack of or reduced sexual interest or arousal in almost all sexual encounters, as manifested by at least three of six symptoms.

First, there’s little or no interest in sex.

Second, few or no sexual or erotic thoughts or fantasies.

Third, they rarely initiate sex and often refuse when others initiate it.

Fourth, they usually feel little or no sexual excitement or pleasure during sex.

Fifth, there’s little or no sexual interest or arousal in response to sexual cues that may be written, verbal, or visual.

And sixth there’s reduced or absent genital or nongenital sensation during sexual activity.

And lastly, genito-pelvic penetration disorder presents difficulties with one or more of four situations.

First is difficulty with vaginal penetration during intercourse or with tampon insertion.

Second, there’s vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.

Third, there’s fear or anxiety about vulvovaginal or pelvic pain related to vaginal penetration.

And fourth, the pelvic floor muscles are tense or tighten during vaginal penetration.

And finally, substance or medication-induced sexual dysfunction requires a disturbance in sexual function that’s directly correlated with use of a substance or medication.

Treatment options include cognitive-behavioral therapy, psychodynamic sex therapy, group therapy, talk therapy, and sex education.

Lifestyle changes include physical activity, at least 60 minutes per day, mindfulness, yoga and other relaxation techniques.

In delayed ejaculation, medication includes amantadine, buspirone, and cyproheptadine.

In erectile disorder, sildenafil and vardenafil are recommended.

In some cases supplemental testosterone is used.

In male hypoactive sexual desire disorder, pharmacotherapy can include testosterone, methylphenidate, and bupropion.

In premature ejaculation, SSRIs like paroxetine, sertraline, or fluoxetine are used.

In female orgasmic disorder, options include E. angustifolia and sildenafil.

In female sexual interest or arousal disorder, individuals can receive treatment with testosterone, estrogen, and flibanserin.

And in genito-pelvic pain or penetration disorder, botulin toxin type A injections could reduce muscles hyperactivity, while topical treatments with amitriptyline, lidocaine, and nifedipine can be applied to treat vulvar pain.

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Video transcription:

