GROUP 6

BCM 4110: MENTAL HEALTH AND SUBSTANCE ABUSE

ASSIGNMENT ONE

SUBMTTED ON 24th OCTOBER 2024

NAME REGISRATION NUMBER SIGN

KEVIN KIRUI BSCM/2021/94027
ALFRED MOMO BSCM/2022/57913
CELDON ODIE BSCM/2021/96163
BEATRICE ACHIENG OMULO BSCM/2021/96024
IRENE JEPKOGEI BSCM/2021/96589
GLORIA JEPKORIR BSCM/2022/51410
RODHA HAD BSCM/2022/58394
YAHLA LIBAN BSCM/2020/69276
JOSEPH MNALA BSCM/2021/40637

TASK: WITH RELEVANR EXAMPLES DIFFERENTIATE AND DISCUSS SEXUAL

CONDITIONS AND SEXUAL DISORDERS FOR BOTH MEN AND WOMEN
INTRODUCTION
Sexual disorders and sexual conditions
Sexual conditions -Refers to anything that prevents you from feeling pleasure from sexual
activity. Being unable to enjoy or not wanting to engage in sexual activities. Sexual disorders are
specific sexual dysfunctions caused by persons inability to fully engage in and derive pleasure
from sex, It’s very common and highly treatable. Things like stress, health conditions,
medication or past sexual trauma can cause it.
SEXUAL DISORDERS
EXAMPLES OF SEXUAL DISORDERS
 Low sexual desire. This most common of female sexual dysfunctions involves a lack of
sexual interest and willingness to be sexual.
 Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with
arousal or are unable to become aroused or maintain arousal during sexual activity.
 Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after
sufficient sexual arousal and ongoing stimulation.
 Sexual pain disorder. You have pain associated with sexual stimulation or vaginal
contact.
 Sexual sadism disorder
 Sexual sadism is infliction of physical or psychological suffering (e.g., humiliation,
terror) on another person to stimulate sexual excitement and orgasm. Sexual sadism
disorder is sexual sadism that causes clinically significant distress or functional
impairment or is acted on with a nonconsenting person.
 Sexual sadism is diagnosed in < 10% of rapists but is present in 37 to 75% of people
who have committed sexually motivated homicides
 Treatment of Sexual Sadism Disorder: Sometimes cognitive-behavioral therapy
(group or individual) Sometimes antiandrogen medications. Treatment of sexual
sadism is not necessary if the interests, fantasies, and behaviors do not involve
nonconsenting persons and there is an absence of clinically significant distress or
impairment.
 Pedophilic disorder
 Pedophilic disorder is characterized by recurrent, intense sexually arousing fantasies,
urges, or behaviors involving sexual activity with prepubescent children (generally 13
 years); based on clinical criteria, it is diagnosed only when the patient is 16 years and
5 years older than the child who is the target of the fantasies or behaviors.
 Most pedophiles are male. The prevalence is unknown but estimated to be up to 3%
of the adult male population and substantially lower in women. Attraction may be to
children or adolescents of one or more than one gender. But pedophiles prefer
opposite-sex to same-sex children 2:1. In most cases, the adult is known to the child
and may be a family member, stepparent, or a person with authority (e.g., a teacher,
clergy, a coach). Looking at children undressed and fondling their genitals seems
more prevalent than intercourse for non-incest cases of pedophilia.
 Treatment of Pedophilic Disorder: Individual and/or group psychotherapy ,Treatment
of comorbid disorders ,Pharmacologic therapy (e.g., antiandrogens, selective
serotonin reuptake inhibitors [SSRIs]) Long-term individual or group psychotherapy,
particularly cognitive-behavioral therapy, is usually necessary and may be especially
helpful when it is part of multimodal treatment that includes social skills training,
treatment of comorbid physical and psychiatric disorders, and pharmacologic therapy
CAUSES

Sexual problems often develop when your hormones are in flux, such as after having a baby or
during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel
(cardiovascular) disease, can also contribute to sexual dysfunction.
Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:
* Physical. Any number of medical conditions, including cancer, kidney failure, multiple
sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain
medications, including some antidepressants, blood pressure medications, antihistamines and
chemotherapy drugs, can decrease your sexual desire and your body's ability to experience
orgasm.
* Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues
and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic
region, which can result in less genital sensation, as well as needing more time to build arousal
and reach orgasm.The vaginal lining also becomes thinner and less elastic, particularly if you're
not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire
also decreases when hormonal levels decrease.Your body's hormone levels also shift after
giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your
desire to have sex.
* Psychological and social. Untreated anxiety or depression can cause or contribute to sexual
dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy
and demands of being a new mother may have similar effects.Long-standing conflicts with your
partner — about sex or other aspects of your relationship — can diminish your sexual
responsiveness as well. Cultural and religious issues and problems with body image also can
contribute.

