The World Health Organization's definition of Sexual Health;
“Sexuality consists of the combination of the effects of physical, emotional, intellectual and social aspects that enrich
personality, communication and love. Everyone has the right to access sexual information and to have sexual intercourse for pleasure or procreation. As a sexual being, man is not only physical; It is a state of health that ensures emotional,
intellectual and social integrity, and enriches and increases personality development, communication and sharing of love in a positive
direction.
Gender (Sex)
Gender is shaped by the anatomical, physical and genetic biological characteristics that make us male or female.
According to anatomical and hormonal changes, the individual belongs to one of the female or male genders.
The roles of the genders in reproduction are different.
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In addition, the reproductive organs of the genders are different and their functions are complementary to each other. The word sex is sometimes used in society
to mean a sexual activity that includes sexual intercourse.
GENDER
Gender refers to the woman of an individual or society. Or it's a way of defining a man. Gender
roles are the attitudes, behaviors, expectations and responsibilities defined for men and women and approved in that society. Gender identity is the personal and
private identity that individuals have as men and women.
SEXUAL ORIENTATION
According to the gender to which a person is sexually attracted in terms of thoughts, feelings and behaviour, the following are: It is a defined feature as grouped
Attraction to the opposite sex (Heterosexual): A person's sexual interest in the opposite sex,
Same-sex interest (Homosexual, homosexual): Sexual interest in one's own gender.
Being bisexual: Having sexual interest in people of both sexes,
Being a transvestite: Enjoying the behavior and clothing specific to the opposite gender,
Being transsexual: Feeling the need to change one's gender, mentally and physically Believing that one should have the other gender. /p>
Gender Identity (Gender Identity)
It is a person's perception of femininity or masculinity. Your behavior reflects inherent aspects of masculinity or femininity. Even if the biological
factors have fully developed, there may be a problem in the development of the feeling of masculinity or femininity.
Sexual Role and Behavior (Gender Role)
Sexual behavior is due to the characteristics of the person's biological factors. These are the behaviors that society expects and accepts. Sexual behaviors are related to sexual identity
According to the psychoanalytic approach;
Sexual dysfunctions arise from underlying repressed conflicts.
In sexual dysfunctions, the relationship between repressed anger and aggression and the satisfaction of sexual needs
br /> attention is drawn to the conflict.
Therefore, a man who disappoints his wife by ejaculating too early may actually be subconsciously expressing
his repressed hostility towards women who remind him of his mother.
A woman with vaginismus in childhood He may be expressing his hostility towards men due to the sexual abuse he was exposed to or his wife's bullying attitude.
Sexual behavior deviations seen in adulthood are also closely related to the problems the child encounters in the oedipal period.
According to some psychologists According to him, people who have not been able to regain their individuality and get rid of the authoritarian mother image turn to these deviations as if they were a medicine in order to overcome the fear of not being able to maintain their identity and to gain victory against the images in their minds.
Cognitive behavioralists also treat sexual dysfunctions. They began to appreciate the role of psychoanalytical themes and reached consensus.
Masters and Johnson's theoretical model
In conceptualizing the causes of sexual deficiencies, they were able to identify current and past causes
performance They reduced the fear of being in the role of a spectator into two groups.
Fear of inadequacy is the most important reason that prevents a successful sexual relationship. Because this fear prevents the person from being aware of sexual
stimulants, causing the person to completely distance himself from his own natural reactions.
The emergence of these disorders is determined by past experiences. It should be considered to have a role in this.
These are:
Religious rigidity
Psychosexual trauma
Homosexual tendency
Inadequate counseling
Excessive alcohol intake
/> Biological factors
Socio-cultural factors
Subtypes
The following subtypes apply to all primary sexual dysfunctions.
To show how sexual dysfunction begins. One of the following subtypes may be used:
Lifetime Type: If there is sexual dysfunction from the beginning of sexual functioning.
Acquired Type: If sexual dysfunction occurs after a period of normal functioning.
>One of the following subtypes
may be used to indicate the general framework in which Sexual Dysfunction occurs:
Pervasive Type: When Sexual Dysfunction is not limited to a specific set of stimuli, situations, or sexual partners.
Situational Type: If Sexual Dysfunction is limited to certain stimuli, situations or sexual partners. Although these
dysfunctions most often occur during sexual activity with a sexual partner, in some cases
it may also be appropriate to describe the dysfunctions that occur during masturbation.
To show the etiological factors accompanying sexual dysfunctions. One of the following subtypes
can be used:
Due to Psychological Factors: Psychological factors play a major role in the onset, aggravation, exacerbation or
continuation of sexual dysfunction and it is a general
etiology of sexual dysfunction. /> when medical conditions and substances are judged not to play any role.
