DOCSLIB.ORG

Sexuality, Relationships, Intimacy and Mental Health

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sexuality, Relationships, Intimacy and Mental Health No. 8, Spring/Summer 1999 BC’s Mental Health Journal Sexuality, Intimacy, and Relationships How do we include sexuality as a part of by Neil Henderson by recovery and rehabilitation? How are relationships © “Cheryl and Matthius: Two as One” © “Cheryl and Matthius: Two affected by mental illness? What is healthy sexuality? When is it a problem? honourable mentions editor’s message Thank you to Neil Henderson for his art contribution for this issue’s front cover. Neil — businessman turned artist, envi- ronmentalist, and vegetarian— took up painting only seven e are all in relationship months ago at the Art Studios (a program supported by the Wwith each other in one Greater Vancouver Mental Health Service). This is his four- form or another. And the na- BC’s teenth painting. Art, like every other worthwhile endeavour is ture and depth of our relation- Mental a talent acquired through training, dedication, and persistence. ships differ with each person. Health It is not, as many believe, something one is either born with or For some of us, we choose to Journal without. Neil says he would like this piece to evoke depths of be less intimate, even prefer- emotion, whatever those emotions may be. ring the company of animals or nature. For others, we need Editorial Board Nancy Dickie, Jane Duval, friendship, warmth, touch, Dr. Raymond Lam, Rajpal Singh physical and/or sexual intima- is a quarterly publication pro- Executive Director Bev Gutray cy, or a combination of these. duced by the Canadian Mental Editor Dena Ellery Health Association, BC Division. It is Staff Contributors Dena Ellery, Marie-Claude This issue of Visions gives life based on and reflects the guiding philos- Lacombe, Sarah Hamid to a topic which can often be ophy of the CMHA, the “Framework for Sup- Coordinator of Resource Development Ina Hupponen overlooked in the rehabilita- port.” This philosophy holds that a mental Design Sarah Hamid tion efforts of recovery from a health consumer (someone who has used Printing Advantage Graphix psychiatric diagnosis. Sexual- mental health services) is at the centre of ity, intimacy and relationships any supportive mental health system. It also The Canadian Mental Health Association is grateful to the BC can easily be forgotten in the advocates and values the involvement and Ministry of Health which has assisted in underwriting the search to find the right treat- perspectives of friends, family members, production of this journal. ments, the supports needed to service providers, and community. In this sustain a quality of life, and journal, we hope to create a place where the This issue of Visions is dedicated to the memory of former the right support people to many perspectives on mental health issues Canadian Mental Health Association, BC Division staff mem- help you along the way. But the can be heard. ber, KENNETH (Ken) P. SMITH. Ken lived in North Vancouver, humanness of our need to be BC. He was born October 2, 1961 in Vancouver, and died April in relationships must be ac- The Canadian Mental Health Association in- 11, 1999, at the age of 37. Ken lived with HIV/AIDS and died knowledged and be included vites readers’ comments and concerns re- of lung cancer. He will be remembered by many who worked as part of our vision of recov- garding articles and opinions expressed in with him as a creative and ever-journeying soul. The prayer ery for ourselves and for those this journal. Please e-mail us at here is one he chose to be part of his memorial, before he died: we work with who live with [email protected] or send your letter with mental illness. Hopefully, this your contact information to: issue of Visions will help to Lord, make me an instrument of thy peace make this happen. Visions Editor Where there is hatred let me sow love CMHA - BC Division Where there is injury; pardon I leave the editor role of Visions 1200 - 1111 Melville Street Where there is doubt; faith to begin studying in a new (but Vancouver, BC Where there is despair; hope not unrelated) field in Septem- V6E 3V6 Where there is darkness; light ber, 1999. I leave a journal Where there is sadness; joy which I’ve seen grow from Subscriptions are $25 a year for 4 issues. newsletter to national award- For more information, call us at 688-3234 Ken Smith Divine Master, grant that I may not so much winning publication (Visions or if you are calling from outside the Lower seek to be consoled as to console received the 1998 National 1961 – 1999 Mainland, dial our toll-free number: To be understood as to understand Media Award from the nation- 1-800-555-82221-800-555-8222. To be loved as to love. al Canadian Mental Health As- sociation). I hope you continue The opinions expressed in this journal are For it is in giving that we receive to read and be informed, sup- those of the writers and do not necessarily It is in pardoning that we are pardoned ported, inspired, and hopeful. reflect the views of the Canadian Mental It is in dying that we are born to eternal life. Health Association, BC Division or its branch offices. St. Francis Dena Ellery Guest Editorial ....................................................... 