engleski

Anxiety and somatoform disorders

Anxiety is an important maintaining factor in sexual problems, so it is not a surprise that anxiety disorders have the highest prevalence of comorbid sexual problems among all the mental disorders. Some sexual problems are specific for a specific anxiety disorder. Men with panic disorder have a high prevalence of erectile dysfunction, while women with the same anxiety disorder have high rates of orgasmic disorders. Obsessive-compulsive disorder (OCD) is tightly connected with sexuality as in many patients with OCD, their obsessions have sexual content. One of the prevalent obsessions is about sexual orientation. Also, many OCD patients consider sexuality as an anxiety-provoking subject, so their OCD symptoms worsen after masturbation or when fantasizing about sex. Patients with social phobia have problems in dating and finding a partner as they fear social situations. People suffering from post traumatic stress disorder (PTSD) have high comorbidity of erectile dysfunction and may have communication problems and intimacy concerns. The pathophysiology of sexual problems in anxiety disorders can be explained also by the fact that both share some brain structures (i.e., amygdala), neurotransmitter systems (e.g., noradrenergic activity), and the importance of hypothalamic-pituitary-adrenal axis. The treatment of sexual problems in anxiety disorder patients should be adjusted to their anxiety symptoms, and anxiety-reducing techniques should be an integral part of the therapy. Emotions connected to sexuality should be explored and normalized, and when sexual symptoms are just symptoms of their anxiety disorder, this should be clearly explained to the patient.

anxiety disorders ; obsessive-compulsive disorder ; panic disorder ; posttraumatic stress disorder ; sexual orientation

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