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Premature Ejaculation Disorder

Premature Ejaculation Disorder

Causes

Diagnosis

Treatment

There is no fixed time when a man should ejaculate during sexual activity, but if a man ejaculates and loses his erection pretty early, he or his partner might feel a lack of pleasure.

Overview of (PED)

It can be unsatisfying and even embarrassing for a man to have this disorder, but it is a common problem for men. Almost 30% to 40% of men suffer from it at some point in their life. If it occurs on rare occasions there is nothing to be concerned about. 

A man is caught in Exhibitionistic Disorder

Causes and Risk Factors of PEJO:

The cause of premature ejaculation is not known. Brain chemistry may be a contributing factor. Men who have low levels of serotonin have a tendency to ejaculate early. 

Emotional factors which can contribute to the disorder include the following:

  • Guilt
  • Concern over your sexual performance
  • Depression
  • Stress
  • Lack of confidence or poor body image
  • Anxiety
  • Relationship issues
  • Sexual repression

Some other factors:

Some physical circumstances might also be the reason for premature ejaculation and include:

  • Irregular levels of hormones
  • Irregular levels of neurotransmitters
  • Infection or inflammation of prostate or urethra
  • Genetic characters inherited from parents

At times premature ejaculation can be a challenge for men having erectile dysfunction. That’s when the erection does not remain long enough for sex. Men who are stressed that they could lose their erection might develop a habit of hastening to ejaculate. However, treating erectile dysfunction may resolve the premature ejaculation issue. 

Diagnosis of Premature Ejaculation Disorder:

A health care professional will start by asking if you have always had the problem or has it recently started. The doctor will ask about your sex drive and your relationships. You will most likely get a physical exam.

The doctor will more than likely refer you to a urologist for a full check-up and tests. If it is determined that the problem is psychological, you will be referred to a mental health professional who works with people that suffer from sexual disorders. 

Treatments of Premature Ejaculation:

The majority of men recover by behavioral practices that can help to control ejaculation.

  • Stop and start:

This is a technique where you or your partner arouse the penis until you feel like you are going to reach orgasm. Then the arousing behavior is stopped for about a minute or until the feeling subsides. Stimulation starts again and the cycle is repeated three or four times before you ejaculate.

  • Strengthening of pelvic muscles:

Weak muscles of the pelvic floor can sometimes contribute to premature ejaculation. Kegel exercises can help to strengthen these muscles. Tighten the muscles of your bladder like you are stopping your urine in midstream. Hold the muscles tight for 3 seconds and then release them for 3 seconds. Do this 10 times, at least three times a day. 

  • Masturbation:

Some men believe that masturbation before sex helps them to stay regulated during intercourse. This has not been proven.

  • Professional Counseling:

A therapist who specializes in sexual disorders can help you work through problems like depression, stress, or anxiety that may be the causative factor for premature ejaculation.

Premature Ejaculation Disorder

There are no drugs specifically approved to treat premature ejaculation, but there are some medications that are prescribed to treat stress and depression which might be the cause of a co-occurring condition.

Medicines include:

  • Antidepressant medications: These can help delay ejaculation. Some examples are Lexapro, Celexa, Prozac, Zoloft, and Paxil. These medications can have side effects, so talk to your doctor about if they are right for you.
  • Numbing sprays and creams: These are applied to the penis to decrease its sensitivity, potentially delaying ejaculation. Apply them 10-30 minutes before sex and wash off before intercourse to avoid numbing your partner’s genitals.
  • Erectile dysfunction medications: While primarily used for erectile dysfunction, these medications (Viagra, Levitra, Cialis, Stendra) can sometimes help with premature ejaculation, especially in men with both conditions.
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Frotteuristic Disorder

Frotteurism

Symptoms

Causes

Treatment

Frotteurism is a sexual paraphilia where an individual achieves sexual arousal by rubbing or touching others without their consent. For example, a person with this problem may use taking public transportation to their advantage to rub up against or touch strangers on a crowded bus or train. It usually does not matter what part of the body the individual rubs against or touches. The behavior typically develops through improper sexual fantasies or prolonged daydreams of molesting others. 

Overview of Frotteuristic Disorder:

  • Paraphilias are the umbrella term in which frotteurism is categorized. It is the immoral act of non consented groping or sexual touching by rubbing someone’s body part to achieve sexual arousal and pleasure. Sometimes it may produce a psychological orgasmic euphoric state or physical orgasm. 
  • The disorder is more prevalent among shy teenagers or young adults, but it can occur within any age group. The most common age range is 15 to 25. With older adults, the condition is at high risk to develop if the person is shy and does not have relationships. The condition is more common in men and rarely seen in women. Overall, approximately 10 to 14% of males are affected by this disorder. 
Frotteuristic Disorder

Symptoms of Frotteuristic Disorder:

According to the DSM-%, the criteria for the disorder is: 

  1. This act of molestation occurs for a minimum of 6 months
  2.  Presence of high anxiety levels associated with the behavior  
  3. Social withdrawal or lack of social interactions
  4.  The person has rubbed or touched one or more individuals in the past and this occurred at least 3 times over a short period of time
  5.  Signs in teenagers occur in stages and mostly appear around closed ones like family members, friends, inmates, or peers

Known causes of Frotteuristic Disorder?