Sexual dysfunctions are a group of dysfunctions that prevent individuals from wanting or enjoying sexual activity. They can have a profound impact on a person’s life and can lead to high levels of distress and anxiety. There are many factors that lead to sexual dysfunctions. Emotional factors include depression, sexual fears or guilt past sexual trauma and anxiety. Physical factors include pain and discomfort during sex. Additionally, drugs like alcohol, nicotine or narcotics, premenstrual syndrome, pregnancy, the postpart period and menopause, can all affect a person’s libido and the ability to experience sexual pleasure sexual dysfunctions can be divided into four subtypes, lifelong or acquired and generalized or situational. Lifelong is when the sexual problem has been present from first sexual experiences. Acquired applies to problems that develop after a period of relatively normal sexual function. Generalized is when the problem occurs across many types of stimulation situations or partners and situational refers to sexual difficulties that only occur in certain contexts. In all the disorders. The sexual dysfunction should not be better explained by a non-sexual mental disorder or as a consequence of severe relationship to stress or other stressors, and it shouldn’t be attributable to another medical condition. Additionally, the symptoms must persist for at least six months and should cause significant distress. Sexual dysfunctions can further be divided into three categories: male sexual disorders, which include delayed ejaculation, erectile disorder, male hypoactive, sexual desire disorder and premature ejaculation. Female sexual disorders include female orgasmic disorder, female sexual interest or arousal disorder and genital pelvic pain or penetration disorder, and three common disorders, namely substance or medication-induced. Sexual dysfunction other specified sexual dysfunction and unspecified sexual dysfunction. First up in male sexual dysfunctions is delayed, ejaculation, which causes either a marked delay in ejaculation marked infrequency of ejaculation or absence of ejaculation. The delay shouldn’t be intentional and should occur almost every time the individual has sex. Second is erectile disorder, which causes marked difficulty in having an erection during sex difficulty in maintaining an erection until the end of sex or decrease in erectile rigidity. Some common factors that can cause this problem include the health of the relationship, poor body image or a history of sexual or emotional abuse, a psychiatric comorbidity or stressors, the individual’s cultural or religious background and medical factors. Third, is male hypoactive sexual desire disorder, which is when there are few or no sexual thoughts or fantasies and a low or absent desire for sexual activity. A desire discrepancy in which individuals have a lower desire for sexual activity than their partners is not sufficient to diagnose male hypoactive sexual desire disorder. The fourth male related condition is premature ejaculation. This happens when ejaculation occurs within one minute of vaginal penetration and before the individual wishes it. There are three levels of severity mild when ejaculation occurs within 30 seconds to a minute moderate when it occurs within 15 to 30 seconds and severe, when it occurs before individuals even start having sex at the start of sexual activity or within 15 seconds of penetration. Next up are the female sexual dysfunctions. First, female orgasmic disorder causes a delay in infrequency of or absence of, orgasm. Alternatively, it can cause reduced or absent, orgasmic sensations. The symptoms are experienced in most or all occasions of sexual activity. Many individuals require clitoral stimulation to reach orgasm, with only a minority of females being able to consistently experience an orgasm during penile vaginal intercourse, so experiencing orgasm through clitoral stimulation, but not during intercourse does not meet the criteria for female orgasmic disorder. Second, there’s female sexual interest or arousal disorder, and that’s diagnosed when there are at least three of the following six symptoms: first, there’s little or no interest in sex; second few or no sexual or erotic thoughts or fantasies. Third, they rarely initiate sex and often refused when others initiate it. Fourth, they usually feel little or no sexual excitement or pleasure during sex. Fifth, there’s little or no sexual interest or arousal in response to sexual cues that may be written verbal or visual and sixth there’s reduced or absent genital or non-genital sensation during sexual activity. Third, there’s genital pelvic penetration disorder, which causes problems in one or more of the following four situations. First, is difficulty with vaginal penetration during intercourse or with tampon insertion, and this can occur only in some situations or in all situations. Second, there’s volvo vaginal or pelvic pain during vaginal intercourse or penetration attempts. Third, there’s fear or anxiety about volvo, vaginal or pelvic pain related to vaginal penetration and fourth, the pelvic floor. Muscles are tense or tightened during vaginal penetration. A disorder common to both males and females is a substance or medication-induced sexual dysfunction, usually there’s evidence that the dysfunction developed during or soon after substance, intoxication or withdrawal or after exposure to a medication and that the substance is capable of producing the disturbances. Also, the disturbance shouldn’t occur exclusively during the course of an episode of deliri other specified. Sexual dysfunction applies to presentations in which symptoms characteristic of a sexual dysfunction cause distress and impairment, but do not meet the full criteria of any of them, and the clinician chooses to communicate the specific reasons they don’t. If the clinician chooses not to specify the reason, diagnosis is unspecified, sexual dysfunction, treatment for sexual dysfunctions can involve behavioral and psychological therapies. Lifestyle changes and medication, behavioral and psychological therapies are designed to achieve a number of goals, treat sex-related anxiety, improve self-confidence and communication in the relationship and ultimately improve the individual’s sex life. The first treatment option is cognitive, behavioral therapy, which focuses on dysfunctional thoughts, unrealistic expectations, behavior that decreases desire for intercourse and insufficient physical stimulation. These sessions can include both partners and homework. Assignments are often used. Psychodynamic sex therapy, which addresses underlying developmental and identity issues that impact sexual desire is a short-term form of counseling generally involving 5 to 20 sessions with a