Human sexuality

Lack of sexual satisfaction

There are normal sexual reactions and orgasm is experienced, but there is no adequate pleasure. This complaint is much more common in women than in men.

Diagnostic criteria:
1) all genital reactions (orgasm and / or ejaculation) occur during sexual stimulation, but do not cause pleasant sensations or feelings of pleasant excitement;
2) in the course of sexual activity there are no clear and persistent signs of anxiety, fear.
Included: anhedonia (sexual).
Sexual or orgasmic angedonia is associated with loss of the mental component of the orgasm, with the result that the subject does not feel pleasure and sexual satisfaction, although the physiological component of the orgasm is preserved.

It is believed that such disorders are manifestations of the neurotic reactions of the dissociative type, which separate the affective component of orgasm from consciousness. They can be based on conflicting partnerships, sexual complexes (unconscious ban on sensual pleasure), etc. The current depressive episodes of varying severity (Р32, РЗЗ) also lead to a decrease or loss of pleasure from experiencing an orgasm.

The survey is conducted, as a rule, on an outpatient basis. Includes standard sex examination. In case of aversion, it is necessary to conduct a detailed inquiry about the nature of the partnership in their longitudinal (both interpersonal and sexual) and find out the possible causes of aversion to sexual intimacy. In women, a careful collection of obstetric and gynecological history is required to exclude the organic nature of the disorder – hormonal imbalance, inflammatory diseases of the reproductive sphere, and so on. Consultation of the urologist with posterior urethroscopy to exclude colliculitis is shown to men complaining of weak orgasm.

Additional examinations: experimental psychological research; a conversation with a regular partner for the objectification of the information received and the correction of his sexual behavior; examination by a gynecologist.

The treatment is aimed at increasing interest in sexual contacts and enhancing the severity of the patient’s sexual experiences. After exclusion of organic pathology, which could lead to the development of sexual aversion or lack of sexual satisfaction, the focus is on psychotherapeutic activities. An individual, steam room (including behavioral sex therapy) and group psychotherapy are conducted, which are focused on identifying and resolving the true causes of sexual aversion or anhedonia, increasing interest in the sexual sphere and activating sexual life. Important elements of psychotherapeutic correction are hypnotic techniques aimed at neutralizing negative sexual experience (age regression and processing of traumatic situations in intimate life), as well as strengthening positively colored sexual experiences (accompaniment in a pleasant memory). For the same purpose, instead of hypnotherapy, the method of desensitization and processing by eye movements (DPDG) can be used. When necessary, psychotherapy focuses on comorbid neurotic disorders.

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