These disorders previously referred to as inhibited sexual activation are divided into:
1) Erectile dysfunction in men characterized by a recurring and persistent partial or complete inability to achieve or maintain an erection until sexual intercourse is completed;
2) Sexual activity disorder in women characterized by a recurring and persistent partial or complete inability to maintain sexual excitation accompanied by moistening and swelling of the genitalia until sexual intercourse is completed.
The diagnosis takes into account the focus, intensity, and duration of sexual activity in which the subject participates. If the stimulation is inadequate for focus, intensity or duration, the diagnosis should not be set. Below are the diagnostic criteria for activation disorders.
Diagnostic criteria for erectile dysfunction in men:
A. Or 1) or 2):
- Stable or actual partial or complete inability of a man to achieve or maintain an erection until the sexual intercourse is completed;
- stable or repetitive absence of a subjective sense of sexual arousal or satisfaction of a man during sexual activity,
B. Manifestation only during another Disorder of Axis 1 (non-sexual dysfunction) such as severe depression.
Diagnostic criteria for sexual activity disorder in women:
A. Or 1) or 2):
- Stable or actual partial or complete inability to maintain sexual excitement, accompanied by moistening and swelling of the genital organs, until sexual intercourse is completed;
- Persistent or repetitive absence of a subjective sense of sexual arousal or satisfaction of a woman during sexual activity.
B. Manifestation only during another Disorder of Axis 1 (non-sexual dysfunction), such as severe depression.
The prevalence of female sexual disorders is usually underestimated. Women who have dysfunction in the phase of excitation also usually have a violation of the orgasm phase. In one study conducted on relatively happy couples, it has been found that 33% of women have sexual arousal.
Female sexual inhibition is associated with many psychological factors. Psychological conflicts can be expressed through the inhibition of sexual arousal and orgasm. In some women, disorders of the phase of the violation are associated with dyspareunia or with a lack of desire.
Physiological studies of dysfunction have shown that a hormonal pattern can contribute to the reactivity of women who suffer from a function disorder in the excitation phase. Sexologist in Delhi found that women with normal reactivity are particularly prone to sexual intercourse before menstruation. Women with dysfunction usually experience most sexual anxiety immediately after menstruation or during ovulation. Changes in levels of testosterone, estrogen, prolactin, and thyroxin also affect anxiety disorder in women.
An erection disorder in men is also called erectile dysfunction or impotence. In the case of primary impotence, a person can never achieve an erection sufficient for the introduction of the penis into the vagina. With secondary impotence, a person successfully reaches an erection that is sufficient for sexual intercourse, in some periods of his sexual life, whereas at another time he can not do this. In selective impotence, a man can, under certain circumstances, commit intercourse, and in others, he does not; for example, a function may be normal when dealing with a prostitute, but with a spouse, there is impotence.
Secondary impotence is observed in 10 – 20% of all men. Sexologist doctor in Delhi often heard these complaints from his patients. Among all men treated for sexual dysfunction, more than 50% is referred to as impotence as the main complaint. Primary impotence is a rare disorder that occurs in 1% of men up to 35 years of age. With age, the number of cases of impotence increases. Among adults of young age, it occurs in 8% of the population. Sex specialist in Delhi notes that, at the age of 80, 75% of men are impotent. Sex doctor in Delhi notes that the fear of impotence is felt by all men over 40, which, according to researchers, reflects the male fear of the loss of libido with age. However, age varies in different ways on the sexual function of different people; more important than age in itself for normal sexual function, the presence of a sexual partner.
Etiologically, impotence may be due to organic factors, psychological factors, or a combination of both. Many studies are devoted to the analysis of the ratio of psychological and organic impotence. Some sexologists in Delhi report that the frequency of organic impotence among patients undergoing treatment in a hospital is 75-85%. Others believe that these same patients have not been adequately psychologically tested and argue that more than 90% of patients suffer from impotence, which is caused psychologically. Below are listed the organic causes of impotence or diseases that cause erectile dysfunction:
- Infectious or parasitic diseases – elephantiasis, epidemic mumps;
- Cardiovascular diseases – atherosclerosis, aneurysm of the aorta, heart failure;
- Kidney and urological diseases – Peyronie’s disease, chronic renal insufficiency, hydrocele or varicocele;
- Liver disease – cirrhosis (usually associated with alcoholism);
- Lung disease – respiratory failure; genetic diseases – Kline-Felter syndrome, congenital or structural violation of the penis;
- Disorders related to nutrition – malnutrition, lack of vitamins; endocrine disorders-diabetes mellitus,
- Dysfunction of the pituitary-adrenal axis – testicle, acromegaly, Addison’s disease, chromosomal FOBN adenoma, neoplasia of the adrenal glands, myxedema, hypertension rheodism;
- Neurological diseases – multiple sclerosis, transverse myelitis, tremorous paralysis, epilepsy of the frontal lobe, diseases of the spinal cord, central nervous system tumors, amyotrophic lateral sclerosis, peripheral nervous system disease, general paresis, spinal cord dysfunction;
- Pharmacological effects – alcohol and other substances that cause addiction (heroin, methadone, morphine, cocaine, phenamine, barbiturates), intended for the treatment of drugs (psychotropic substances, antihypertensive, extra genes, antiandrogens);
- Poisoning – lead, herbicides;
- Surgical operations – perineal prostatectomy, abdominal-perineal colonectomy, sympathectomy (often prevents ejaculation), aortic ankle-joint anastomosis, radical cystectomy, retroperitoneal lymphadenectomy;
- Mixed diseases – radiation therapy, pelvic fracture, every serious systemic disease or exhausting condition. antiandrogens);
Side effects of drugs may interfere with sexual function in a variety of ways, both in men and in women. Castration (ovarian or testicle removal) does not always lead to sexual dysfunction depending on the subject. Erection may occur after castration. Reflex arc, excited by stimulation of the internal surfaces of the thighs, acts through the sacral part of the spinal cord to the centers of erection, which causes this phenomenon.
The best sexologist in Delhi described one type of impotence as the result of an inability to reconcile with the feeling of affection or desire for the same woman. Such men can only have sexual intercourse with a woman who is believed to be humiliated. Other factors that can lead to impotence are a punitive superstitious, inability to believe, a feeling that the partner does not meet his desire or that he is not desirable for the partner.
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