Risk factors
Some factors may increase your risk of sexual dysfunction:
* Depression or anxiety
* Heart and blood vessel disease
* Neurological conditions, such as spinal cord injury or multiple sclerosis
* Gynecological conditions, such as vulvovaginal atrophy, infections or lichen sclerosus
* Certain medications, such as antidepressants or high blood pressure medications
* Emotional or psychological stress, especially with regard to your relationship with your
partner
* A history of sexual abuse

Symptoms and Causes

Overview
Sexual dysfunction can happen at any point during the sexual response cycle. The sexual
response cycle is a four-stage model of a person’s response to sexual stimulation. It includes:
 Excitement: This phase includes desiring sex and becoming aroused. It includes much of
the sexual activity before intercourse such as foreplay, a penis becoming erect or a
clitoris swelling.
 Plateau: This is the phase just before orgasm. Heart rate, muscle tension and breathing
intensify. A penis may discharge pre-ejaculate (pre-cum).
 Orgasm: A sudden release of sexual tension and pleasure in your genitals. Ejaculation
occurs during orgasm.
 Resolution: The calming down period just after orgasm. Your body relaxes and your
genitals return to their normal state.
While research suggests that sexual dysfunction is common, many people don’t like talking
about it. Because treatment options are available, though, you should share your concerns with
your partner(s) and healthcare provider.
MALE AND FEMALE SEXUAL DYSFUNCTION
Some types of sexual dysfunction affect men and people assigned male at birth (AMAB) more
than women and people assigned female at birth (AFAB). Conversely, some types of sexual
dysfunction affect women and people AFAB more than men and people AMAB.
In people assigned male at birth:
1. Inability to achieve or maintain an erection (hard penis) for intercourse (erectile
dysfunction).
2. Absent (anejaculation) or delayed ejaculation despite enough sexual stimulation.
3. Inability to control the timing of ejaculation (premature ejaculation).

In people assigned female at birth:

1. Inability to achieve orgasm (anorgasmia).
2. Vaginal dryness before and during intercourse. This could be due to vaginal atrophy.
3. Inability to relax your vaginal muscles enough to allow for intercourse (vaginismus).
4. Sexual dysfunction that affects anyone:
5. Lack of interest in or desire for sex (low libido).
6. Inability to become aroused.
7. Pain with intercourse (dyspareunia).
Physical causes of sexual dysfunction could include:
 Chronic conditions such as kidney or liver failure.
 Diabetes.
 Heart and vascular diseases.
 Neurological disorders like multiple sclerosis (MS) or nerve damage.
 Hormonal imbalances.
 Cancer.
 Alcohol use disorder and substance use disorder (SUD).
 Pregnancy and breastfeeding (chestfeeding).
 Menopause.
Additionally, the side effects of some medications, including antidepressant drugs, can affect
sexual function.

Psychological causes of sexual dysfunction

Your emotions and feelings can also play a role in sexual dysfunction. These could include:
 Stress or anxiety.
 Marital or relationship problems.
 Depression.
 Poor body image.
 History of sexual trauma or abuse.
 Depression or feelings of guilt.
 Concerns about your sexual performance.
 Advertisement
SEXUAL CONDITIONS
Ejaculatory dysfunction
Ejaculatory dysfunction can be broadly classified into 2 types:

 Diminished ability to produce ejaculate (retrograde ejaculation, anejaculation)

 Abnormal timing of ejaculation (premature ejaculation, delayed ejaculation)

Diminished ability to produce ejaculate is usually due to advanced age, pathology, or

iatrogenic causes, while the abnormal timing of ejaculation is more often related to
psychological factors.

Retrograde ejaculation can have multiple causes. Neuropathy from diabetes mellitus and
certain medications such as alpha blockers (eg, tamsulosin for benign prostatic hyperplasia
[BPH]) can cause impaired relaxation of the urethral sphincter, and surgical BPH procedures
such as transurethral resection of the prostate (TURP) can cause permanent iatrogenic
retrograde ejaculation.

1. Anejaculation can be caused by seminal tract obstruction, neurological dysfunction,

injury, radiation, or surgery. A classic cause of anejaculation is radical prostatectomy
for prostate cancer, which results in removal of seminal vesicles and, consequently,
elimination of semen production.

2. Premature ejaculation is defined as ejaculation occurring sooner than desired by the

man or his partner and causing distress to them both. It is usually caused by sexual
inexperience, anxiety, and other psychological factors rather than disease. It can be
treated successfully with topical anesthetics, sex therapy, tricyclic antidepressants,
and selective serotonin reuptake inhibitors.

3. Delayed ejaculation is often related to psychological factors, but erectile dysfunction

and certain medications (eg, serotonin reuptake inhibitors) can contribute as well.
Treatment of underlying erectile dysfunction and psychosexual therapy are the
 mainstays of treatment. Some medications are used to treat delayed ejaculation (eg,
cabergoline and bupropion).