3 Challenges of Dating ............................... 15 2 Perspectives on Relationships and Intimacy ... 4 The Decision to Parent ............................ 16 Intimacy in Supervised Housing ......................... 11 Sex and Sexuality Problems .................. 18 ooNTENTSNTENTS Intimacy and Aging ............................................... 12 Abuse: A Challenge to Relationships .... 26 CC Sexual Orientation and Mental Illness .............. 12 Building a Healthy Sexuality .................. 28 Correction from last issue ................................... 13 Book Reviews ........................................... 30 Cross-Cultural Perspectives ................................. 14 Resources ................................................. 32 Visions: BC’s Mental Health Journal Sexuality, Intimacy, and Relationships No. 5, Spr/Summ ‘99 guest editorial Sex and Rehabilitation: Condoms in the bathroom are not enough ondoms in the nition of “sex” and when Dr. Bill bathrooms of men- William (Bill) L. Maurice MD, considering rehabilitation, Maurice C tal health centres FRCP(C) works at the Division of so many questions arise: make all of us feel better — Sexual Medicine, Department of What does the mentally ill as if we are actually doing Psychiatry at the University of person think about the con- something in the area of safe British Columbia, and at the Greater nection? What is the effect sex to help people with men- Vancouver Mental Health Service’s of pregnancy on that per- tal illness. While condoms in (GVMHS) Sexual Medicine Consul- son’s illness? What is the ef- the bathroom no doubt send tation Clinic. His recent book, a fect of the illness on that an important message, they guide to addressing sexuality issues person’s pregnancy? How might also be seen as the in primary care, is reviewed in this well is someone with a men- mental health equivalent of issue of Visions. tal illness equipped to man- the doctor who provides the age child-care? Is the person patient with a book instead using any form of birth con- of talking about a sexual Knowledge about sexual cal illness, we sometimes trol? If so, what kind? problem when it surfaces. matters is reasonably includ- think that people with a ed in the definition of “sex” mental illness should be Other issues may be includ- What do condoms in the and, therefore, we must talk grateful for the help they are ed in the definition of “sex” washroom have to do with about information deficits. already receiving, and that and may be grist for the rehabilitation of people with People with mental illness, sex should be a secondary mental health professional mental illness? One incon- especially those who have and subsidiary considera- mill including the capacity testable answer is that reha- schizophrenia, may have tion? Could it also be that we for intimacy, sexual orienta- bilitation must take place in come from families in tur- avoid regularly asking about tion, gender concerns, and an environment that is safe. moil and as a consequence, sexual side effects of medi- paraphilias (previously If that concept includes sex- lose the opportunity of see- cations because we don’t known as perversions). ual safety, and if talking ing the affectionate exchang- want people in our care to about the details of acquir- es between parents that make the connection and Since Visions is a quarterly ing and preventing STDs is Masters & Johnson identified thus stop using their medi- journal rather than a book best accomplished within as being instrumental in the cation (similar to the idea of and space is therefore limit- the context of talking about sex education of a child. In not asking a client about su- ed, it is possible to consider sexual matters generally, addition, people with men- icide because it might sug- only some of the compo- then sexuality will have to tal illness have often fore- gest that very notion to them nents of the word “sex” in join such issues as housing, gone the relationship and — a discredited idea)? this issue. However, the cru- transportation, and voca- sexual experimentation of cial point is not to be com- tional rehabilitation in the adolescence, and may (for In thinking about sexual prehensive, but for us to list of goals for working with example, in the case of those function, one could ask such always consider the subject people living with men- who are heterosexual) be questions as “How are you in the rehabilitation of peo- tal illness. missing basic information managing sexually when you ple with mental illness. In about the opposite sex. are alone?” “What about the days of the mental hos- Given the attention to sexu- when you are with a part- pital, sexual issues were ig- al issues in the rehabilitation Sexual function is unques- ner?” And if there are prob- nored until patients ended of those with a physical ill- tionably included in the def- lems “What do you think is up in bed with one another.