  • Childhood sexual motivations: According to many behavior specialists, the events of childhood or teenage ages may stimulate by touching someone and lead to future development of these kinds of behaviors. It is not easily diagnosed and is more commonly discovered later in life during later adolescence or young adulthood. 
  •  Antisocial behavior and hypersexuality: The lack of social skills, being shy and timid, having trust issues, anxieties, bad influences, or lack of relationships are thought to be contributing factors for the development of Frotteuristic Disorder.
  • Addictions or drug abuse: Illicit drug use or prescription medications that can lead to a high sex drive or sexual arousal such as cocaine or amphetamines. 

Treatment options for Frotteuristic Disorder

When these behaviors become significantly dangerous for not only the future of the individual but for others in society and also cause distress in daily life,  it is necessary to be assessed and start treatment as soon as possible. Psychotherapy will help the individual discover the root causes, triggers, and help them to manage sexual urges and control daydreaming of molesting others. 

Psychotherapy:

It is important to find a therapist who specializes in paraphilias in order to be able to discuss and explore the disorder openly without judgment. It is important to openly examine the onset of the behavior and its progression. 

Cognitive Behavioral Therapy (CBT)

CBT can help the individual control impulsive behavior and urges. It can train the person through appropriate strategies to manage sexual desires and vivid fantasies. Common techniques include aversion therapy and guided imagery techniques.

Antidepressants

The use of SSRIs (e.g., Prozac) may be useful in helping to balance mood disorders and other psychological issues such as depression and/or anxiety. Prozac also is known to decrease sexual drive. 

Antiandrogens

Classes of medications that can decrease high testosterone levels are prescribed along with behavior therapy (e.g. Medroxyprogesterone acetate and cyproterone acetate).

Group Therapy

In order to improve social anxiety or withdrawal,  group therapy helps improve self-esteem and confidence while engaging in direct social contact 

Early intervention is a key to a more positive prognosis. If this disorder is ignored, it can easily progress to resulting in severe legal consequences. 

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Male Hypoactive Sexual Desire Disorder

Male Hypoactive Sexual Desire Disorder

Symptoms

Causes

Risk Factors

Treatment

Male Hypoactive Sexual Desire Disorder (MHSDD) is defined as the lack or inability to have normal sexual thoughts or desires in a consistent or recurrent manner for a long time. The symptoms must be present for at least 6 months and cause stress. The disorder is categorized on the basis of the severity of symptoms.

Overview of MHSDD

Data suggests that Male Hypoactive Sexual Desire Disorder is categorized as a generalized sexual disorder that is unrelated to specific gender; however, new research clearly demonstrates the significant differences between gender roles and their association. Some studies show that at least 15% of men are affected by this disorder. The association of complete lack of, or substantial decrease in sexual desire is generally considered to occur because of erectile dysfunction (ED) and other sexual disorders.   

Male Hypoactive Sexual Desire Disorder

The epidemiology of Male Hypoactive Sexual Desire Disorder:

Recent studies show there is a strong association with psychological distress and issues with men aged 16-44 with decreased sexual interest or erectile dysfunction by 15-17%. Older men typically go through bodily changes that impact desire or performance but that does not constitute a diagnosis of Male Hypoactive Sexual Desire Disorder because these changes may very well fall within what is considered normal limits. 

Symptoms of Male Hypoactive Sexual Desire Disorder:

  • Either delayed or decreased desire for sexual activities along with the inability to reach orgasm during sex.
  • Early ejaculation is usually within 1 minute after engaging in sexual activity and feeling dissatisfied.
  • Physical or psychological distress due to interpersonal conflicts with your partner or interactions with others.

Types of Male Hypoactive Sexual Desire Disorder

There are four subtypes: 

  1. General (general lack of sexual desire)
  2. Situational (loss of sexual interest with your partner at a given time)
  3. Acquired, which occurs normally due to prolonged periods of sexual relations
  4. Lifelong (i.e., a person may be asexual)

Possible causes of Male Hypoactive Sexual Desire Disorder

There are two major etiologies related to MHSDD: 

Biological causes:

  • Neurological involvement
  • Circulatory abnormalities
  • Hormonal imbalances like decreased levels of testosterone
  • Alcoholism
  • Smoking 
  • Illicit drug use

Psychosocial causes:

  • History of child abuse
  • Depression
  • Lack of relationships
  • Psychological disorders associated with decreased sexuality
  • Social anxiety
  • Physiological or systemic causes leading to lack of arousal
  • Overburden of work causing stress

 How is Male Hypoactive Sexual Desire Disorder diagnosed?

