engleski

Sexual disorders

Sexual medicine and sexual therapy are multidisciplinary fields that started to develop in the second half of the 19th century. In Croatia, formal education in sexual therapy started in the 21st century, and today we have thirty or so sexual therapists and sexual counsellors. In Europe in the early 21st century, the European excellene exam in sexual medicine (for physicians) and exam in clinical sexology (for psychologists and psychiatrists) was established. Sexual problems are common problems in the general population, but only a minority of people with them contact a medical Professional. Sexual disorders are divided into three categories: sexual dysfunctions, paraphilias and gender dysphoria. Sexual dysfunctions are: loss of sexual desire, erectile dysfunction, anorgasmia, premature ejaculation, retarded ejaculation, vaginismus and dyspareunia. The cause of these disorders can be biological (e.g. thyroid problems), psychological (e.g. depression), iatrogenid (e.g. antihypertensives), cultural (e.g. social expectations and double gender standards). In treatment it is important to cover all the etiological factors, so the treatment should be complex and multidisciplinary (i.e. use of pharmacotherapy, e.g. phosphodiesterase inhibitors, dapoxetine ; psychotherapeutic techniques, e.g. anti-anxiety techniques, partner therapy ; and use of highly specific sexological techniques, e.g. ideal sexual scenario, sensate focus exercises). Paraphilias should be distinguished from paraphilic disorders. Paraphilic disorders are mainly disorders in men (extremely rarely of women), and people with them are poorly motivated for treatment and usually have some secondary motivation (e.g. the partner sent them for treatment, the Court referred them). But in motivated people it is possible to treat paraphilia pharmacotherapeutically and psychotherapeutically. Gender dysphoria (old term - transsexuality) is characterisezd by the incongruence between gender and sex. People with gender dysphoria usually start transition through three steps (but many do not go through all the three steps): social, hormonal and surgical transition.

sexual disorders ; sexual dysfunctions ; paraphilias ; gender dysphoria

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