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SEXUAL PROBLEMS A. Sexual desire disorders: Hypoactive sexual desire disorder Sexual aversion disorder B. Sexual Arousal Disorders: Male Erectile Disorder (Impotence) Female Sexual Arousal Disorder (Frigidity) C. Orgasmic Disorders: Male Erectile Disorder (inhibited male orgasm) Premature ejaculation Female Orgasmic Disorder (inhibited female orgasm) D. Sexual Pain Disorders : Vaginismus Dyspareunia E. Common Functional problems: Penis anxiety Masturbation guilt Dhaat syndrome Unconsummated marriage Myths & Misconceptions about sexuality etc. F. Paraphilias: Homosexuality Transvestism Fetishism Pedophilia Sadism Masochism etc. G. Gender Identity Disorder Transsexualism H. Sexual Dysfunction due to General medical Conditions Diabetes Hypertension Heart attack Endocrinal diseases Psychiatric illness Malignancy Pregnancy Menopause HISTORY TAKING 1. General Sexual problems do occur in persons who do well in the other areas of health. Sexual Dysfunction may have its root in a simpler problem e.g. a. Pressure of performance or fear of failure b. Fear of rejection by the partner c. Imaginary demand of sexual performance d. Negative attitude towards sex e. Homosexual orientation f. Traumatic sexual experience in the past g. Dislike for the partner Sexual appetite varies depending upon: a. Basic biological drive b. Psychological need c. Physical & mental health d. Anxiety / Depression e. Defective interpersonal relationship Take the history of both the partners since it is the relationship to be treated and not the individual. 2. Identification data (of both) Name Age Sex Address Occupation Education Single/ Married No.of children Religion Marital Status Tel. No. Email ID Attendance Single/Couple 3. General Information O.D.P. Of the problem Male : Attitude towards Masturbation, Nocturnal emission, Size of Penis , Semen, Libido Female : Masturbation, Menstruation, Pregnancy, Coitus. 4. Past History H/O Diabetes, Hypertension, Tuberculosis, IHD, Liver/Kidney disease, mumps, STI/HIV infection H/O pre/Extra marital intercourse, sexual abuse Homosexual experiences (Attitude) Sex Games (Punished) H/O Surgery 5.Personal History Interpersonal relationship between the partners Drugs, Smoking, Alcohol, Medications, Diet, Exercise, Sleep Parents attitude towards sexuality Fatigue, Fear, Guilt 6. Psychiatric History Anxiety: Headache, Palpitation, Anger, Insomnia Depression: Crying spells, Sad mood, Suicidal ideas Personality disorder, Paranoid behavior, Schizophrenia 7.Cotial History Privacy, Communication, Light (on/off), Foreplay (yes/No) Frequency, Duration, Peno- Vaginal , Oral, Anal , Posture Male0 Desire, Erection, Penetration, Movements, Ejaculation Female- Desire, Lubrication, Intromission, Orgasm