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Healthinmind/Mental Health Disorders Sexual Disorders (excluding paraphilias) In this section we consider the kinds of problems that can arise in what most societies and most individuals consider as "normal" heterosexual relationships. In the section on paraphilias (literally, abnormal attractions) we consider diagnoses of sexual problems that involve socially disapproved forms of sexual behavior, and in the section on gender identity disorders we cover problems that arise when people are not satisfied with their biologically determined sexual identity. The importance of sex is so great that it is hardly necessary to say, in the case of each possible diagnosis, that the symptoms must "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." This DSM-IV requirement is almost guaranteed to apply to any substantial and persistent difficulty in an area so critical to human self-images and relationships. DSM-IV distinguishes four stages through which heterosexual intercourse is expected to progress: the desire phase, which involves fantasy and expectation; the excitement phase that should follow, during which both male and female prepare for intercourse; the orgasm phase, during which both male and female should experience pleasure, release, and the physiological accompaniments of orgasm; and the resolution phase, during which the partners should feel the sense of well-being that follows successful consummation of the sex act. Each of these phases is subject to disruption, and serious disruption of an earlier phase guarantees disruption (or nonexistence) of the later phase or phases. The repeated disruption of any phase puts a strain on sexual relationships. If the disruption occurs during attempted masturbation, the direct strain is limited to the individual involved. The first step in diagnosing a sexual disorder must be a thorough medical examination. Many medical or substance-related problems can cause sexual disorders; link to the medically caused dysfunctions page below for examples. Sexual disorders can also be a symptom of a mental disorder; depression is a good example. If you or someone you love experiences enough
symptoms to feel upset about it, you should consult a mental health
professional (clinician, therapist). A mental
health professional will conduct a thorough evaluation
to first understand what is happening and then will discuss
treatment options, including medications.
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