In order to make an exact and early diagnosis, the Diagnostic and Statistical Manual of Psychological Disorders-5 has made certain criteria necessary:

  • For minimum criteria, the person suffering from MHSDD should have 75% of decreased sexual arousal or desire for at least 6 months persistently.
  • A history of marked absence decreased level or continuous stimulation and reaching of orgasm during sexual interactions for a minimum period of 6 months or more.
  • History of clinically assessed distress persistently caused by the sexual disorder
  • The problem at hand does not correlate with other associated comorbidities or medicinal effects and should completely be ruled out by proper assessments.

What are the common risk factors associated with Male Hypoactive Sexual Desire Disorder?

  • Psychological: it is associated with the presence of depression or having anxiety
  •  Physiological: these include hormonal imbalances with decreased testosterone levels as seen in andropause 
  •  Behavioral abnormalities associated with biological disturbances: A person who drinks alcohol, smokes or uses illicit drugs that lead to neurological or vascular disturbances.
  • History of surgical Procedures: surgeries involving the prostate or spinal cord cause decreased sex drive.
  • Psychosocial Factors:

Past history of traumas from growing up in an abusive household. This trauma can be emotional, physical, or sexual in nature and does not permit healthy and trusting relationships during adulthood.  

Treatment options for Male Hypoactive Sexual Desire Disorder

  • Psychotherapy involves engaging with both partners and creating a better understanding of the disorder, how to work through it, and manage their sex life. 
  • Cognitive-behavioral therapy (CBTs): Includes making strategies for sexual arousal problems and resolving them by effective sexual stimulatory training for both partners by improving sexual skills. Solving the root cause is always a better management plan.
  • Hormonal replacement therapy or hormonal treatments. There are medications that can help to improve testosterone levels usually caused by andropause or hypogonadism. Testosterone therapy is the only scientifically evident hormonal replacement therapy for men and has proven to improve sexual drive.
  • Medication changes: If you take any prescription drugs speak to your doctor about how they may affect your sexual desire and performance. An example of this is medications that are prescribed for high blood pressure or depression. Your doctor will help find an alternative prescription medication. 
  • Antidepressant drugs if necessary to manage psychological distress that the disorder causes. The medication is prescribed for those who experience depression and/or anxiety caused by stress within their relationships or sexual behaviors. 
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Sexual Masochism Disorder

Sexual Masochism Disorder

Symptoms

Causes

Diagnosis

Treatment

Sexual masochism is a disorder in which an individual becomes sexually aroused from fantasies, desires, or behaviors related to being degraded, humiliated, or engaging in sexual acts that result in pain. 

Overview of SMD:

Sexual Masochism Disorder is a type of paraphilic disorder. Paraphilia is a strong sexual interest in abnormal activities that cause stress, harm, or problems. People with masochistic interests may fantasize or engage in sexual activities that involve humiliation, being tied up, beaten, or suffering. Experiencing pain during sexual play doesn’t mean someone has a Sexual Masochism Disorder, but it’s important to ensure safety measures are taken.

Sexual masochism is part of BDSM, where one partner has all the power and control, and the other partner is submissive and enjoys being hurt or humiliated. BDSM urges are a normal part of sexual arousal.

Sexual Masochism Disorder

Asphyxiophilia:

Assessing sexually masochistic interests includes checking if someone gets sexually excited by asphyxiophilia, which is restricting breathing. This is very dangerous and can cause serious harm or death. Protecting the trachea is crucial, and pressure should never be applied to the front of the throat.

Symptoms of Sexual Masochism Disorder:

To be diagnosed with Sexual Masochism Disorder, a person must:

  • Feel intense sexual arousal from being beaten, humiliated, tied up, or made to suffer in other ways.
  • Have these feelings, fantasies, or behaviors for at least six months.
  • Experience significant distress or problems in their daily life because of these feelings.

It’s common for people with this disorder to also be interested in pornography with themes of humiliation, suffering, or being hurt.

Causes & Triggers of (SMD):

Experts believe frequent porn use might be related, but the exact cause is unknown.

  • SMD typically starts in young adulthood (around age 19).
  • Some people may have had masochistic thoughts since childhood or after puberty.
  • Like other similar disorders, SMD may become less prominent as individuals age.

Prevalence:

  • There is no link between experiencing childhood sexual abuse and having SMD.
  • Studies show more men than women are aroused by masochistic fantasies.

How Is Sexual Masochism Disorder Diagnosed?

Sexual Masochism Disorder is usually diagnosed through self-report of disturbing masochistic fantasies, urges, or behaviors. Diagnosis is based on specific criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

  • The individual has been recurrently and extremely aroused by being disgraced, beaten, bound, or being abused in any other way, arousal is expressed as intense urges, fantasies, or behaviors.
  • Their fantasies, intense urges, or behaviors cause noteworthy stress or disturb their functioning at work, in social situations, or in other important areas.
  • The condition has been present for at least 6 months.

Treatment of Sexual Masochism Disorder:

Psychotherapy helps people who feel bad about their masochistic desires. It’s best to see a therapist who knows about sexual paraphilias. They can help you understand why you feel this way and how to deal with it.

