Human sexuality

Patients with sexual disorders

Examination of patients with sexual disorders is carried out on an outpatient basis, only some methods of objective examination of patients of a sexological profile are carried out in a hospital, for example phalloarteriography. A standard sexological examination provides for an obligatory assessment of mental status (in particular, the identification of psychopathological symptoms), the condition of the genitourinary system in men, or the gynecological status in women; neurological and endocrine support, as well as the state of the genital blood flow in men. A sex-examination map is used, where the doctor records patient complaints, a history of sexual dysfunction, the dynamics of the main manifestations of sexuality, features of intimate relationships with a relevant sex partner, and objective data: sexological anthropometry (trochanter index, pubic body hair pattern, determination of the length and circumference of the penis, and lactic status glands, etc.), mental, neurological, gynecological / urological statuses. There are male and female versions of the standard card of the sexological survey, each of which contains a questionnaire-application with relevant questions to clarify the sexual history and history of the patient’s life. If possible, the doctor conducts a conversation with a regular partner to objectify the information received. The survey uses diagnostic methods from various fields of medicine (psychiatry, neuropathology, urology, gynecology, etc.). For rapid assessment of the state of the sexual sphere, all patients who first applied for sexological assistance first fill out the questionnaire Male Sexual Formula (SFM) or Female Sexual Formula (SFY), which allows the doctor to familiarize themselves with them at the beginning of the reception. Next, the patient’s complaints are clarified, anamnesis is collected and appropriate diagnostic procedures are carried out with the aim of a comprehensive objective assessment of the state of his sexual sphere.

Particular attention is paid to the collection of sexological history, ie, obtaining information about the patient’s life and the characteristics of his sexual dysfunction. To this end, the doctor interrogates the patient, and also receives the necessary information from other sources (sexual partner, relatives, friends). Unlike the general medical history consisting of the history of life and the history of the disease, this division in sexology is relative. This is due to the fact that manifestations of sexual dysfunction are often closely intertwined with certain life events, imprint the patient’s fate, his mental state and relationship with a partner. The sexological history along with the clarification of traditional aspects (heredity, living conditions, bad habits, occupational hazards, past diseases) involves obtaining information about the parental family, peculiarities of communication with peers, school performance, interests and preferences of adolescence, character peculiarities, changes in social status , stressful situations, etc. It is obligatory to study the conditions under which the patient first had the idea of ​​having sex of the disorder and his personal response to this fact, the actions taken, including all cases of seeking medical help and the effectiveness of previous treatment. The physician must establish what exactly the patient sees as the manifestation of a sexual disorder, in what cases his symptoms occur or intensify, and what are the features of the course of the disease.

Sexological history includes obtaining information about the arousal of sexual desire and the characteristics of its manifestations, the timing of the first ejaculation in men or menarche in women, masturbatory practice, the use of petting, the age and subjective experience of the circumstances of the first sexual intercourse. The number and success of premarital sexual relationships, the age and motives for entering into marriage, the nature of marital relations, the presence of extramarital sexual relationships, sexual activity during different periods of life, the characteristics of sexual intercourse in this couple (conditions, acceptance range, nuances of preliminary and final caresses, preferred positions of coitus and its duration, the level of orgasticity in women, methods of contraception used). It is also necessary to find out other sexual manifestations: the presence and frequency of pollutions in men, erotic dreams in women, periods of sexual abstinence and their subjective tolerance, features of spontaneous (spontaneous) and adequate erections, content of erotic fantasies and dreams. An important place in the sexological history is the assessment of the personal and sexual characteristics of a permanent partner, the degree of his awareness of the patient’s intimate experiences, the response to sexual disorder and his readiness to take part in his treatment. Obtained during the collection of anamnesis, the data is entered by the doctor in a special card of sexological examination and taken into account when making a diagnosis and conducting therapeutic measures.

Briefly consider the main components of a sexological survey.

Sexological anthropometry makes it possible to obtain a number of objective indicators (trochanter index, type of pubic hair growth, size of penis and testicles in men, diameter of areola of the nipple in women, etc.), which are important for assessing the sexual constitution of an individual, characterize the rate of puberty and reflect the function of the sex glands.

The study of the mental state of patients takes an important place in sexological examination. This is due to the exceptional role of the psyche, both in the formation of a person’s sexual behavior and in the regulation of his sexual reactions at all stages of intimacy. A significant number of sexological patients detect certain psychopathological disorders, which in some cases are the direct cause of impaired sexual function, while in others they appear secondary and significantly complicate their course. For most people, sexual dysfunctions are a source of painful experiences and alarming concerns due to the possible deterioration of relationships with a sexual partner and the threat to the stability of marriage. The loss of mental equilibrium affects the general condition of a person, often contributing to an increase in symptoms of sexual dysfunction.

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