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