Sexual Dysfunction

Hello!

I am Dr Ashish Sakpal I am a consultant psychiatrist and sexologist practicing in suburban areas of Mumbai.

Today we are going to talk about sexual dysfunctions, as we know there are many misconceptions related to sex and its problems. So, today I would like to clear certain types of sexual problems which may exist. Sexual dysfunction can be classified into mainly 5 categories, first is disorders related to desire, jaise ki ichha mein problem hona, in desire related disorders there are mainly two categories like first is hypoactive sexual desire disorder and hyperactive sexual desire disorder. In hypoactive ichha kam ho jati hai sex ke baare mein and in hyperactive bahut tej ichha hoti hai sex ke baare mein. And the second category in sexual dysfunctions is a problem related to excitement in which there is condition called as erectile dysfunction, erectile dysfunction mein sexual activity ke dauran penis ka flaccidity ho jana, ya phir penis ka erection hone main difficulty hona yeh usually dekha gaya hai. Third category in sexual dysfunction is disorders related to orgasm in which the first is premature ejaculation and second is anorgasmia. In premature ejaculation during the sexual activity the person loses his erection early and thus resulting into problems related to reaching orgasm, jaise ki sexual dysfunction jo premature ejaculation hai usme jo penis hai uska dhilapan ho jata hai or during activity shurvat mein ek kadak pan rahta hai lekin aage chal ke dhilapan aa jata hai. Second is anorgasmia jisme jo patient hain unko kabhi orgasm hi achieve nahi hota hai. Fourth part in sexual dysfunction is problem related to pain, the category is mainly in vaginismus, vaginismus mein during sexual activity jo dono partners hai unko dard ho sakta hai jis wajah se sexual activity puri nahi ho pati. Fifth part is miscellaneous category in which there are problems related to general medical conditions and problem related to substance abuse.

In which basically jo sex ki problems hona due to koi medical condition jaise ki diabetes hona, blood pressure hona, ya phir koi drugs, ya phir koi madak dravyoin ke sevan ki wajah se sexual problems hona. These are broadly the five categories under which sexual dysfunction exist. Now we will talk about the causes of the sexual dysfunction ya phir karan yeh sexual dysfunction hone ke. The most common cause is local genital pathology, jaise ki genital organs hai unmein koi pathology ki wajah se sex mein problem aana, second cause is endocrine dysfunction ya phir hormonal changes hona body mein jiss vajah se sexual problem hona. Third cause is neurological dysfunction jaise brain ki bimariyon ki wajah se sexual dysfunction hona. Fourth cause is due to drugs jaise ki koi dawaiyoo ke lene ki vajah se, jaise ki blood pressure ki dawaiyan, psychiatric dawaiyan and the last is due to substance jaise ki koi nashe ki cheeze, jaise ki tambaku ka sevan, alcohol, ya phir koi bhi nashile padhartho ka sevan ke vajah se sex main problem aana.

So how to diagnose these kind of sexual dysfunction, inn saare sex related bimariyon ko hum pehchane kaise. The first most common thing what we do, is take general history of the patient and physical examination, second is we send the patient for some blood investigation related to his problems described in the examination and thus there are certain special tests which can be done for these sexual problems like phenyl plethysmography or doppler or a duplex ultrasonography or maybe we can do is nocturnal penile monitoring, tumescence manassin monitoring and lastly what we do is cavernosography. Now how to treat this sexual dysfunction, the first and foremost is to identify the cause causing the sexual dysfunction and treat it as per your diagnosis, second is counselling it can be individual counseling or group counselling. In counselling what we exactly do is we understand the education about sexuality and sex related problems the patient has, any particular problems related to the couple or any communicated issue with the couple which can be there during the sexual intercourse or otherwise. After counselling what we can start is behavioural therapy for the patient in which first is relaxation therapy to calm the patient the excitement related to the sexual act. Second is ascertain skill in which we explain how to communicate to each other for couples, third is biofeedback and forth is systematic desensitization. What else is there is master in johnson therapy, in which these are specialised skills which can be taught during the sexual intercourse to the patients like squeeze technique, start stop start technique and later what we can try after behavioural therapy is medication or medicines which can be given to enhance the performance of the patient during the sexual intercourse. It is a temporary phase for the medication, gradually we have to work upon the counselling and the behavioural therapy and after which the medications can be stopped.

This was the brief description of sexual dysfunctions for more information you can contact me through Lybrate or book appointment through Lybrate portal and do not hesitate to come and talk about sex and its problems related to your life. Thank you.