health.am

Because there are numerous physical conditions that can contribute to pain during sexual encounters, a careful physical examination and medical history are always indicated with such complaints. In women, common physical…

The complaint of dyspareunia is most typically regarded as a problem unique to women, and in fact, dyspareunia is relatively rare in men (Sandberg and Quevillon 1987). Bancroft (1989) indicated that only 1% of the men…

One common theory about the development and maintenance of pedophiliac interest is that pedophiliac individuals recall sexual experiences with children because these memories are intensely erotic and become more so as they are paired…

Early attempts at aversion therapy involved the pedophiliac patient’s pairing or associating mildly painful, aversive stimulation (via electrical aversion) or nausea (induced by apomorphine) with sexual fantasies and sexual thoughts of children. These…

The single factor that separates pedophiles from nonpedophiles is the former’s ongoing, recurrent sexual fantasies or urges generally involving children under age 14 years. It is therefore not surprising that multiple treatments…

Most sexual behaviors are the result of an extensive chain of events that end with the consummation of a sexual act. Similarly, pedophiliac sexual acts are the eventual consequences of a chain of…

As previously described in this chapter, anxious and depressive symptoms and disorders have been identified in paraphilic sex offenders, nonoffender paraphilic men, and men with PRDs. DSM-IV (American Psychiatric Association 1994) notes that symptoms of…

In summary, although a paucity of empirical data are available from which to draw definitive conclusions about the efficacy of treatments for paraphilias and paraphilia-related disorders, the scientific rigor of such…

Although definitive research elucidating the complex neurobiological substrates of sexual behavior in humans is lacking, laboratory research of mammalian sexual behavior and monoamine neurotransmitters offers some potentially valuable data that might help…

The identification of consistent developmental events, psychological “traits,” or psychiatric comorbid diagnoses would be helpful in understanding developmental antecedents, risk factors, or possible pathophysiological correlates associated…

Contemporary biological investigators have noted an association between temporal lobe disorders and variant sexuality in males, including hypersexuality, hyposexuality and altered sexual preference (Langevin 1990). The temporal lobe, an integral component of…

Assessment of treatment outcome for paraphilias involving sexual aggression is fraught with methodological complexity. Indeed, some forensic clinicians doubt whether sex offenders have “psychiatric” disorders at all, inasmuch as…

Before considering specific treatment modalities for PAs and PRDs, it is useful to recognize the commonalties among these conditions. Both PAs and PRDs affect predominantly men, but published research…

We have witnessed an unprecedented expansion and popularity of the treatment of male erectile disorder during the last decade. Our society, though still quite prudish and hypocritical about sexual issues, is becoming…

The data on short-term outcome of treatment for male erectile disorder demonstrate various success rates. Sporadic studies with psychological treatment modalities have reported success rates of up to 80%. Some studies…

One additional comment addresses an important question - who should treat, who should counsel? As McConaghy (1993, p. 236) pointed out, many psychiatrists and psychologists would feel that only a…

Each patient with erectile dysfunction should receive individualized and integrated treatment of his erectile dysfunction, with all indicated modalities applied.

The first step after the thorough evaluation, diagnosis determination, and patient…

Topical vasodilatators Numerous topical vasodilatators have been tried in the management of erectile dysfunction (Crenshaw and Goldberg 1996, pp. 443-458). These include nitroglycerin 2% ointment, glyceryl trinitrate paste, and minoxidil gel rubbed…

Male erectile disorder should always be viewed in the broader psychosocial context. The treatment approach should be integrated and should include educational, psychological, and (if indicated) biological components. Treatment of any established underlying condition…

A comprehensive evaluation of erectile dysfunction is the cornerstone of the management plan. The evaluation should include an initial assessment; a detailed psychosexual, medical, and psychosocial history; a physical examination; and, if indicated,…

As Schiavi pointed out in the previous edition of this book, “emphasis on specific determinants of erectile disorders has been influenced by prevailing theoretical perspectives as they have shifted over the time”. We…

According to the latest estimate of prevalence of sexual dysfunction in the United States, sexual dysfunction was reported by 31% of males in a national probability sample from the 1992 National Health and…

Knowledge of the physiological processes underlying erection is essential in order to comprehend how the newest pharmacological agents exert their effects in treating male erectile disorder. Following is a brief…