Medication:

Although there is no medication therapy for this disorder, many times the disorder coincides with other psychological problems, for example, depression. In these cases, medication might be helpful. 

Antidepressants:

Fluoxetine (Prozac), a type of SSRI, can help with mood disorders like anxiety or depression. It can also reduce sex drive, which may help with impulsive behaviors and thoughts related to masochism. However, it won’t directly address masochistic urges.

Antiandrogens:

Cyproterone acetate and Medroxyprogesterone acetate are medications that lower testosterone levels, reducing sex drive and improving therapy. They lower testosterone in the blood and may reduce compulsive or impulsive sexual behavior.

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Exhibitionistic Disorder

Exhibitionistic Disorder Case Study

Exhibitionistic Disorder is also known as Exhibitionism, is a paraphilic disorder. It is characterized by the achievement of sexual excitement and gratification through the act of exposing one’s genitals to others (usually to non-consenting people). It may also include a strong urge to show one’s sexual activity to other people.  

Overview of Exhibitionistic Disorder

Exhibitionistic Disorder is more common in men compared to women. The disorder usually begins in early adulthood. About 30% of men charged with a sexual crime also enjoy, or are, exhibitionists. The person may become sexually aroused or masturbate when revealing their genitals. Typically the individual has no intention of engaging in a sexual act with the non-consenting spectator.  In the world of technology, there is a trend of sending sexually explicit pictures (of genitals) online to strangers through various methods. Exhibitionistic Disorder includes the continuous, strong, and abnormal sexual arousal patterns that may go along with clinically notable suffering or distress, but there is a good prognosis for the exhibitionism treatment.

Following Topics of This Blog Have Been Discussed Below:

Symptoms
Symptoms
Types
Types
Causes
Causes
Diagnosis
Diagnosis
Treatment
Treatment

Exhibitionistic Disorder Symptoms:

The most common and specific exhibitionistic disorder symptom is a frequent and strong sexual arousal that is achieved by the exposure of one’s genitals to an unknown person.

An individual with Exhibitionistic Disorder is typically only able to achieve sexual excitement and gratification when they expose themselves to someone.  

Getting exhibitionistic impulses, or attempts for at least 6 months.

Satisfying exhibitionistic urges with an unknown person.

Sexual urges or fantasies cause disruption at work or within social relationships.  

The individual becomes excited by exposing genitals to either adults, adolescence, children, or all age groups. 

A man is caught in Exhibitionistic Disorder

Types of Exhibitionist Disorder:

There are different types of exhibitionism:

Pure exhibitionists are people who show their sexual organs to other people at a distance. They do not touch or physically harm the people to whom they expose their body.

Exclusive exhibitionists they are individuals who struggle with being involved in a romantic relationship and they are unable to have sexual relations normally. Exposing themselves is their way to get the sexual satisfaction. This type of exhibitionistic disorder is less common.

Exhibitionistic Disorder Causes

Exhibitionistic Disorder usually develops during young adulthood. The exact Exhibitionistic Disorder causes are unknown but it is thought that one or multiple factors such as antisocial personality disorder,  substance abuse, or other paraphilic disorders may play a role.  There have been some schools of thought that there is an association between the disorder and childhood sexual abuse and/or hyper-sexuality as a potential risk factor for developing the disorder, but there is no proven data for the triggers and Exhibitionistic Disorder causes. 

Exhibitionistic Disorder Effects

  • Negative implications for the individual as it can cause feelings of shame, guilt, and other emotional turmoil. 
  • Social isolation. 
  • Trouble communicating in sexual relationships
  • Partners of the affected individuals also go through emotional distress. For example, they can feel unattractive or inadequate.
  • Sexual dysfunction such as delayed ejaculation or erectile dysfunction may occur

Exhibitionistic Disorder Diagnosis

  • The individual is strongly and repeatedly aroused by revealing their genitals to an unknown person or being seen by someone while they are engaged in a sexual act. 
  • The individual satisfies sexual urges with an unknown and non-consenting person. If the urge is not satisfied the individual could develop distress or day-to-day functioning can be impaired. 
  • The individual’s behavior has occurred for more than 6 months.

Treatment of EXD

Exhibitionistic Disorder Treatment usually is accomplished through psychotherapy with a clinician who specializes in sexual disorders. It may also include prescribed psychotropic medications if the urges are severe and cannot be controlled through self-motivation and therapy alone. 

Cognitive Behavioral Therapy (CBT) is a type of therapy that may be helpful to recognize triggers that lead to urges and teach different and appropriate ways to deal with exhibitionistic urges.  

Medications such as SSRIs (Selective serotonin reuptake inhibitors) like Fluoxetine can help with complications such as depression, anxiety, and lower the individual’s sex drive. 

Antiandrogens:  Cyproterone acetate and Medroxyprogesterone acetate are medicines that can be used to reduce testosterone levels which in turn, decrease hypersexuality. 