Load more

Recommended publications
  • Erectile Dysfunction and Premature Ejaculation
    GUIDELINES ON MALE SEXUAL DYSFUNCTION: Erectile Dysfunction and Premature Ejaculation (Text update April 2014) K. Hatzimouratidis (chair), I. Eardley, F. Giuliano, D. Hatzichristou, I. Moncada, A. Salonia, Y. Vardi, E. Wespes Eur Urol 2006 May;49(5):806-15 Eur Urol 2010 May;57(5):804-14 Eur Urol 2012 Sep;62(3):543-52 ERECTILE DYSFUNCTION Definition, epidemiology and risk factors Erectile dysfunction (ED) is the persistent inability to attain and maintain an erection sufficient to permit satisfactory sex- ual performance. Although ED is a benign disorder, it affects physical and psychosocial health and has a significant impact on the quality of life (QoL) of sufferers and their partners. There is increasing evidence that ED can be an early mani- festation of coronary artery and peripheral vascular disease; thus, ED should not be regarded only as a QoL issue but also as a potential warning sign of cardiovascular disease includ- ing lack of exercise, obesity, smoking, hypercholesterolaemia, and the metabolic syndrome. The risk of ED may be reduced by modifying these risk factors, particularly taking exercise or losing weight. Another risk factor for ED is radical prostatec- tomy (RP) in any form (open, laparoscopic, or robotic) because of the risk of cavernosal nerve injury, poor oxygenation of the corpora cavernosa, and vascular insufficiency. 130 Male Sexual Dysfunction Diagnosis and work-up Basic work-up The basic work-up (minimal diagnostic evaluation) outlined in Fig. 1 must be performed in every patient with ED. Due to the potential cardiac risks associated with sexual activity, the three Princeton Consensus Conference stratified patients with ED wanting to initiate, or resume, sexual activity into three risk categories.
    [Show full text]
  • The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified
    Arch Sex Behav DOI 10.1007/s10508-009-9552-0 ORIGINAL PAPER The DSM Diagnostic Criteria for Paraphilia Not Otherwise Specified Martin P. Kafka Ó American Psychiatric Association 2009 Abstract The category of ‘‘Not Otherwise Specified’’ (NOS) Introduction for DSM-based psychiatric diagnosis has typically retained diag- noses whose rarity, empirical criterion validation or symptomatic Prior to an informed discussion of the residual category for expression has been insufficient to be codified. This article re- paraphilic disorders, Paraphilia Not Otherwise Specified (PA- views the literature on Telephone Scatologia, Necrophilia, Zoo- NOS), it is important to briefly review the diagnostic criteria philia, Urophilia, Coprophilia, and Partialism. Based on extant for a categorical diagnosis of paraphilic disorders as well as the data, no changes are suggested except for the status of Partialism. types of conditions reserved for the NOS designation. Partialism, sexual arousal characterized by ‘‘an exclusive focus The diagnostic criteria for paraphilic disorders have been mod- on part of the body,’’ had historically been subsumed as a type of ified during the publication of the Diagnostic and Statistical Man- Fetishism until the advent of DSM-III-R. The rationale for con- uals of the American Psychiatric Association. In the latest edition, sidering the removal of Partialism from Paraphilia NOS and its DSM-IV-TR (American Psychiatric Association, 2000), a para- reintegration as a specifier for Fetishism is discussed here and in a philic disorder must meet two essential criteria. The essential companion review on the DSM diagnostic criteria for fetishism features of a Paraphilia are recurrent, intense sexually arousing (Kafka, 2009).
