Interest in sexual behaviour increased dramatically in the last two decades.
With launching of Viagra and subsequent worldwide attention, questions were raised about the need for psychological treatments. Doubts about the role of mental health professionals in treating sexual dysfunctions have been shortlived. Although Sildenafil citrate alone as treatment has been sufficient for some men suffering from erectile dysfunction ,for many others this has not been the case. Viagra has not cured marital and relationship problems, has not corrected myths and misunderstandings (nor has it provided accurate educational material), has not overridden negative sexual messages and sexual trauma and has not taught sexual skills( nor how best to creat sexual feelings and a conducive sexual environment). No pharmacological agent will substitute for these basic and essential ingredients of enjoyable and fulfilling sexual experiences.
Sildenafil citrate in various trade names is one of the most misused and overused drugs today. Many of these patients approach some friend in a medical shop, get it across the counter and start using this ‘wonder drug’ . With the myths and misconceptions uncorrected , failures are inevitable as Sildenafil itself is not an aphrodisiac (substance capable of increasing the sexual desire). An unmarried man aged 26 years came with Erectile Dysfunction . He was taking Tab.Pen____50mg od for the past 30 days with some Vitamins. He never had a sexual encounter with anyone – he thought he was not getting sufficient erections because of his earlier masturbation habit which robbed him of his manliness. He was in depression because this wonder drug too failed to help him [even after using Pen____ he was not getting Erections , unless stimulated ]. All he needed was proper sex education and counselling. He was reassured & requested go for counselling again before marriage.
[In the 18th century numerous treatises were written describing the physical & mental ‘consequences’ of masturbation. Among many physical and mental disorders purportedly caused by masturbation were failing eyesight, gonorrhea, haemorrhoids, brittle bones, anorexia, nervous weakness , impotence , imbecility and insanity! Today in stark contrast masturbation is prescribed as therapy( directed masturbation is a particularly effective therapy for Lifelong female orgasmic disorder) ]
“Viagra failures” are most likely a result of insufficient psychosocial screening and a purely biomedical approach to a complex, bio-psychosocial experience. A decided benefit of the Sildenafil craze is that it has legitimized help seeking for sexual problems.
There are nine major diagnostic categories for sexual dysfunction in
DSM-IV-TR[Diagnostic and Statistical Manual of Mental disorders 4th edition Text Revision-2000 of American Psychiatric Association] which include the following:
Hypoactive sexual desire disorder (HSDD), Sexual aversion disorder(SAD), Female sexual arousal disorder , male erectile disorder , female orgasmic disorder, male orgasmic disorder, premature ejaculation, dyspareunia and vaginismus .
Knowledge of sexual deviations or paraphilias or atypical sexual behaviour is important for assessment and treatment of sexual dysfunctions . To treat sexual dysfunction effectively it is necessary to analyse the predisposing, precipitating & maintaining factors of the dysfunction in any relationship. Effective treatment will be the one which has a bio-psycho-social approach to the problem as the etiology of most sexual dysfunctions will be multiply determined , involving transaction of biological , psychological and social factors over a period of time.
-Dr.J.C.P.Prince MBBS, M-CSEPI, IMAPGC[STDs &HIV/ AIDS], M.S[Counselling&Psychotherapy]
MARRIAGE COUNSELLOR& CONSULTANT FOR SEXUAL DYSFUNCTIONS&
SEXUALLY TRANSMITTED DISEASES
126,Nethaji Road, MARAPALAM, ERODE-638001 Ph:98430 59565