sex therapist. A typical session might be one hour every week or every other week. Other options include group therapy, talk therapy and sex education. Second, regular physical activity, at least 60 minutes per day, has been associated with improved blood flow to the genital area. Psychosocial well-being and improved sex performance fatigue and stress can contribute to low libido and sexual problems for all sexes. So addressing these issues through mindfulness, yoga or other relaxation techniques, often results in improved sexual interest and satisfaction. Third is medication in delayed ejaculation medication is a last resort, and options include amantadine, which is a weak glutamatergic antagonist used in parkinson’s busperone, which is an anti-anxiety medication and cyproheptadine in allergy. Medication for erectile disorder, phosphodiesterase, 5 or pde5 inhibitors like sildanophil or vardenafil, are recommended. Sildenafil should be taken in initial doses of 50 milligrams, orally on an empty stomach. Approximately 30 minutes to 1 hour before a planned sexual encounter testosterone is an important regulator of sexual desire and sexual function in those with male reproductive organs and as a result, combination therapy with a pde5, inhibitor and testosterone has become increasingly common. In addition, several m echanical devices have been developed that utilize vacu pressure to encourage increases in arterial inflow, but they should be used for only 30 minutes. At a time. Intracavernosal injection therapy with alprostadil a vasodilator, has also been used for purposes of inducing an erection in male hypoactive sexual desire disorder. Pharmacotherapy can include testosterone methylphenidate, which is a stimulant medication and bupropion, which is an antidepressant that doesn’t lower libido in premature ejaculation management depends on the etiology, but ssris are considered first line treatment and they include peroxide, usually 10 to 40 milligrams per day search, a line 50 to 200 milligrams per day or fluoxetine 20 to 40 milligrams per day. Topical anesthetics, like lidocaine prilocaine spray, have been reported to improve ejaculatory, latency, ejaculatory control and sexual satisfaction when applied topically to the glands of the penis five minutes before sex in female orgasmic disorders. Eongustifolia a medicinal plant and sildenafil may be used in some cases in female sexual interest or arousal disorder. Individuals with low levels of androgens can receive treatment with testosterone or estrogen estrogen being recommended for desire problems that stem from volvo vaginal atrophy phlebancerin a drug that increases levels of norepinephrine and dopamine and reduces levels of serotonin can also help improve libido and in genital pelvic pain or penetration disorder. Botulin toxin type, a injections could reduce muscle’s hyperactivity by blocking presynaptic, cholinergic synapses and the release of neurotransmitters involved in pain, perception, topical treatments with amitriptyline, lidocaine and ephetipine can be topically applied to treat vulvar pain, vulvar vestibulectomy or the complete removal of vestibular mucosa is a well-established invasive treatment for some individuals. Now, after initiating therapy for sexual dysfunction, individuals should be seen for regular follow-up visits approximately every three months until the sexual problem has improved. Individuals may then be seen every 6 to 12 months, depending on the potential risks of the treatment selected treatment. Efficacy is best assessed by self-report of improvement of symptoms and achieving treatment goals. Alright, as a quick recap, delayed ejaculation causes either a marked delay in ejaculation market infrequency of ejaculation or absence of ejaculation in erectile disorder. There is marked difficulty in having an erection during sex difficulty in maintaining an erection until the end and a decrease in erectile rigidity in male hypoactive sexual desire disorder. There are few or no sexual thoughts or fantasies and lower absent desire for sexual activity. Next is premature, ejaculation, where ejaculation occurs approximately one minute after vaginal penetration and before the individual wishes it in female orgasmic disorder. Individuals have a delay in in frequency of or absence of, orgasm or, alternatively, the orgasmic sensations are reduced or absent in female sexual interest or arousal disorder. There’s a lack of or reduced sexual interest or arousal in almost all sexual encounters, as manifested by at least three of six symptoms. First there’s little or no interest in sex second few or no sexual or erotic thoughts or fantasies. Third, they rarely initiate sex and often refuse it when others initiate. Fourth, they usually feel little or no sexual excitement or pleasure during sex. Fifth there’s little or no sexual interest or arousal in response to sexual cues that may be written verbal or visual and sixth there’s reduced or absent, genital or non-genital sensation during sexual activity and, lastly, genital pelvic penetration disorder presents difficulties with one or more of four situations. First is difficulty with vaginal penetration during intercourse or tampon insertion. Second, there’s volvo vaginal or pelvic pain during vaginal intercourse or penetration attempts. Third, there’s fear or anxiety about volvo, vaginal or pelvic pain related to vaginal penetration and fourth, the pelvic floor. Muscles are tense or tightened during vaginal penetration and, finally, substance or medication-induced. Sexual dysfunction requires a disturbance in sexual function. That’s directly correlated with use of a substance or medication treatment options include cognitive, behavioral therapy, psychodynamic sex therapy group therapy, talk therapy and sex education. Lifestyle changes include physical activity at least 60 minutes per day, mindfulness yoga and other relaxation techniques in delayed ejaculation medication includes amantadine busparone and cyproheptadine in erectile disorder, sildenafil and vardenafil are recommended. In some cases, supplemental testosterone is used. Male hypoactive sexual desire disorder. Pharmacotherapy can include testosterone, methylphenidate and bupropion in premature ejaculation, ssris like peroxide, sertraline or fluoxetine, are used in female orgasmic disorder. Options include e augustophilia and sildenafil in female sexual interest or arousal disorder. Individuals can receive treatment with testosterone, estrogen and phlebancerin in in genital pelvic pain or penetration disorder, botulin toxin type, a injections could reduce muscle hyperactivity, while topical treatments with amitriptyline, lidocaine and nephetipine can be applied to treat vulvar pain.

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