    [Show full text]
  • Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases
    SPECIAL ARTICLE Use of DSM Paraphilia Diagnoses in Sexually Violent Predator Commitment Cases Michael B. First, MD, and Robert L. Halon, PhD There is legitimate concern in the psychiatric community about the constitutionality of sexually violent predator (SVP) commitment statutes. Such constitutionality depends on the requirement that a sexual offender have a mental abnormality that makes him commit violent predatory sex offenses and reflects almost exclusively a concern for public safety, with little regard for notions of clinical sensibility or diagnostic accuracy. However, given that mental health experts’ diagnostic opinions are, and will continue to be, important to the triers of fact in regard to the application of the SVP statutes, we describe valid means of making a DSM-IV-TR paraphilic diagnosis. We also provide a three-step approach for the judicious application of the diagnosis in the context of SVP commitment evaluations that emphasizes the importance of not making a paraphilia diagnosis based solely on the sexual offenses themselves. Finally, we discuss the appropriate use of a paraphilia NOS diagnosis in SVP cases. J Am Acad Psychiatry Law 36:443–54, 2008 In 1990, the state of Washington passed the first Despite several challenges to the constitutionality sexually violent predator (SVP) involuntary commit- of SVP statutes, the U.S. Supreme Court in two sep- ment statute, which was designed to allow for the arate rulings (Kansas v. Hendricks3 and Kansas v. civil commitment of sex offenders to mental hospi- Crane4) upheld the constitutionality of the Kansas tals after they complete mandatory prison sentences. State Sexually Violent Predator laws, essentially mak- According to the Washington SVP statute, the of- ing similar laws with analogous proof requirements fender must be found to be “a person who has been constitutional in all states.
    [Show full text]
  • Delayed Ejaculation & Anorgasmia
    Delayed ejaculation & anorgasmia EMMANUELE A. JANNINI Chair of Endocrinology & Sexual Medicine Tor Vergata University of Rome, Italy It Soc Androl & Sex Med – President-elect Taxonomy of ejaculatory disorders Epidemiology of ejaculatory disorders 25 a) timing 20 – PREMATURE EJACULATION 15 – DELAYED EJACULATION 10 Percentage 5 b) modality 0 E N IA R PE DE IO M AS ‐ RETROGRADE EJACULATION LAT G U R O JAC ‐ ANEJACULATION (impotentia ejaculationis) E AN AN Taxonomy of ejaculatory disorders • EMISSION PHASE DISORDERS: – Retrograde ejaculation • EJACULATION PHASE DISORDERS: – Premature ejaculation – Deficient ejaculation: • Delayed ejaculation • Anejaculation • ORGASM DISORDERS: – Anorgasmia – Postorgasmic illness syndrome Standard Operating Procedures (SOP) in Diagnosis and Treatment of Delayed Ejaculation/Anejaculation ISSM Standards Committee Meeting June 23-25, 2010 Hotel Agneshof Nürnberg, Germany Pierre Assalian Canada Emmanuele A. Jannini Italy Chris G McMahon (Chairman) Australia David Rowland USA Marcel Waldinger (Chairman) The Netherlands DELAYED EJACULATION Delayed ejaculation • Much less frequent than PE • A rare reason for medical help seeking • Underdiagnosed • Undertreated Is DE a disease? • girls are happy… …where is the problem? …but girls are not happy… Why so poor science? • Low prevalence • Few studies • Classically considered A new psychogenic in nature • Classically treated with behavioral therapies challenge • Definition(s) lacking • Etiologies largely unknown for • Pathogenesis obscure • Lack of awareness and Sexual acknowledgements
    [Show full text]