If these medicines are not helpful, drugs like Anti-androgens are used which include:

  • Depot medroxyprogesterone acetate
  • GnRH (Gonadotropin-releasing hormone) agonists i.e. elagolix, degarelix etc.

These medications decrease the production of follicle-stimulating hormones and luteinizing hormones from the pituitary gland and ultimately will decrease the production of testosterone.

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Voyeuristic Disorder

Voyeuristic Disorder | Symptoms, Causes & Treatment

The voyeuristic disorder is a category of Paraphilic Disorders which are disorders characterized by a strong and profound sexual interest in unusual sexual objects or activities.  The voyeuristic disorder is sexual arousal from watching a person who is naked or engaged in sexual activity when they do not know or have consented to be watched.  People suffering from the voyeuristic disorder are known as “voyeurs.” Another common term is  “peeping toms.” They may look into windows, use binoculars from a distance, or set up cameras to watch other individuals and couples naked and/or engaging in sexual activities. While watching others the voyeur becomes sexually aroused and usually masturbates or practices other erotic acts. 

What is Voyeurism?

Voyeurism refers to an interest in watching others. It is not uncommon for people to view others naked or involved in sexual activity to become aroused, and even to the point of masturbation. If the person purposely looks for situations where they can watch others without their knowing it, then it can give rise to a paraphilic disorder known as a voyeuristic disorder.  Voyeuristic behaviors are illegal and criminal charges can be filed against the voyeur.  Women are less likely to be voyeurs compared to men by a ratio of 4% and 12 % respectively. Sexual content and pornographic images and/or videos are readily found on the Internet. This is not considered to be part of this disorder because you are in the privacy of your own home and you are not viewing others naked or having sex without their consent. That’s why, to get better voyeurism treatment, you must know about paraphilic disorder symptoms as well as voyeurism symptoms.

Following Topics of This Blog Have Been Discussed Below:

Symptoms
Symptoms
Causes
Causes
Effects
Effects
Medications
Medications
Voyeuristic Disorder

Voyeuristic Disorder Symptoms

The most common voyeurism Symptoms are:  

  • Continuous and strong sexual arousal by observing others naked or performing sexual acts.  
  • Voyeuristic thoughts urge, or behaviors interfere with day to functioning.  
  • Watching someone without their consent. 

Some individuals with this voyeurism disorder carry out sexual actions on themselves when fantasizing about, or watching, others involved in sexual activities. 

Voyeurism is often comorbid with other disorders such as substance abuse, anxiety, depression, etc.  In some cases, individuals with this disorder can develop other paraphilic voyeurism disorders (sexual sadism, exhibitionist disorder, sexual masochism, etc.)

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What Causes Voyeuristic Disorder?

There are no specific Voyeuristic Disorder causes but certain risk factors or reasons can increase an individual’s potential to develop the voyeurism disorder. Some aspects are: 

  • Sexual abuse in the past or during childhood
  • Substance misuse/abuse 
  • Hyper-sexuality 
  • Sexual obsessions

Voyeuristic Disorder Effects

A person who suffers from voyeuristic disorder can feel emotional distress, isolation, fear of being judged by others, and humiliation. All of these will negatively impact relationships.  The partner of individuals with the voyeuristic disorder might also feel inadequate, unattractive, or concerned about the consequences and complications this disorder can have. A couple with one person in the relationship having this disorder should seek appropriate couples therapy. 

Complications of Voyeuristic Disorder:

The complications for individuals with Voyeuristic Disorder include hyper-sexuality. This is having a very frequent and extremely high sex drive. The person had problems controlling their thoughts, urges, and behaviors. A person with this disorder can develop other paraphilias or other mental health disturbances such as depression, anxiety, etc.   

Voyeuristic Disorder Diagnosis:

An individual must meet the following criteria to be considered for having this disorder: 

  • Individuals are recurrently and strongly aroused by watching a person without their knowledge or consent of them undressed, removing clothes, or engaging in sexual activities. Arousal is present in fantasy, urges, or activities.
  • The individual satisfies their sexual urges by watching an unaware person; or, fantasy, strong urges, or activities cause distress or impact daily functioning.
  • The disorder is present for more than six (6) months.

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Voyeuristic Disorder Treatment

Similar to the majority of other psychological disorders, Voyeuristic disorder is curable if the person is motivated to stop the voyeuristic behaviors. The important thing is to identify when you are in need of help. People with this disorder, as with other paraphilic disorders, are fearful of being judged, embarrassed, or feeling humiliated at the thought of speaking to anyone about it, even a therapist. This leads them to not seek help and often the disorder will become worse or other paraphilias and/or mental health issues can develop. Voyeuristic Disorder Treatment by a qualified therapist who specializes in sexual issues can help by:

  • Introducing ways to control desires
  • Exploring healthy outlets when triggers or urges occur
  • Addressing and correcting thinking errors and negative thoughts
  • Recognizing places or circumstances that would increase the probability voyeuristic behavior may occur and how to change this

Psychotherapy for Voyeuristic Disorder:

  • Cognitive behavior therapy (CBT) can help with learning skills to control urges and learn why voyeuristic behaviors are unhealthy. 
  • Voyeurism Treatment can introduce appropriate coping mechanisms to assist with fighting voyeuristic sexual desires.
  • Voyeurism Treatment helps the individual develop insight toward the root cause and thinking errors that promote voyeuristic behaviors and assist them with making positive changes.

