《精神病学 Psychiatry》课程教学课件（PPT讲稿）Sexual problems

Sexual problems

Sexual problems

SexualproblemsPsychiatrists are sometimesportrayed as being obsessed withsex-a relic of Freudian theoriesno helped bymediaportrayals ofpsychiatrists.The reality is ratherdifferent and moremundaneNevertheless,an understanding ofsexual problemsandhowtoassess themis important inpsychiatry.Auguste Rodin:TheKiss (Paolo and Francesca)1886

Sexual problems Psychiatrists are sometimes portrayed as being obsessed with sex – a relic of Freudian theories, no helped by media portrayals of psychiatrists. The reality is rather different and more mundane. Nevertheless, an understanding of sexual problems and how to assess them is important in psychiatry. Auguste Rodin: The Kiss (Paolo and Francesca) 1886

Sexualproblems.sexual dysfunctions,inwhichsexual performancefailsto satisfythesubjectorpartnersexualdeviations.inwhich sexuapracticedepartsfromconventioninawaythatdistressesthesubjectoroffendsothersgender-identity disorders.homosexuality, which is not adisorder,butis convenientlyconsideredhere

Sexual problems • sexual dysfunctions, in which sexual performance fails to satisfy the subject or partner • sexual deviations, in which sexual practice departs from convention in a way that distresses the subject or offends others • gender-identity disorders • homosexuality, which is not a disorder, but is conveniently considered here

SexualproblemsMaleFemaleDesireReduced libidoReduced libidoExcitementErectile dysfunctionUnresponsivenessIntercourseLoss oferectionVaginismusOrgasmAnorgasmiaPremature/delayed ejaculationResolutionPriapismAll stagesDyspareuniaDyspareunia

Sexual problems

Sexual dysfunctionsTheseconditions,inwhichsomeaspectofsexualperformancefailstosatisfythesubjectorpartner,maybe categorizedinseveralwaysbutperhapsmostclearlybyrelatingthemtothefivestagesinthemodelof normal sexualresponsedescribedbyMastersandJohnson.FemalereproductiveMalereproductivesystemsystem

These conditions, in which some aspect of sexual performance fails to satisfy the subject or partner, may be categorized in several ways but perhaps most clearly by relating them to the five stages in the model of normal sexual response described by Masters and Johnson. Sexual dysfunctions

Sexual dysfunctionsReduced libido in women,and erectile andejaculatoryproblemsinmen,are among the mostcommon reasons thatcouplespresentforadviceThe terms“frigidity"and“impotence”areimpreciseandjudgemental,and should be avoided.编号：45152云海[上传】图片联盟www.tcbm23.ca

Reduced libido in women, and erectile and ejaculatory problems in men, are among the most common reasons that couples present for advice. The terms ‘frigidity’ and ‘impotence’ are imprecise and judgemental, and should be avoided. Sexual dysfunctions

CausesBackgroundfactors:anxiety orignorance about sex,pastexperience ofsexualabuse,general disharmonybetweenthecouple concerned,aconstitutional discrepancyin sexdrivebetweenthetwopartners,oralackofphysicalattractionbetweenthem

Causes Background factors: anxiety or ignorance about sex, past experience of sexual abuse, general disharmony between the couple concerned, a constitutional discrepancy in sex drive between the two partners, or a lack of physical attraction between them

CausesAgeing:sexual drive and performance inbothsexes decreasewithage,althoughthedeclineismoremarkedinmalesForexample,theprevalenceoferectiledysfunctioninmenis about2percentatage40,and25-30percentatage65

Causes Ageing: sexual drive and performance in both sexes decrease with age, although the decline is more marked in males. For example, the prevalence of erectile dysfunction in men is about 2 percent at age 40, and 25–30 percent at age 65

CausesPsychiatric illness:mostpsychiatric illnesses,especiallydepressiveillness andanxiety states,reduce sexualdrive,performance,andpleasure.Theexception ismania,in which sexual interest and activity increase..Organic brain disease:thedementias,and lesions ofthe frontal lobe may produce sexual disinhibition..Genital and pelvic pathology:for example,congenitalabnormality, infection,and injury to the genitalia or spinalcord

Causes Psychiatric illness: most psychiatric illnesses, especially depressive illness and anxiety states, reduce sexual drive, performance, and pleasure. The exception is mania, in which sexual interest and activity increase. • Organic brain disease: the dementias, and lesions of the frontal lobe may produce sexual disinhibition. • Genital and pelvic pathology: for example, congenital abnormality, infection, and injury to the genitalia or spinal cord

CausesThe production of testosteroneEndocrineandmetabolicbythetestisis.controlled bythepituitary glanddisorders:hypothalamusforexample,diabetes,sexpituitaryhormone deficiency,hyperprolactinaemia,Testosterone causes beard andhypertension,arteriosclerosis,spermbodyhairgrowth.promotes-thegrowth of theprostate gland.FSHLHand renal failurecontributes to male sexualityand causes bone and musclegrowth.Alcohol:impairedsexualfunctionmay result from intoxication.peripheral neuropathy,disturbedsexhormonemetabolismduetotestisTestosterorspermtubuleLeydig cellcirrhosisoftheliver,maritalconflict,or treatment withTestosterone stimulates celis inthetestis to produce sperm.disulfiram

Causes Endocrine and metabolic disorders: for example, diabetes, sex hormone deficiency, hyperprolactinaemia, hypertension, arteriosclerosis, and renal failure. Alcohol: impaired sexual function may result from intoxication, peripheral neuropathy, disturbed sex hormone metabolism due to cirrhosis of the liver, marital conflict, or treatment with disulfiram