The Effects Of Drugs On Womens Orgasmic Ability

A number of psychotherapeutic drugs have been noted to affect the ability of women to attain orgasm. The selective serotonin reuptake inhibitors (SSRIs) frequently affect orgasmic functioning, leading to delayed orgasm or anorg-asmia. There is variability, however, in that some antidepressants have been associated with anorgasmia less frequently than others. For example, the anti-depressant, nefazodone, has been reported to produce fewer sexual side effects in women (34) than many of the...

Vulvar Vestibulitis Syndrome

Treatment for vestibulitis is typically guided by the medical model. This model follows a traditional strategy of starting with conservative, non-invasive treatments and progressing to more invasive ones (89). Palliative interventions (e.g., sitz baths) to reduce the pain are the first-line treatment choice for dyspa-reunia. If these are not effective, treatment progresses to topical interventions (e.g., lidocaine, corticosteriods), systemic medications (e.g., oral corticosteriods,...

Definition

In DSM-IV (American Psychiatric Association, 1994), retarded ejaculation is termed Male Orgasmic Disorder and defined as a persistent or recurrent delay in, or absence of, orgasm in a male following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration. In more simple terms, retarded ejaculation means that a man finds it difficult or impossible to ejaculate, despite the presence...

Diagnosing FSAD

FSAD refers to inhibition of the vasocongestion-lubrication response to sexual stimulation (1). In the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), FSAD (302.72) is defined as the pervasive or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement, coupled with marked distress or interpersonal difficulty (1). The DSM classification of sexual disorders...

Sexual Desire Disorders

The DSM-IV-TR (6) category of Sexual and Gender Disorders is divided into three parts, one of which is Sexual Dysfunctions. One of the group of sexual dysfunctions is Sexual Desire Disorders (SDD) of which there are two kinds (A) hypoactive sexual desire disorder (HSDD) and (B) sexual aversion disorder (SAD). No distinction is made between SDDs that affect men and those affecting women. The assumption is evidently made that sexual desire and desire problems are the same in both gender groups a...

Does He have a Vascular Basis to His ED

Diabetes, smoking, hypertension, hyperlipidaemia, and so on, are all underlying causative factors for vascular impairment. Since the erectile response is a hemo-dynamic event, it is hardly surprising that damage to the vessels will result in partial or complete loss of the ability to not only achieve but also maintain an erection long enough for it to be useful to its owner and his partner. A standard vascular examination can reveal important clues that may not only indicate a vascular reason...

Pharmacological Treatment of the Paraphilias

There is no data to suggest that pharmacological intervention cans specifically target or ameliorate underlying paraphilic mechanisms. Rather, pharmacological interventions are either symptom focused or directed toward ameliorating or managing comorbid conditions. For example, where hypersexuality is a factor, pharmacological treatments are commonly implemented to lower libidinal drive where concurrent mania fosters hypersexuality, mood stabilizing agents are indicated where comorbid depression...

Introduction The False Dichotomy

The 20th century marked huge strides in our knowledge of sexual disorders and their treatments, however, advancements were followed by periods of reductio-nistic thinking. Etiology was conceptualized dichotomously, first as psychogenic and then organic. Early in the 20th century, Freud highlighted deep-seated anxiety and internal conflict as the root of sexual problems experienced by both men and women. By mid-century, Masters and Johnson (1) and then Kaplan (2) designated performance anxiety...

Other Unlicensed Treatment Therapies for Men with ED

Several new formulations are being developed, such as topical alprostadil and intranasal apomorphine. New agents are being developed, including selective PDE3 4 5 inhibitors MS-223131 (Bristol-Myers Squibb), T-1032 (Tanabe Seiyaku), TA-1790 (Vivus), sildenafil nitrate (NCX-911) (NicOx) nonselective inhibitors of postsynaptic alpha-adrenoceptors within the corpus cavernosum phentolamine (Vasomax Schering Plough), melanocortin receptor agonists such as melatonan II (Palatin) (s.c. and intranasal)...

Lifelong Delayed Ejaculation

According to the classical psychological view, lifelong delayed ejaculation is attributed to fear, anxiety, hostility, and relationship difficulties (85-87). Many different manifestations of anxiety and fear have been hypothesized, including fears of death and castration, fear of loss of self resulting from loss of semen, fear of castration by the female genitals, fear that ejaculation would hurt the female, fear of being hurt by the female, performance anxiety, unwillingness to give of oneself...

References

Human Sexual Response. Boston Little, Brown and Co., 1966. 2. Levine SB. The nature of sexual desire a clinician's perspective. Arch Sex Behav 2003 32 279-285. 3. Blumstein P, Schwartz P. American Couples. New York William Morrow and Company, Inc., 1983. 4. Nichols M. Low sexual desire in lesbian couples. In Leiblum SR, Rosen RC, eds. Sexual Desire Disorders. New York The Guilford Press, 1988 387-412. 5. Tiefer L. Sex is Not a Natural Act and Other Essays. Boulder...