Medications that May Help for Voyeuristic Disorder:

Antidepressants: SSRIs (Selective serotonin reuptake inhibitors) can decrease sex drive and help with any mental health complications such as depression or anxiety that are being caused by the disorder. 

Antiandrogens: Cyproterone acetate and Medroxyprogesterone acetate are medicines that reduce testosterone levels.

If these medicines are not helpful, drugs like Anti-androgens are used which include:

  • Depot medroxyprogesterone acetate
  • GnRH (Gonadotropin-releasing hormone) agonists like elagolix, degarelix, etc.

These medications decrease the production of FSH (follicle-stimulating hormone) and LH (luteinizing hormone) from the pituitary gland and thereby decrease the production of testosterone. 

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Female Orgasmic Disorder

FEMALE ORGASMIC DISORDER | SYMPTOMS, CAUSES & TREATMENT

Female orgasmic disorder or Anorgasmia is a condition associated with slowed down or absence of proper orgasmic response even after complete sexual arousal or when a female is sexually active and this occurs for medical or psychological reasons.   

The Female Orgasmic Disorder symptoms are present most or all of the time and lead to clinically significant distress. Female Orgasmic Disorder has several specifications in the Diagnostic and Statistical Manual that include whether the condition includes lifelong anorgasmia, acquired anorgasmia, generalized anorgasmia, or situational anorgasmia. Female Orgasmic Disorder is co-morbid with depression and a number of medical conditions.

Overview:

Females affected by the orgasmic disorder are not able to have an orgasm under any possible method undertaken. Even if they become highly aroused through foreplay or masturbation they cannot reach orgasm which leads to frustration and agitation because of the lack of physical relief.  The inability to have an orgasm is considered a disorder only when the lack of orgasm causes distress or without experiencing orgasm during sexual relations it results in resentment and/or creates a dislike for future sexual relations with a partner. 

Whether the problem is due to psychological or medical reasons, remaining unsatisfied physically can have drastic effects on your psychosocial life factors. If the condition is ignored it can result in depression, dysmorphia, cause problems in your significant relationship, lead to social isolation, or other physical health problems can develop. 

Following Topics of This Blog Have Been Discussed Below:

Types
Types
Causes
Causes
Symptoms
Symptoms
Diagnosis
Diagnosis
Treatment
Treatment
Female Orgasmic Disorder

Female orgasmic disorder (FOD) /Anorgasmia is broken down into two major subtypes:

  1. Primary Anorgasmia:  a female has never been able to experience an orgasm.
  2. Secondary Anorgasmia:  females that previously were able to experience or reach an orgasm but are now no longer able to do so.

 FEMALE ORGASMIC DISORDER CAUSES (FOD)

PHYSICAL CAUSES:

  • Disease association: Serious conditions like multiple sclerosis (MS) and Parkinson’s disease (PD) and their associated effects on psychological well-being.
  • Recent surgeries: Gynecologic surgical procedures, for example, a hysterectomy, or cancer surgeries can affect orgasm.
  • Medication side effects: Many prescribed medications and over-the-counter medications can inhibit orgasm. This includes antihypertensive medications, antipsychotic drugs, antihistamines, and antidepressants in the serotonin reuptake inhibitors (SSRIs) class.
  • Alcohol abuse and tobacco smoking: Alcohol abuse can result in a lack of ability to reach climax. Smoking can decrease blood flow to the genitalia and causes an alcohol orgasm.
  • Aging: When we age degenerative changes occur which can affect body functioning, hormones, the neurological system, and the circulatory. This can affect sexuality. The difference in estrogen levels post-menopause and menopausal symptoms, such as night sweats and mood changes, can have an impact on sexuality.

PSYCHOLOGICAL CAUSES:

  • Anxiety, depression, or other mental disorders
  • Poor body image or dysmorphia
  • High-stress levels 
  • Cultural and religious beliefs/differences
  • Severe exposure to embarrassing situations
  • Guilt about enjoying sex 
  • Past sexual or emotional abuse

RELATIONSHIP ISSUES:

  • Lack of emotional connectedness with your partner
  • Prolonged unresolved 
  • Poor communication of sexual needs, orientation, and preferences
  • Infidelity or breaching of trust
  • Unprotected or unhealthy sexual practices

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Female Orgasmic Disorder Symptoms And Signs

Persistent delay in reaching orgasm for a long period

  1. Absence of female orgasm for an extended period of time
  2. No orgasmic response even after seeking physical or psychological professional help. 
  3. Psychological distress related to the absence of orgasm
  4. Interpersonal difficulties

Female orgasm symptoms and signs are not easy to detect because women can fake an orgasm and usually do not report this condition. They may remain in denial. 

