Education on Sexual Disorder: What we can do?

What is Sexual Disorder?


Education on Sexual Disorder

This is a big problem in couples or might be in all over the world when want to do sex with an opposite partner, resists to do physical relation and prevents you to enjoy sexual activity. Sexual dysfunction is different from asexual reproduction. It can happen at any time. People of all ages experience sexual dysfunction or disorder, although this problem increases by age.

'Stress and Anxiety are a common cause of sexual disorder or dysfunction. There might be other reasons below:

  1. Psychological problems
  2. Heart disease or other diseases
  3. Sexual trauma
  4. Medication
  5. Drinking Alcohol
  6. Excessive Smoking
  7. Diabetes
  8. Due to some drugs


What is Chromosomal Sex Disorders?

There are some chromosomal disorders include:
  1. Klinefelter syndrome (Klinefelter syndrome is a genetic condition caused by an extra copy of the X chromosome when a boy is born. Klinefelter syndrome is a genetic disease that affects men and is usually not diagnosed until adulthood)
  2. XX male
  3. Gonadal dysgenesis
  4. Mixed gonadal dysgenesis
  5. True hermaphroditism


What is Gonadal Sex Disorder?

Prue gonadal dysgenesis
Absent testis syndrome


What is Phenotypic Sex Disorder?

Female pseudohermaphrodites
Congenital adrenal hyperplasia
Nonadrenal female pseudohermaphroditism
Developmental disorders of Mullerian ducts


Sexual disorder in Male:

Hypogonadism is a failure of the production of spermatozoa and/or secretion of androgens.

Causation
  1. Primary testicular diseases- trauma, tuberculosis, syphilis, malignancy, orchitis.
  2. Hypergonadotropic- leprosy, lymphoma
  3. Secondary to hypothalamic/pituitary disease.

Symptoms
These depend on the age of the patient at the onset of the disease.
  1. Pre-pubertal
  2. If the disease occurs before puberty, the external genitalia and the secondary sex characteristics fail to develop.
  3. The patient grows to an excessive height because epiphyses of the long bones unite later than the usual age.
  4. The face is hairless, with very scanty pubic hairs present.
  5. Voice is high-pitched.
  6. Anorexia nervosa.

Post-pubertal
  1. Tiredness
  2. Decreased libido and impotence
  3. Decreased muscle power
  4. Decreased body hair
  5. Decreased shaving

Investigations
  1. Height, testicular size using orchidometer
  2. Plasma testosterone
  3. Plasma LH and FSH
  4. Estradiol estimation if gynecomastia is present
  5. Bone age if delayed puberty
  6. Klinefelter syndrome is confirmed by karyotyping or measuring leukocyte x-inactive specific transcriptase.

Sexual Disorders in Females

Disorders can be classified into those arising from
hypothalamic-pituitary defects
Primary gonadal defects
The presentation is often menstrual abnormalities such as primary or secondary amenorrhea.

Amenorrhea

Failure of menstruation or absence of mensuration, either sudden or gradual, for 3 or more periods in normally menstruating women in the absence of positive signs of pregnancy is termed secondary amenorrhea.

Primary amenorrhea

Causation
  1. It Maybe due to chromosomal abnormality
  2. Unrecognized or ineffectively treated congenital adrenal hyperplasia
  3. The testicular feminization's syndrome due to defective androgen receptor
  4. Primary autoimmune ovarian failure is a rare cause
  5. Structural abnormalities of the genital tract
  6. Chronic systemic diseases

Symptoms
  1. Headaches
  2. Visual field disturbances
  3. Short stature(Decreased growth hormone)

Secondary amenorrhea

Causation
  1. Acquired obstruction in the lower genital tract, operation, injury, chemical burn
  2. Hysterectomy

Ovarian causes
  1. Destruction of both the ovaries by diseases, radiation, or removal by operation
  2. Primary ovarian failure
  3. Masculinizing of the ovary- masculinizing cell tumor, adrenal like tumors

Disorders affecting the pituitary
  1. Psychogenic from the higher center via thalamus and hypothalamus
  2. Basophil adenoma. Cushing's disease
  3. Acidophil tumors
  4. Pituitary failure due to chromophobe adenoma, cyst, Simmonds's diseases, and postpartum pituitary necrosis (Sheehan's Syndrome)
  5. Suppression of FSH by the persistence of L.H (Chiari Frommel Syndrome)
  6. Adrenal cortical hyperplasia, adrenal cortical tumors, and adrenal failure(Addison's disease)
  7. Hyperthyroid state and late sage of hypothyroidism
  8. Endometrial T.B

Clinical features

Weight Loss: It may be primary as in anorexia nervosa or it may be secondary to an underlying disease such as TB, malignancy, or hyperthyroidism.

Weight gain: May suggest crushing's syndrome, hypothyroidism, or rarely a hypothalamic tumor.

Hirsutism: 
May indicate androgen excess
Androgen secretory tumors may produce virilization, e.g. Clitoromegaly(enhancing of the clitoris), deepening of the voice, sweating.

Anxiety
Emotional lability

Genitourinary:
Dyspareunia (Senile vaginitis)
Vaginal infection
Urgency of micturition
Irregular menstruation

With the increased incidence of vertebral compression, fracture, fracture neck of femur and distal radius.

Investigation;
Pregnancy testing(Pregnancy most common cause of secondary amenorrhea)
Serum FSH, LH, TSH, PRL analysis

Treatment:
Explanation and reassurance
Hormone replacement therapy
Diet rich in calcium be given- milk and milk products
Regular mild to moderate exercises



How to treat the mental causes?

Counseling may be helpful. The therapist can teach you how to deal with stress and anxiety. Need to counsel jointly with your partner about sexual activity and how to behave with each other. Sometimes, you just need support and education for sex. You can resolve body image and other obstacles in the consultation. For deep-rooted sexual dysfunction, psychotherapy may be required.



When you have Ejaculation Disorder?

Premature ejaculation is the most common form of sexual dysfunction among men and is usually caused by people feeling nervous about their performance during intercourse. But the reason is usually not clear. In some cases, premature ejaculation and ejaculation are blocked due to lack of attractiveness to a partner, past traumatic events, and psychological factors, including a strict religious background, and it may compel a to person doing sex crime. Certain medications (including certain antidepressants) may affect ejaculation, and nerve damage to the spinal cord or back can also affect ejaculation.

Retrograde ejaculation is common in diabetic men with diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and bladder neck, which causes ejaculation to flow back and enter the bladder. In some cases, Ejaculation disorder happens due to bladder or prostate sugary.



How can it be managed?

Management is the main key in this condition. Management includes:
Underlying psychological treatment such as stress, anxiety
Education on Sex activity
Control bad habits like, alcohol, Smoking
Regular mild to moderate exercise
A good diet with abundant calcium, protein
Control metabolic disease if any such as diabetes, thyroid disorder
Think always good for others
Good cooperation to each other



Homeopathic medicines

Some homeo-medicines are very helpful along with underlying causes. Though Constitutional medicine is only helpful in this condition after proper "case-taking". These include:

Ignatia Amara: Where there is disappointment and contradiction. This medicine gives miraculous results.
Lachesis: It comes from snake poison and the patient seems too high BP, suspicious, and jump one word to another.

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