4. Low Libido
 Libido is the conscious component of sexual function. Decreased libido manifests as
a lack of sexual function.Afffects both men women
 Decreased libido manifests as a lack of sexual interest or a decrease in the frequency
and intensity of sexual thoughts, either spontaneous or in response to erotic stimuli.
 Libido is sensitive to testosterone levels as well as to general nutrition, health, and
drugs. Conditions particularly likely to decrease libido include depression; up to 25%
of men with hypogonadism, chronic kidney disease, and diabetes may meet the
definition of hypogonadism.
 Drugs that potentially decrease libido include weak androgen receptor antagonists
(e.g., spironolactone, cimetidine), luteinizing hormone-releasing hormone agonists
(e.g., leuprolide, goserelin, buserelin) and antagonists (e.g., degarelix) used to treat
prostate cancer, antiandrogens used to treat prostate cancer (e.g., f flutamide,
bicalutamide), 5-alpha-reductase inhibitors (e.g., finasteride, dutasteride) used to treat
benign prostatic hyperplasia, some antihypertensives, and virtually all drugs that are
active in the central nervous system (e.g., selective serotonin reuptake inhibitors
[SSRIs], tricyclic antidepressants, antipsychotics).

5.Erectile disfunction

 Erectile dysfunction is the inability to attain or sustain an erection satisfactory for

sexual intercourse. Most erectile dysfunction is related to vascular, neurologic,
psychologic, and hormonal disorders; drug use can also be a cause.
 Evaluation typically includes screening for underlying disorders and measuring
testosterone levels. Treatment options include oral phosphodiesterase inhibitors,
intraurethral or intracavernosal prostaglandins, vacuum erection devices, and surgical
implants. The prevalence of partial or complete ED is > 50% in men aged 40 to 70,
and prevalence increases with aging
 Most affected men can be successfully treated.
  Etiology of Erectile Dysfunction There are 2 types of erectile dysfunction (ED):
Primary ED, the man has never been able to attain or sustain an erection Secondary
ED, acquired later in life by a man who previously was able to attain erections
 Primary ED is rare and is almost always due to psychologic factors or clinically
obvious anatomic abnormalities.
 Secondary ED is more common, and > 90% of cases have an organic etiology. Many
men with secondary ED develop reactive psychologic difficulties that compound the
problem.
 Psychologic factors, whether primary or reactive, must be considered in every case of
ED. Psychologic causes of primary ED include guilt, fear of intimacy, depression, or
anxiety. In secondary ED, causes may relate to performance anxiety, stress, or
depression.
 Psychogenic ED may be situational, involving a particular place, time, or partner. The
major organic causes of ED are physiologic (organic) Vascular disorders Neurologic
disorders These disorders often stem from atherosclerosis or diabetes.
 The most common vascular cause is atherosclerosis of cavernous arteries of the penis,
often caused by smoking, endothelial dysfunction, and diabetes.
 Neurologic causes include stroke, partial complex seizures, multiple sclerosis, peripheral
and autonomic neuropathies, and spinal cord injuries. Diabetic neuropathy and surgical
injury are particularly common causes. Complications of pelvic surgery (e.g., radical
prostatectomy [even with nerve-sparing techniques], radical cystectomy, rectal cancer
surgery) are other common causes
SCHIZOPHRENIA AND SEXUAL DYSFUNCTION.
1. Antipsychotic medication and sexual dysfunction
The link between antipsychotic medication and sexual dysfunction is widely accepted
and it’s estimated that between 16-60% of people with a diagnosis of schizophrenia who
take antipsychotic medications experience sexual dysfunction (e.g. loss of libido,
difficulty maintaining an erection, vaginal dryness, inability to orgasm) (Serretti &
Chiesa, 2011).
2. Negative symptoms
The experience of psychosis/schizophrenia is often associated with a reduction in an
individual’s thought processing and emotions, meaning people can struggle to be
emotionally expressive, enthusiastic or motivated. Reduced functioning in these areas is
often collectively referred to as ‘negative symptoms’. It is thought being emotionally
inexpressive may be associated with a decrease in sexual interest and could also make it
difficult to meet and interact with people (de Jager et al., 2017; Zemishlany & Weizman,
2008).
3. Stigma
Internalised stigma may increase social isolation and concerns about sexual inadequacy,
having a detrimental impact on sexual interest and activity (de Jager et al., 2017,
Redmond, Larkin & Harrop, 2010).
REFERENCE
1. Mulligan T, Frick MF, Zuraw QC, et al: Prevalence of hypogonadism in males
aged at least 10.11
2. Harman SM, Metter EJ, Tobin JD, et al; Baltimore Longitudinal Study of Aging.
Longitudinal effects of aging on serum total and free testosterone levels in healthy
men.
3. Rastrelli G, Guaraldi F, Reismann Y, et al: Testosterone replacement therapy for
sexual symptoms.
4. Balon R: Medications and sexual function and dysfunction. J Lifelong Learning
Psychiatry 7(4). Published online. October 2009.
5. Stoffel JT, Van der Aa F, Wittmann D, et al: Fertility and sexuality in the spinal
cord injury patient.
6. Sadowski DJ, Butcher MJ, Köhler TS: A review of pathophysiology and
management options for delayed ejaculation.