Sexual Health Center
Sexual Health Center
The World Health Organization (WHO) defines sexual health as the positive enrichment and empowerment of personality, communication, and love through the comprehensive consideration of sexual life in physical, mental, intellectual, and social aspects. Sexual health is also regarded as an important and positive aspect of personal health.
Sexuality is a significant part of human life, playing a crucial role in forming and maintaining close relationships. Therefore, sexual problems can be a major source of distress for individuals, extending beyond the loss of pleasure and satisfaction. Sexual dysfunction refers to disorders that hinder a person from engaging in sexual intercourse as desired. Sexual intercourse involves four phases: desire, arousal, satisfaction, and relaxation. Problems in one or more of these phases can lead to sexual dysfunction. These problems can have both organic and psychological causes. Often, sexual dysfunction results from a combination of organic and psychological factors. This makes it important to approach sexual dysfunction from a multidisciplinary perspective, involving psychiatrists, urologists, and gynecologists as necessary. Common organic causes include vascular diseases, hypertension, diabetes, chronic illnesses, side effects of medications, alcohol or drug use, and more.
Various psychological factors contribute to sexual dysfunction and can play a role in its persistence. These include a person's upbringing, societal attitudes toward sexuality, misinformation or lack of knowledge about sexuality, misconceptions about sex, psychiatric disorders, relationship conflicts, loss of attraction between partners, infidelity, post-pregnancy and post-partum psychological problems, sexual problems in the partner, exposure to physical and sexual violence, traumatic sexual experiences, lack of sexual self-confidence, and performance anxiety, among others. Most often, sexual dysfunction is a result of psychosocial and cultural factors.
Hypoactive Sexual Desire
Hypoactive sexual desire is a condition characterized by a decrease or absence of sexual desire and fantasies. It can develop early in life or later on. It may be accompanied by sexual aversion disorder, which is an aversion to sexual intercourse and masturbation. It is more common in women. Hypoactive sexual desire can be associated with sexual fears, chronic stress, anxiety, depression, marital problems, negative sexual experiences, and medication use.
Sexual Arousal Disorder
Sexual arousal disorder refers to an inadequate level of arousal. Women with arousal issues often experience insufficient lubrication. In contrast, men with arousal problems struggle to achieve and maintain an erection, a condition known as erectile dysfunction. Erectile dysfunction occurs when the erection is not sufficient for sexual intercourse in terms of duration and strength. In men, erectile dysfunction is the most common reason for seeking sexual therapy. It affects 10-20% of the adult male population and becomes more common after the age of 60. In younger and middle-aged men, the condition is primarily psychological. Many men experience occasional difficulties with erections, and if these problems persist for more than two months and occur frequently, it is important to consult a specialist.
Orgasm Disorder
Orgasm disorders involve persistent and recurrent delays or the absence of orgasm during masturbation or sexual intercourse. These disorders are more prevalent in women than in men. Women who previously experienced orgasm may develop difficulties achieving it at some point in their lives. Approximately 25% of women are unable to reach orgasm in the first year of their marriage. Research suggests that women have an easier time achieving orgasm as they gain sexual experience. Fears of pregnancy or injury, feelings of guilt, marital problems, and medication use can negatively impact the ability to orgasm. In men, orgasm may be delayed or not occur at all. In some cases, men with diabetes or those taking antipsychotic medications may experience retrograde ejaculation, where the semen goes into the bladder, leading to a weak orgasm. Urine may appear cloudy after an orgasm. Premature ejaculation is the most common sexual dysfunction in men. It is characterized by the inability to control ejaculation during sexual intercourse. Ejaculation can occur before penetration, during penetration, or shortly after penetration. This issue is mostly related to psychological factors and is a common reason for men to seek sexual therapy. The primary goal of treatment is to reduce anxiety. Specific techniques can be taught to help improve ejaculation control. Psychotherapy, often in combination with medication, can be effective in managing premature ejaculation.
Vaginismus
Vaginismus is a condition in which involuntary contractions of the muscles around the vagina occur, making it painful or impossible for women to engage in sexual intercourse. It is the most common reason for women to seek sexual therapy. Typically, the first specialist women consult is a gynecologist. Physically, there are no pathologies that prevent sexual intercourse in women with vaginismus. Vaginismus is often related to inadequate or incorrect sexual education, along with fears associated with it. Other contributing factors include a repressive or overly conservative upbringing, insufficient knowledge of their genital anatomy, baseless concerns about the size of the penis and the tightness of the vagina, and the fear of pain during intercourse. While not uncommon, vaginismus can lead to other sexual problems within the relationship, such as early ejaculation, reduced sexual interest, and erectile dysfunction. If left untreated, it can lead to marital issues. In some cases, couples' therapy may be necessary.
Sedatives, alcohol, pain relief ointments, and hymenectomy do not provide a solution and can exacerbate hopelessness and fear. Couples are advised to seek therapy together.