Unseen aspects of sexual disorders

“ Jeewani starts her life with Sasanka harbouring millions of hopes to spend a happy life together. Despite many proposals Jeewani choses Sasanka because of his simplicity and kindness. However their marriage starts to show cracks due to frictions between them. Jeewani holds a higher executive post in a renowned company. Sasanka starts suspecting Jeewani of having relationships with other men.

He then starts consuming alcohol which further aggravates the problem. When the attractive Jeewani goes out well-dressed, Sasanka is very unhappy. One day Jeewani returns home late after a meeting. Sasanka keeps questioning Jeewani about her other relationships. This leads to an argument and finally Sasanka lands a blow and Jeewani’s head bangs on a wall. The report by Forensic psychiatrists reveals that Sasanka has been suffering from Erectile Dysfunction and this led him to experience delusions of infidelity (suspecting the fidelity of spouse beyond reasons).”   

Human Sexuality   
Human sexuality is a common topic being discussed in the society at present. Human sexuality denotes sexual feelings and related expressions regarding human relationships. The real sexual intercourse between man and woman is only one part of human sexuality. From a biological point of view this leads to the conception of a baby and allows the genes to be progressed over generations. In the Sri Lankan cultural setup marriage fulfills some important aspects related to human sexuality. At the same time sexuality and sexual intercourse increases the bond between husband and wife. Sexual intercourse is one mode where a couple can express love, care and strengthen bond. It is evident that relaxing hormones are being secreted after climax in sexual inter-course, like “ Endorphins” and “ Enkephalins” hence sex acts as a mode which relieves anxiety. However to fulfill all these one has to have a healthy sex life.   

Common sexual disorders   
When considering sexual disorders common among males, erectile dysfunction is the commonest . Here the male is unable to maintains his erection until sexual intercourse is satisfactory; till both male and female reach climax. In premature ejaculation, the male reaches climax and ejaculates early without the female reaching climax. Lack or loss of sexual desire is also a disorder present in males.   
When it comes to the sexual disorders of females vaginismus, dyspareunia and loss of sexual desire is common. In vaginismus the smooth muscles around vagina go into spasm (contracted)so there is a difficulty inserting the penis through vagina. In dyspareunia there is pain during sexual intercourse. At the same time lack of sexual desire is also common in females.   

There is an entity called ‘Nymphomani’ in which females have excessive sexual desire and ‘Satyriasis’ where males have high sexual desire.   

What are the reasons behind sexual disorders?   
 There are physical and psychological causes leading to sexual disorders. There is a misconception among the general public that most of the causes of sexual disorders are physical. However most of the causes are psychological than physical.   

Smoking, excessive alcohol use, other drug use, physical illnesses like diabetes, high blood pressure, high cholesterol and other disorders related to nervous system may contribute to the physical causes of sexual disorders. At the same time certain medication used to treat illnesses can cause sexual dysfunction.   

Stress is a major factor leading to sexual dysfunction. The stress arising from marital conflicts are leading causes. However work stress, stress arising through matters related to children may also lead to sexual dysfunction. When it comes to the psychiatric causes of sexual dysfunction, depression, anxiety disorders, alcohol dependency are the main. At the same time psychotic disorders and other mood disorders can also lead to sexual dysfunction. However without any physical or psychological cause one can experience sexual dysfunction.   

Are sexual preference deviations, homosexuality and gender identity issues, psychiatric illnesses ?   
Heterosexual sexual contacts are said to be ‘ Normal’ mode of sexual contact. Here the predominant way of arousal and gratifying sexual need is male having a sexual contact with a female or vice versa. ‘Homosexuality’ is not considered as a psychiatric illness. In sexual preference deviation disorders the predominant mode of sexual arousal is other than a heterosexual partner. In ‘pedophilia’ the predominant mode of sexual arousal and gratification is children which can cause detrimental effects to the affected child, family as well as the society. In ‘voyeurism’ the main mode of arousal is seeing other people having sex, in ‘sadism’ the partner inflicts pain on the other to get aroused. In ‘exhibitionism’ people tend to show their genitalia to others, especially publicly. In ‘fetichism’ the person concerned needs an object related to the opposite partner to get sexual arousal. The commonly used items are under garments. 

Because of social stigma these people tend to wander around during night to collect undergarments which leads to massively detrimental psychosocial issues.These are considered as psychiatry disorders which need treatment.   

In ‘transsexualism’ a person tends to think and play the role meant for the opposite sex. For an example a biological male who likes to live as a female and a biological female who likes to live as a male are considered as being transexuals. This is categorised in classification systems of the psychiatric disorders. However the positive point here is that the person who is having transsexualism can utilise health services and resources when they are identified as transsexuals.   

Good sexual health  
Even though there are no sexual disorders, there are factors that lead to good sexual health. A balanced diet, good physical health, maintaining a healthy weight according to your height, exercises, refraining from consuming excessive alcohol and avoiding smoking are recommended. At the same time better communication with the partner and freedom during sexual contact are also important factors. One very common reason for non satisfactory sexual encounters is the lack of awareness regarding the sexual organs and the process. Therefore it is very important to be educated on the sexual organs and the process.   

Can they be treated?
It is apparent from the research studies that most patients with sexual disorders come for treatment very late. This is due to the misconception about sexual disorders and the related stigma associated with this condition. More than that the lack of awareness regarding sexuality, sexual intercourse and sexual disorders are the main reasons. 

Therefore there is a tendency for people to seek alternative treatments as well as obtain medication without the proper recommendation of a qualified doctor. What should be stressed here is ‘taking over the counter medications’ can even lead to death. There are pharmacological treatments (using medications) as well as psychological treatments (psychotherapy) for sexual disorders. However it is utmost important that one should get proper advise from a qualified psychiatrist before starting treatment. This can prevent many detrimental effects and help get over illnesses without complications.   

A message for you!   
Sexuality and good sexual health are important factors for every human. Sexual disorders are common. However it is very rarely that these patients  receive the attention of doctors. Sexual disorders can pop up in the society in many forms. Be careful when taking treatment because in the absence of proper advise, from a qualified psychiatrist, the patient can be led to death.   

Talk about your sexual problems openly. Seek treatment early. There may be many Jeewanis and Sasankas in society. If you are aware of the these illnesses and come for treatment, how many valuable lives would you save?   
Note : Please note that all the names are hypothetical