  • List of Paraphilias
    List of paraphilias Paraphilias are sexual interests in objects, situations, or individuals that are atypical. The American Psychiatric Association, in its Paraphilia Diagnostic and Statistical Manual, Fifth Edition (DSM), draws a Specialty Psychiatry distinction between paraphilias (which it describes as atypical sexual interests) and paraphilic disorders (which additionally require the experience of distress or impairment in functioning).[1][2] Some paraphilias have more than one term to describe them, and some terms overlap with others. Paraphilias without DSM codes listed come under DSM 302.9, "Paraphilia NOS (Not Otherwise Specified)". In his 2008 book on sexual pathologies, Anil Aggrawal compiled a list of 547 terms describing paraphilic sexual interests. He cautioned, however, that "not all these paraphilias have necessarily been seen in clinical setups. This may not be because they do not exist, but because they are so innocuous they are never brought to the notice of clinicians or dismissed by them. Like allergies, sexual arousal may occur from anything under the sun, including the sun."[3] Most of the following names for paraphilias, constructed in the nineteenth and especially twentieth centuries from Greek and Latin roots (see List of medical roots, suffixes and prefixes), are used in medical contexts only. Contents A · B · C · D · E · F · G · H · I · J · K · L · M · N · O · P · Q · R · S · T · U · V · W · X · Y · Z Paraphilias A Paraphilia Focus of erotic interest Abasiophilia People with impaired mobility[4] Acrotomophilia
    [Show full text]
  • 2018 Juvenile Law Cover Pages.Pub
    2018 JUVENILE LAW SEMINAR Juvenile Psychological and Risk Assessments: Common Themes in Juvenile Psychology THURSDAY MARCH 8, 2018 PRESENTED BY: TIME: 10:20 ‐ 11:30 a.m. Dr. Ed Connor Connor and Associates 34 Erlanger Road Erlanger, KY 41018 Phone: 859-341-5782 Oppositional Defiant Disorder Attention Deficit Hyperactivity Disorder Conduct Disorder Substance Abuse Disorders Disruptive Impulse Control Disorder Mood Disorders Research has found that screen exposure increases the probability of ADHD Several peer reviewed studies have linked internet usage to increased anxiety and depression Some of the most shocking research is that some kids can get psychotic like symptoms from gaming wherein the game blurs reality for the player Teenage shooters? Mylenation- Not yet complete in the frontal cortex, which compromises executive functioning thus inhibiting impulse control and rational thought Technology may stagnate frontal cortex development Delayed versus Instant Gratification Frustration Tolerance Several brain imaging studies have shown gray matter shrinkage or loss of tissue Gray Matter is defined by volume for Merriam-Webster as: neural tissue especially of the Internet/gam brain and spinal cord that contains nerve-cell bodies as ing addicts. well as nerve fibers and has a brownish-gray color During his ten years of clinical research Dr. Kardaras discovered while working with teenagers that they had found a new form of escape…a new drug so to speak…in immersive screens. For these kids the seductive and addictive pull of the screen has a stronger gravitational pull than real life experiences. (Excerpt from Dr. Kadaras book titled Glow Kids published August 2016) The fight or flight response in nature is brief because when the dog starts to chase you your heart races and your adrenaline surges…but as soon as the threat is gone your adrenaline levels decrease and your heart slows down.
    [Show full text]
  • Male Anorgasmia: from “No” to “Go!”
