Generally, the terms sex and sexuality are confused, and although they are related they are different concepts. Sex is what distinguishes us as males or females, according to whether we have male or female genitalia. Being male or female implies implicit differences and not only physical (body shape) but psychic (way of thinking, feeling) and social (relationships with others).
The best sexologist in Jaipur defines sexual health or sexuality as: “the integration of the somatic, emotional, intellectual and social elements of the sexual being by means that are positively enriching and that empower people with communication and love”. In short, sexuality intervenes in the body, emotions, feelings, knowledge we have of it, experiences and the society in which we live, and is designed to enrich and facilitate us to communicate. Sex is part of the human being before birth, has its origin in the conception. Sexuality is not exclusive of any specific age and is manifested differently in each stage of life.
The idea of sexuality that prevails in our environment, enhanced by television, film, advertising, is pure coital activity. This can certainly be a part of sexual activity but not the only one. Reduce sexuality to genitality, genitality to intercourse and coitus to orgasm is to renounce almost everything.
Definition and classification of sexual dysfunctions
Sexual dysfunctions are characterized by an alteration of desires and psychophysiological changes in the cycle of the human sexual response or with the pain associated with the execution of the sexual act. In short, there is a sexual dysfunction when something does not go well or a problem appears in the sexual relationship.
According to sexologist in Jaipur there are 7 major categories of sexual dysfunction:
- sexual desire disorders (hypoactive sexual desire, sex aversion disorder);
- disorders of sexual arousal (erectile dysfunction, sexual arousal disorder of women);
- disorders of the orgasmic phase (premature ejaculation, anorganic dysfunction or anorgasmia);
- sexual dysfunctions due to pain (vaginismus, dysparereuria);
- dysfunction due to a medical illness;
- dysfunction due to the use or abuse of substances, drugs, drugs or hormones, and non-specific sexual dysfunction.
The anamnesis must be very meticulous since it is one of the fundamental pillars in the diagnosis of sexual dysfunction.
All patients who come to sexologist in Alwar for problems in sexual relations should be questioned about:
Personal history: toxic habits (alcohol, tobacco, drugs); drugs; acute / chronic diseases a careful history of organic diseases must be carried out according to sexologist in Jhunjhunu; surgical history and sequel of traumas in the genital area; life cycle of the individual (marriage, children, divorce, deaths); and other significant influence factors: socio-labor, legal, economic, etc.
Family background: attitudes toward sexuality, religious/moral conditions, parental influences, parent-family relationships, assessment of the family nucleus (aggression, violence, etc.), and relevant family events (death, illness, etc.).
Sexual history: initiation of sexual relations; presence of myths and fallacies; frequency and type of relationships; early experiences or negative previous events (incest, rape, aggression); assessment of your body image; sexual orientation; degree and types of excitement; presence or absence of orgasms; sexual preferences; type of contraception, and exclusion of paraphilia.
Current dysfunction: if we identify a problem of sexual origin, we must define more specifically some aspects such as place and time of appearance; duration; associated symptomatology; dysfunction context (global if it occurs in all occasions and possible partners, or situational if it is specific to a specific partner or sexual activity); primary character (from the first sexual relationship or activity) or secondary (appearance after normal primary sexual activity); Patient’s knowledge of the disorder and subjective assessment of the origin of the problem, diagnostic processes and previous treatments.
The physical examination must be completed by devices and not only the genital area since many systemic diseases such as diabetes or hypertension (HTA) can be the cause of the sexual problem.
- Constants: temperature, blood pressure, heart rate, respiratory rate.
- Skin: coloration, lesions, alterations of pigmentation or hydration.
- Neurological: reflexes, strength, sensitivity.
- Cardiovascular: cardiac auscultation, peripheral pulses, signs of chronic venous insufficiency.
- Endocrine: palpate thyroid, observe striae, distribution of adipose panniculus.
- Genitals: discard malformations, observe secondary sexual characteristics. The examination of the male genitalia includes the inspection, palpation, and transillumination of any mass that may be found. We must insist on size, shape, temperature, sensitivity, mobility, consistency, texture and secretions. As for the genital examination in women, the vulva, the lips, and the urethra should be checked, as well as the vagina and cervix should be inspected with a speculum and discarded exudate through the cervical and vaginal orifice.
Likewise, the presence of adenopathies must be assessed and the device scan must be completed.
Sexual dysfunction due to sexual impulse disorder
It is estimated that the prevalence of inhibited sexual impulse or desire is 20% and is more frequent in women than in men. To make this diagnosis it is necessary that the loss of sexual desire is the main problem (for at least 6 months) and not secondary to other sexual disorders, such as failure in erection or dispareuria. The absence of sexual desire does not exclude pleasure or excitement but makes it less likely that the individual will begin any sexual activity in this regard. The excessive labor dedication and the attempt of sexual practice at night, when the stress of the whole day has been endured, or after small discussions do not facilitate the appearance of an adequate sexual desire.
Sometimes, learning problems due to a very restrictive education are manifested as phobia to sex, irrational fear of nudity and physical approach with the consequent avoidance behaviors. In this case, the disorder according to sexologist in Jaipur is called sex aversion disorder, which must be differentiated from hypoactive sexual desire.