Model Of Sexual Response Showing Various Incentives And Motivations To Be Sexual And Arousal Triggering And

For one or more of the earlier mentioned reasons, a woman choosing to be receptive to sexual stimuli (or to provide them) can subsequently become sexually aroused. The degree of emotional intimacy with her partner that may have even been the major motivating force, is also a very important influence on her arousability to the sexual stimuli. Various other psychological and biological factors will influence this arousability such that the processing of the sexual information in her mind may or...

Etiologysexual Disorder

The syndrome is probably very rare. Treatment No treatment is available yet. CONCLUSIONS In this chapter, I omitted all sorts of methodologically weak publications in the field of psychotherapy that have been published during the last 30 years. Unfortunately, in last decade hardly any or even no progress has been made in the development of evidence-based research into the psychology and psychotherapy of ejaculatory disturbances. Instead, I have tried to provide you with...

Marcel D Waldinger

Leyenburg Hospital, The Hague, The Netherlands Utrecht Institute for Pharmaceutical Sciences and Rudolf Magnus Institute for Neurosciences, Utrecht University, Utrecht, The Netherlands Neurobiology of Ejaculation 219 Serotonin, 5-Hydroxytryptamine Neurotransmission and Positron Emission Tomography-Scan Studies in Humans 222 The First Period (1887-1917) Early Ejaculation 223 The Second Period (1917-1950) Neurosis and Psychosomatic Disorder 223 The Third Period (1950-1990) Learned Behavior 224...

Psychological Treatment of the Paraphilias

As earlier research has demonstrated, medication may modify target symptoms such as anxiety, depression, obsessionality, or hypersexual drive, but cannot cure the paraphilia or interpersonal problems (166). Psychotherapy is essential to foster compliance with medication, ameliorate attitudinal problems, and to develop cognitive skills in resisting and managing paraphilic fantasies and urges. Because concurrent treatment modalities may demand the involvement of multiple clincians, issues of...

Vacuum constriction devices and constriction rings for men with

ED A vacuum constriction device (VCD) (93) is simply a rigid tube that is placed over the penis. A vacuum is then created inside the tube either manually or by a battery-powered motor. The penis becomes erect when such a negative pressure surrounds it. This principle is not new, and was being used as a treatment for ED as far back as 1874. For some men, this vacuum is sufficient, but others need a constriction ring which when applied to the base of the erect penis, preventing venous leakage...

The Behavioristic View

Another view on the origination of vaginistic reaction comes from the behavior-istic angle. Although the majority of authors with this point of view agree that vaginismus is a conditioned anxiety reaction that results in spasm of the entrance to the vagina 23-26 , only a small minority give an explanation for the origination of this behavior. Brinkman, for instance, gave an explanation model 27 . He assumed that vaginismus is the end result of a classic conditioning process in which painful...

Fetishism and Transvestic Fetishism

Fetishism was first described in 1886 by Richard von Krafft-Ebing and in 1887 by French psychologist Alfred Binet 41-43 . The essential feature is the necessity for an inanimate object to achieve or maintain sexual arousal, either in fantasy or in actual behavior. The fetish is often preferred or required for arousal, egosyn-tonic, and rarely the cause of personal distress. Individuals may experience sexual dysfunction when engaging sexually without use of the fetishistic object or fantasy....

Surgical Interventions for Men with ED

Penile arterial revascularization is only appropriate in young patients with demonstrable arteriogenic ED due to congenital vascular anomalies or traumatic injuries to the pudendal or penile arteries e.g., after road traffic accidents . There are three forms of penile prostheses available semi-rigid, malleable, and inflatable. Typical candidates for a penile implant are patients with chronic disease states such as long-term diabetes and end-organ failure or severe arterio-genic impotence...

Voyeurism Exhibitionism and Frotteurism

Voyeurism, exhibitionism, and frotteurism have also been found to frequently co-occur. It has been proposed that they may be fundamentally related through shared underlying mechanisms 32 . Voyeurism and exhibitionism involve visual processing of sexual stimuli from a distance, without direct physical contact with a partner, whereas in frotteurism physical contact is made. The voyeur looks in order to receive an alluring sexual image, the exhibitionist shows in order to transmit a sexual...

Case Study

Jim, 32 years old, and Rebecca not their real names , 31 years old, were referred to a psychiatrist because of lack of sexual desire on Jim's part. They had been married for 5 years and did not have children. Actually, Rebecca initiated the referral through their family doctor. In tears, she told the doctor of her longing to have children and hearing the ticking of the biological clock. In the course of asking detailed fertility-related questions, the doctor discovered that intercourse was...

The Ejaculation Distribution Theory of Premature Ejaculation

Waldinger 5,49 formulated a new theory on the etiology and genesis of lifelong premature ejaculation. He postulated that lifelong premature ejaculation is not an Figure 9.2 The IELT 29 measured by stopwatch in a sample of 110 Dutch males with lifelong premature ejaculation. Ninety percent ejaculates within 1 min and 80 ejaculates within 30 s 48 . Figure 9.2 The IELT 29 measured by stopwatch in a sample of 110 Dutch males with lifelong premature ejaculation. Ninety percent ejaculates within 1...