    Male Anorgasmia: From “No” to “Go!” Alexander W. Pastuszak, MD, PhD Assistant Professor Center for Reproductive Medicine Division of Male Reproductive Medicine and Surgery Scott Department of Urology Baylor College of Medicine Disclosures • Endo – speaker, consultant, advisor • Boston Scientific / AMS – consultant • Woven Health – founder, CMO Objectives • Understand what delayed ejaculation (DE) and anorgasmia are • Review the anatomy and physiology relevant to these conditions • Review what is known about the causes of DE and anorgasmia • Discuss management of DE and anorgasmia Definitions Delayed Ejaculation (DE) / Anorgasmia • The persistent or recurrent delay, difficulty, or absence of orgasm after sufficient sexual stimulation that causes personal distress Intravaginal Ejaculatory Latency Time (IELT) • Normal (median) à 5.4 minutes (0.55-44.1 minutes) • DE à mean IELT + 2 SD = 25 minutes • Incidence à 2-11% • Depends in part on definition used J Sex Med. 2005; 2: 492. Int J Impot Res. 2012; 24: 131. Ejaculation • Separate event from erection! • Thus, can occur in the ABSENCE of erection! Periurethral muscle Sensory input - glans (S2-4) contraction Emission Vas deferens contraction Sympathetic input (T12-L1) SV, prostate contraction Bladder neck contraction Expulsion Bulbocavernosus / Somatic input (S1-3) spongiosus contraction Projectile ejaculation J Sex Med. 2011; 8 (Suppl 4): 310. Neurochemistry Sexual Response Areas of the Brain • Pons • Nucleus paragigantocellularis Neurochemicals • Norepinephrine, serotonin: • Inhibit libido,
    [Show full text]
  • Paraphilia NOS, Nonconsent: Not Ready for the Courtroom
    ANALYSIS AND COMMENTARY Paraphilia NOS, Nonconsent: Not Ready for the Courtroom Allen Frances, MD, and Michael B. First, MD Sexually violent predators (SVP) constitute a serious potential risk to public safety, especially when they are released after too short a prison sentence. Twenty states and the federal government have developed a seemingly convenient way to reduce this risk. They have passed statutes that allow for the involuntary (often lifetime) psychiatric commitment of mentally disordered sexual offenders after prison time is up. In three separate cases, the Supreme Court has accepted the constitutionality of this procedure, but only if the offender’s dangerousness is caused by a mental disorder and is not a manifestation of simple criminality. The idea that paraphilic rape should be an official category in the psychiatric diagnostic manual has been explicitly rejected by Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R, DSM-IV, and, recently, DSM-5. Despite this, paraphilia NOS, nonconsent, is still frequently used by mental health evaluators in SVP cases to provide a mental disorder diagnosis that legitimizes psychiatric commitment and makes it appear constitutional. This commentary will show how the diagnosis paraphilia NOS, nonconsent, is based on a fundamental misreading of the original intent of the DSM-IV Paraphilia Workgroup and represents a misuse of psychiatry, all in the admittedly good cause of protecting public safety. J Am Acad Psychiatry Law 39:555–61, 2011 The legal system unwittingly created a dilemma for rage when recently released offenders reoffended, itself 30 years ago when it adopted fixed sentencing as sometimes in the most horrible ways imaginable.
    [Show full text]
  • Premature Ejaculation: a Clinical Review for the General Physician
    CLINICAL Premature ejaculation: A clinical review for the general physician Eric Chung, Brent Gilbert, Marlon Perera, Matthew J Roberts Background remature ejaculation is one of the ejaculatory latency time (IELT). The most common sexual dysfunctions, IELT is defined as the time from vaginal Premature ejaculation is one of the most P affecting up to 21–31% of the penetration to ejaculation. Lifelong common sexual dysfunctions in men. Australian adult male population, premature ejaculation is characterised Recent epidemiological studies suggest irrespective of their age, marital status or by an IELT of <1 minutes since first its prevalence in Australia may range ethnicity.1–5 This sexual condition is likely intercourse, whereas IELT of <3 minutes from 21–31%. to be under-reported and under-treated at any point in a man’s life is considered 12 Objective because of the patients’ perceived shame to be acquired premature ejaculation. and low self-esteem. This is in addition to Premature ejaculation can be further This article will discuss the current many physicians feeling uncomfortable divided into authority-based subtypes definition of premature ejaculation from or uncertain about the management ‘variable’ and ‘subjective’ (Table 1), a urological perspective. It will provide of premature ejaculation.6,7 The impact which describe individuals experiencing an understanding of the pathogenesis of premature ejaculation is mostly felt significant distress and dissatisfaction of premature ejaculation, as well as psychologically and in interpersonal with ejaculation.12 assessment and management options. relationships.8 Men with premature ejaculation often experience significant Pathophysiology and Discussion psychological distress, avoid physical and associations Premature ejaculation can have a emotional intimacy, and become victims Psychological components often significant adverse effect on the quality of false medical advertisings and unproven contribute to acquired premature of life for the patient and his sexual medical management.8 –11 ejaculation.
