To sex therapists with complaints of sexual dysfunction disorders (sexual dysfunction) are most often addressed by people of young and middle age – from 25 to 45 years.
Disorders of the sexual function of men can occur in severe form, which leads to mental depression, a decrease in self-esteem, loss of self-confidence, not only as a sexual partner, but also as a person. Sexual dysfunctions lead to a decrease in working capacity, violations of intra-family relationships and even the disintegration of the family.
About the sexual disorders, many men turn to doctors, who in the past with potency were all right, and they are looking for a sex therapist to help their sexual functions recover. Often the initiator of a referral to the doctor is the patient’s wife.
Another category of patients are those who can not marry due to various sexual disorders. In the past, they had a bad experience of sexual intercourse and, fearing a repetition of failure, began to avoid sexual intercourse with women and could not create a family. And already in 30-35 years, when parents complain that the son is still unmarried, these men come to a consultation with a doctor.
There are also such patients who turn to the doctor at the insistence of the wife or on their own initiative with the question what is the “norm” of the frequency of sexual acts per week. For example, the husband has enough 1-2 sexual intercourse, and this is not enough for the wife, she considers her husband uncommon, as other men “can” more. Or vice versa, the husband wants intimacy daily, and the wife believes that this is excessive. And a man or a married couple come to the doctor to find out how many sexual acts a week is “normal”. About what “norm” in sexology is already told in chapter 2 of the first volume of the book.
Sexual dysfunctions can be both individual, that is, inherent in each partner, or partner, that is, inherent to a specific partner couple.
Sexual disorders can be manifestations of biological disorders in the human body (biogenic sexual dysfunctions), the consequence of mental illness, interpersonal conflicts, various stresses and psychotraumatic effects (psychogenic sexual dysfunctions), the manifestation of a disease (symptomatic sexual dysfunction) and a combination of various adverse factors.
Sexual dysfunctions (individual or partner) K.Imelinsky considers all violations:
- potency (lack of ability to sexual reactions and sexual opportunities)
- sexual excitability (lack of adequate preparedness for the appearance of sexual arousal and violation of the pace of sexual reactions)
- sexual arousal (lack of sexual reactions to external and internal stimulation)
- sexual motivation (expression of sexual desire)
- orgastic abilities (lack of ability to achieve sexual satisfaction)
Violations of libido (sexual attraction) and orgasm are more common in women, and violations in sexual intercourse (erection and ejaculation) are in men.
Sexual activity is adversely affected by any stress, emotional disturbance, as well as ignoring the norms of sexual life and physiological characteristics.
In addition, sexual dysfunctions can occur due to delay or premature psychosexual development, the transformation of sex-role behavior, premature or delayed puberty, and in critical age periods – in a transition period accompanied by sexual excesses and in the period of involution (menopause).
Regardless of the cause that causes sexual dysfunction, it is almost always accompanied by anxiety associated with his sexual abilities.
Sexual dysfunctions are congenital and acquired (that is, arising after a period of normal sexual functioning), generalized (ie, observed in any situation and with any partner) and situational (that is, limited to a certain partner and a particular situation), conditioned by psychological factors or a combination of various factors.
According to K.Imelinsky, “Sexual potency, measured by the categories of” performance of duties, “means the ability to exercise sexual functions, sexual behavior and to experience sexual feelings. This is the ability to begin and complete the sexual act that satisfies both partners. In a broader sense, this means the ability to achieve sexual pleasure in sexual intercourse and provide it to a partner, as well as the ability to fertilize. ”
Accordingly, sexual dysfunctions are manifested by the inability to achieve the state of sexual arousal, cause the corresponding reactions of the sexual organs (no erection), perform sexual intercourse (erectile dysfunction), achieve sexual pleasure (orgasmic disorder), give satisfaction to each other (for example, in connection with premature ejaculation), as well as inability to fertilize (ejaculation disorder, anejaculatory disorders).
Sexual dysfunctions sexopathologists usually associate with a certain phase of the cycle of sexual reaction.
The physiological phases of the cycle of sexual reaction include: sexual attraction, sexual arousal, orgasm and resolution phase.
The phase of sexual attraction differs from the rest of the physiological phases of the cycle of sexual reaction. Differences are reflected in motivation, motivation for sexual activity and personality. This phase is characterized by sexual fantasies and the desire to enter into intimacy. Here, the presence of mental disorders and diseases, the conditions of upbringing, and the personality are important.
In this phase, there may be disturbances in the form of a sexual desire disorder.
The phase of sexual arousal lies in the subjective sense of sexual pleasure and the accompanying physiological changes.
In this phase, men can develop disorders that manifest themselves in the form of an erection disorder. The same disorders can also occur in the third phase.
Orgasm is the culmination, the highest stage of sexual pleasure and satisfaction with the reduction of sexual tension and rhythmic contraction of the muscles of the perineum and reproductive organs.
Disorders in this phase are the inhibition of orgasm in women (anorgasmia), and in men – the delay of ejaculation or premature ejaculation.
The phase of resolution is manifested in a feeling of general relaxation, well-being and relaxation of the muscles.
During this phase, men for some time (the duration of this period increases with age) lose the ability to experience orgasm – refractory pause.
As can be seen from the above, sexual disorders can occur in any of the phases of the cycle of sexual reaction.
K.Imelinsky proposed the following version of the classification of psychosexual disorders (here the classification of disorders is only for men).
I. Neurotic sexual disorders.
A. Disorders not related to sexual activity:
1. Daytime Pollution
B. Sexually related disorders:
1. Erectile dysfunction
2. Violations of ejaculation
3. Violations of orgasm
4. Violations of libido
B. Neurotic sexual reactions in combination with organic disorders
II. Psychosexual disorders of non-neurotic origin
1. Sexual infantilism
2. Symptomatic disorders
III. Psychogenic disorders of the ability to fertilize.
IV. Sexual perversion.
The most frequent sexual dysfunctions are erectile dysfunction and ejaculation. In many patients who turn to sex therapists, sexual disorders manifest themselves as the absence of an erection or the combination of a weak erection with premature ejaculation.
Men are much more painfully experiencing sexual dysfunction than women. The inability of a man to have sexual intercourse adversely affects a man’s well-being, deprives his life of meaning and reduces his self-esteem.
Statistical studies of K. Thomas, conducted on a large contingent of individuals, showed that sexual dysfunction in men (erectile dysfunction), making it impossible to perform sexual intercourse, are 10 times more likely to attempt suicide than sexual coldness in women, which also makes it difficult to conduct sexual intercourse act or makes it impossible.