There are 4 female orgasmic disorder types that are used to identify symptoms of orgasm in women:

Primary anorgasmia:

This type is associated with a condition in which the woman never experienced an orgasm.

Secondary anorgasmia: 

Difficulty in achieving orgasm after having no difficulty in the past. 

Situational anorgasmia:

One of the most common types of orgasmic dysfunction is situational female orgasmic disorder (FOD). It occurs when a woman can only orgasm under specific conditions like during oral sex, masturbation, or foreplay that elicit deep sexual fantasies

General Anorgasmia: 

An absence of the ability to reach orgasm under any possible condition, even when you are highly aroused and sexual stimulation is sufficient.

DIAGNOSTIC METHODS:

 It is done in 2 steps:

  • complete history
  • physical assessment
  • the DSM-5 criteria

COMPLETE HISTORY

It includes both subjective and objective information of history taking: 

  • Past medical/surgical history
  • Discussion and interviews with the patient
  • Social history
  • Family history
  • Birth history
  • Sexual history
  • Psychological history

This can provide possible ideas about any chronic or disabling condition which can lead to FOD.

PHYSICAL ASSESSMENT FOR FOD:

This includes proper evaluation by a certified gynecologist and includes:

  • Inspection by proper observation
  • Palpation of female sexually responsive areas for any abnormality
  • Assessment for any chronic/acute medical associated condition

THE DSM-5 CRITERIA FOR FOD

To be diagnosed with Female Orgasmic Disorder, the problem must be apparent for a minimum of six months. It must not be connected to another physical or mental health problem. Some of the Female Orgasmic Disorder factors listed in the DSM-5 are:

  • Difficulties in a relationship (arguments, abuse).
  • Having a partner who is ill, has health problems, or has sexual difficulties.
  • Past sexual abuse.
  • Low opinion of the body image.
  • Anxiety and depression.
  • Religious ideas about sex.
  • Low intelligence level.
  • Has a health problem.
  • Taking particular types of medication.
  • Spinal cord lesions.
  • Chronic illness.
  • Damage to the pelvic blood vessels.
  • Substance abuse problems.
  • Genetics 

FEMALE ORGASMIC DISORDER TREATMENT/ ANORGASMIA

LIFESTYLE MODIFICATIONS:

Understand and explore your body. Learn how to generate a response to the exact area. Speak to your gynecologist for further insight on how the female sexual functions work rather than believing everything that you read on the Internet. 

INCREASE SEXUAL STIMULATION:

Use a vibrator or fantasize during sex. This can help trigger an orgasm. For some women, a device called a clitoral vacuum can improve blood flow and increase stimulation. This device is battery operated and hand-held, with a cup that fits over the clitoris.

firstlight-female-orgasm-treatment

SEEK COUPLES COUNSELING:

Once a medical condition is ruled out, a counselor can help with working through conflicts in your relationship that may be affecting the ability to achieve an orgasm.

TRY SEX THERAPY:

The purpose of this therapy is to provide sex education in a proper way that can have a positive effect on your sex life

FEMALE ORGASMIC DISORDER TREATMENT AND MEDICINES:

ESTROGEN THERAPY FOR POSTMENOPAUSAL WOMEN:

If anorgasmia is associated with menopausal symptoms, such as night sweats and hot flashes, systemic estrogen therapy might relieve those symptoms and improve sexual response.

Estrogen vaginal cream, a slow-releasing suppository, or a ring can increase blood flow to the vagina and help improve sexual arousal.

TESTOSTERONE THERAPY:

Testosterone plays a role in female sexual function but it can cause side effects such as acne, hirsutism, and male-pattern baldness. Testosterone seems most effective for women with low testosterone levels as a result of surgical removal of the ovaries (oophorectomy).

If you choose to use this therapy, your doctor should monitor your blood levels. 

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Erectile Dysfunction

All You Need to Know About Erectile Dysfunction

Erectile dysfunction is defined as the lack of ability to achieve and maintain an erection sufficient enough to have satisfactory sexual interactions. In males, this develops progressively with aging. This disorder is also referred to as “impotence.” It can cause disturbances in a person’s physical and psychological health along with leading to social isolation because of a lack of confidence or self-esteem. 

The normal sexual response in males has four stages. With Erectile Dysfunction (ED) there is a disturbance in the erection and ejaculation phases because of a parasympathetic disturbance or abnormality of neurotransmitter cascading and it leads to an inability to maintain an erection.

Following Topics of This Blog Have Been Discussed Below:

Symptoms
Symptoms
Causes
Causes
Complications
Complications
Prevention
Prevention
Treatment
Treatment

Symptoms of Erectile Dysfunction – ED Symptoms

Erectile Dysfunction Symptoms are:

  • Trouble achieving erection
  • Inefficient maintenance of an erection during sexual intercourse
  • Inability to get an erection by psychological or physical stimulation
  • Decreased interest in sex

Other associated conditions with impotence include:

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Common Risk Factors of Erectile Dysfunction

Age is the major and direct risk factor for the erectile disorder (ED). The prevalence regarding age groups is approximately 5% at age 40, and 15%-25% at age 65 or older.