Due to Combining Factors: 1). When it is judged that psychological factors play a role in the onset, exacerbation, exacerbation or maintenance of Sexual Dysfunction and 2). When a general medical condition or
substance use is judged to be contributing but not sufficient to explain
Sexual Dysfunction. If a general medical condition or substance use (including drug side effects
) is sufficient to explain the Sexual Dysfunction, you can define Sexual Dysfunction Due to a General Medical Condition
(p. 208) and/or the Causes of Substance Use. Opened Sexual Function Bo A diagnosis of psychosis (p. 209) is made.
SEXUAL BEHAVIOR
Physical responses
Sexual response is a real psychophysiological experience. In DSM IV, the sexual response cycle is defined in 4 stages.
1. Desire: the desire or lust stage is separate from all stages defined in physiology and reflects the psychiatrist's basic idea about
motivation, drive and personality. .
Arousal: The arousal phase occurs with psychological stimulation (fantasy or the presence of a love object) or physiological stimulation (caressing or kissing), or a combination of both. It consists of a subjective feeling of pleasure
. The arousal phase is characterized by penile swelling leading to erection in men and vaginal lubrication in women
. Although both genders have erect nipples, this is more common in women. The woman's
clitoris becomes hard and swollen. Initial arousal can last from a few minutes to several hours. With continued stimulation
the man's testicle size increases by 50% and rises. The female vagina characteristically shows contraction
along its outer 1/3. This is the orgasmic labia region. The clitoris rises and the clitoris becomes inaccessible easily.
Breast size in women increases by 25%. Ongoing swelling in the penis and vagina causes specific color changes
. During this period, erotic feelings begin and vaginal lubrication occurs. In addition, breathing deepens
There is an increase in blood pressure and pulse rate. Some women may experience erection due to the increase in clitoral blood flow. The vagina expands.
Orgasm: During the orgasm phase, sexual tension is relaxed and sexual pleasure reaches its peak with rhythmic contractions of the perineal muscles and pelvic reproductive organs. A subjective feeling of ejaculation
inevitably triggers orgasm in men. Semen is released vigorously. Male orgasm is also accompanied by
rhythmic spasm of the prostate, seminal vesicles and vas and urethra 4 or 5 times. Women
orgasm is accompanied by long-lasting strong 3-15 involuntary
contractions in the lower 1/3 of the vagina and uterus, radiating from the fundus down to the cervix. Blood pressure increases and heart rate increases to 160 per minute. Orgasm lasts 3-25 seconds and is accompanied by confusion.
Resolution: Changes due to sexual stimulation disappear quickly. Pulse, ta Pressure breathing returns to normal within a few minutes
. It takes up to 15 minutes for the vagina to return to its resting state. If orgasm
has occurred, resolution is rapid. If not, it may take 2-6 hours. It may be accompanied by a feeling of irritability and discomfort.
Sexual Dysfunctions
In DSM-IV, sexual dysfunctions (SD) are examined in 7 categories:
1. Sexual desire disorders
br /> 2. Arousal disorders
3. Orgasm disorders
4. Sexual pain disorders
5. SD due to general medical condition
6. SD due to substance use
7. SDs that cannot be classified otherwise
In DSM-IV, SDs are considered as Axis I diagnoses. More than one disorder may coexist in patients.
Among SD, the most common single disorder is premature ejaculation. CIBs; It can be lifelong, acquired,
generalized and situational. It may be the result of another disease, due to substance use, or medication side effects. Sexual functions are very quickly affected by relationship problems and performance anxiety.
SDs are accompanied by other
psychiatric disorders such as depression, anxiety disorders, schizophrenia and personality disorders in many patients.
1. SEXUAL DESIRE DISORDERS
302.71 Decreased (Hypoactive) Sexual Desire Disorder
A. Persistent or recurrent low (or absent) sexual fantasies and desire to engage in sexual activity. The clinician makes a judgment that sexual desire is reduced or absent, taking into account the factors that affect sexual functionality, such as the person's age and living conditions.
B. This disorder causes significant distress or difficulties with interpersonal relationships.
C. This sexual dysfunction is not better explained by another Axis I disorder (other than another Sexual
Dysfunction) and is not just a symptom of a substance (e.g., a drug of abuse, a drug used for treatment
) or general It is not due to the direct physiological effects of a medical condition,
Sexual Desire Disorders: In DSM-IV, sexual desire disorders are examined in two groups. i) Hypoactive sexual
desire disorder and ii) Sexual aversion disorder.
Hypo
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