    [Show full text]
  • HIV and Sexual Dysfunction in Men
    Journal of Clinical Medicine Review HIV and Sexual Dysfunction in Men Sara De Vincentis 1,2 , Giulia Tartaro 1,2, Vincenzo Rochira 1,2,* and Daniele Santi 1,2 1 Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; [email protected] (S.D.V.); [email protected] (G.T.); [email protected] (D.S.) 2 Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy * Correspondence: [email protected]; Tel.: +39-059-396-2453; Fax: +39-059-396-1335 Abstract: Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) man- agement, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.
    [Show full text]
  • Delayed Ejaculation* Cal Disease May Also Play a Role in DE
    Patient Highlights JSMInformation about sexual health issues & treatments © 2013 International Society for Sexual Medicine What Causes DE? Physical causes may account for DE, as any procedure or disease that disrupts the nervous systems path to the genitals (spinal cord injury, multiple sclerosis, pelvic-region surgery, severe diabetes, alcoholism, etc.) has the potential to inter- fere with ejaculation and orgasm. It is frequently useful for a doctor to conduct a physical examination and medical history that may identify problems (such as reversible ure- thral, prostatic, epididymal, and testicular infections) as well as hormonal (androgen, etc.) contributory factors. A number of drugs may cause DE. Common culprits include drugs for high blood pressure, antidepressants, antipsychotic drugs, and some drugs that are used to treat prostate growth or baldness. Decreased sensation of the penis (often associated with aging) may also be a factor. Finally, there is increasing evidence that some men have natural variation in their ejacu- lation latency (how long they last during sex) and this may lead to DE-like problems for some couples. What Biological Factors may Play a Role in DE? Many believe that DE is a neurobiological variation of a “normal” ejaculatory statistical distribution curve. It is known from studies in animals as well as humans from around the world that there is a great variation between couples in how long sexual intercourse lasts. Some of these differences may be cultural, but there is increasing evidence that predisposing genetic factors have an effect on the speed and ease of ejaculation by modulating brain chemicals and a variety of biological mechanisms that control ejaculation.
    [Show full text]
  • Childhood Sexual Abuse and Erectile Dysfunction in Gay And
    CHILDHOOD SEXUAL ABUSE AND ERECTILE DYSFUNCTION IN GAY AND BISEXUAL MEN: THE ROLE OF SUBSTANCE USE, EMOTION DYSREGULATION, AND COPING STRATEGIES by Marie Faaborg-Andersen Bachelor of Arts, Concordia University, Montreal, Quebec, 2012 A thesis presented to Ryerson University in partial fulfillment of the requirements for the degree of Master of Arts in the Program of Psychology Toronto, Ontario, Canada, 2015 © Marie Faaborg-Andersen, 2015 AUTHOR’S DECLARATION FOR ELECTRONIC SUBMISSION OF A THESIS I hereby declare that I am the sole author of this thesis. This is a true copy of the thesis, including any required final revisions, as accepted by my examiners. I authorize Ryerson University to lend this thesis to other institutions or individuals for the purpose of scholarly research. I further authorize Ryerson University to reproduce this thesis by photocopying or by other means, in total or in part, at the request of other institutions or individuals for the purpose of scholarly research. I understand that my thesis may be made electronically available to the public. ii Abstract Childhood sexual abuse and sexual dysfunction in gay and bisexual men: The role of substance use, emotion dysregulation, and coping strategies Master of Arts, 2015 Marie Faaborg-Andersen Psychology, Ryerson University Sexual dysfunction has been associated with considerable mental health and interpersonal problems. Gay and bisexual men report a higher rate of sexual dysfunction and childhood sexual abuse (CSA) compared to heterosexual men. The relationship between CSA and adult sexual health problems has been well established; however, the pathways leading from CSA to erectile dysfunction are poorly understood.
    [Show full text]