Risk factors for Erectile Dysfunction

ED risk factors can be an indicator of systemic disease such as:

  • Cardiovascular (heart) diseases
  • High blood pressure
  • Diabetes mellitus (DM)
  • Tobacco use
  • Alcohol use
  • Hyperlipidemia (obesity)
  • Hypogonadism
  • Lower urinary tract disorders
  • Metabolic problems
  • Depression

Diagnostic measures used to determine Erectile Dysfunction

Physical exam:

  • Inspection of genitalia
  • History of trauma
  • Questioning of psychosocial stressors
  • Neurological assessment

Blood test:

  • To investigate for low testosterone levels
  • To check other comorbidities
  • Endocrine dysfunction like glucose level in diabetes

Duplex Ultrasound:

  • To check blood flow to the penis
  • To check for atherosclerosis

Overnight erection test:

  • To check if an erection occurs during the dream cycle of sleep
  • To check other psychogenic causes

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Types of Erectile Dysfunction

Erectile dysfunction is unsatisfactory penile erection consistently over time that leads to lack of sexual activity and causes psychological distress. There are three types of erectile dysfunction: 

  • A psychogenic erection that occurs due to fantasy/imagination
  • A nocturnal erection occurs during the dream stage of sleep.
  • A reflexogenic erection that occurs by physical stimulation

Erectile dysfunction can occur because of an abnormality in any of the above erection types. Many times it is associated with male aging but it can also be caused by a medical or psychological problem. 

Erectile Dysfunction Causes

The main pathophysiological causes of Erectile Dysfunction include:

  • Psychosocial issues
  • Neurological problems
  • Vascular issues
  • Traumatic experiences
  • Surgical side effects
  • Drugs associated
  • Endocrine

Psychosocial causes:

  • Stress
  • Relationship problems
  • Performance anxiety
  • Depression
  • Other psychological associated disorders

Physiological/vascular causes:

  • Atherosclerosis
  • Hypertension leading to damage of vessels
  • Diabetes mellitus
  • Hyaline arteriosclerosis
  • Chronic renal or liver failure

Neurological causes:

  • Stroke
  • Multiple sclerosis
  • Back trauma leading to nerve damage
  • Parkinson’s Disease
  • Dementia

Endocrine dysfunction:

  • Hypogonadism leading to low testosterone levels
  • Thyroid dysfunction
  • Hyperprolactinemia

Effects of medications:

  • Use of anti-hypertensive drugs like diuretics and beta-blockers 
  • Antidepressants
  • Methadone
  • Alcohol or tobacco smoking

 Traumatic Erectile Dysfunction:

  • Pelvic or penile fractures
  • Pelvic radiation
  • Priapism
  • Spinal Cord Injury

Surgical causes:

  • Radical prostatectomy
  • Porto-iliac vascular surgery
  • proctocolectomy

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Complications of Erectile Disorder

  • Relationship difficulties
  • Lack of intimacy
  • Decreased ability for inducing pregnancy
  • Elevated stress
  • Depression
  • Anxiety
  • Low self-esteem
  • Social withdrawal
  • Frustrated sex life

Preventive Measures for Erectile Dysfunction

Erectile Dysfunction (ED) can be prevented by some simple measures like:

  • Avoidance of alcohol abuse
  • Losing weight
  • Seeking help for relationship issues
  • Getting evaluated
  • Avoiding smoking
  • Getting a healthy and nutritional diet plan
  • Exercising properly and remaining active
  • Changing prescribed medications or avoiding illicit drug use
  • Getting involved in healthy mind related activities
  • Going for routine medical checkups 

Erectile Dysfunction Treatment Options – ED Treatment

Medications that can help with erectile dysfunction treatment:

  • Sildenafil (Viagra)
  • Vardenafil (Levitra)
  • Tadalafil (Cialis)

These medications work by responding to sexual stimulation.

Other methods that may help to promote an erection in 5 to 20 minutes include:

  • A vacuum erection device. This applies negative pressure around the penis to increase blood flow
  • Intraurethral suppository
  • Alprostadil (MUSE)

Self-injections:

  • Phentolamine
  • Papaverine
  • Atropine
  • Alprostadil

Surgical treatment:

  • A penile implant. This is a prosthetic device that does not cause an erection but helps keep the penis rigid

Couples therapy:

Erectile dysfunction can lead to depression and other psychological co-morbidities. Couples therapy with you and your partner can help gain a better understanding of the disorder, the root causes, and how to promote and maintain physical and emotional intimacy while managing erectile dysfunction. 

Physiotherapy for Erectile Dysfunction:

Kegel exercises:

  • Physiotherapists can help by giving exercises to help strengthen pelvic floor muscles.
  • These exercises have urinary and sexual health benefits and are easy to perform. 

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