Sexuality as an Important Aspect of Human Nature - Research Paper Example

?Sexual Dysfunctions Introduction Sexuality is an important aspect of human nature and its expression is as important as its effects on the nature ofthe person. Malfunctions in sexuality lead to depression, aggression, frustration, inferiority complex, battered self-esteem, and relationship problems, asserts Dr. Hope Ashby (2008, p.66). Videbeck (2010) defines sexual dysfunction as “a disturbance in the processes in the sexual response cycle” which consists of “desire, excitement, orgasm, and resolution” (p.156). This disturbance may be felt in the form of pain or absence of feeling at all. Some of the very common sexual dysfunctions or disorders are: sexual desire disorders, sexual arousal disorders, orgasmic disorders, sexual pain disorders, paraphilias (in which the person experiences intense sexual urges toward non-human things, children, etc.), gender identity disorder (in which the person wishes to be of the opposite sex due to dissatisfaction of the gender roles assigned to his/her sex), and many more. Also, sexual dysfunctions may be classified as primary or secondary in nature. A primary sexual dysfunction is one which a person has always been experiencing. A secondary sexual dysfunction is one which a person has started experiencing after being normal all his life. A woman who has always experienced pain during intercourse has a primary sexual dysfunction; while, a woman who has started feeling pain with a current partner and did not experience it with any of the previous partners has a secondary sexual dysfunction. This paper intends to elaborate upon one specific kind of sexual arousal dysfunction in men: erectile dysfunction. Erectile Dysfunction Videbeck (2010) defines erectile dysfunction (ED) as “a persistent or recurrent inability to attain or maintain, until completion of the sexual activity, an adequate erection, which causes marked distress or interpersonal difficulty” (p.156). It is the kind of impotence in which the person is totally unable to achieve enough firm erection to complete the sexual act; is inconsistently able to achieve erections; or, attains erections that last only a few seconds. Causes and Risk Factors Agravat (2010) asserts that the main cause of ED is the insufficient flow of blood to the penis (p.1). The blood flow sustains in the penis for such a brief time period that is not enough for the man to achieve and maintain a firm erection. This also results in an inability to ejaculate. For a perfect erection, the nervous system must be healthy enough to conduct sexual impulses from the brain through the spinal cord to the penis. Also, the arteries located in the neighborhood of corpora cavernosa must also be functioning properly. A malfunctioning nervous system or imperfect arteries near corpora cavernosa may cause ED. Moreover, ED can also occur if the muscles and tissues that are located inside the corpora cavernosa are not smooth, or if there is an insufficient supply of nitric oxide inside the penis. Some of the most important risk factors that are likely to cause ED are: advanced age, cardiovascular disease, diabetes mellitus, high cholesterol, cigarette smoking, recreational drug use, depression, psychiatric disorders, and stress (MedicineNet Inc., 2011). Symptoms The symptom of ED is not being able to achieve and maintain an erection. Since, it has been described above, let’s jump onto the diagnosis section. Diagnosis Diagnosis requires that the patient and the physician share a good communicative relationship so that the cause of ED is identified and its severity is taken into account. During diagnosis, the physician brings into consideration questions like: is it really ED or the patient is confusing it with loss of libido or premature ejaculation? Are there any psychological factors involved? Is the patient being able to maintain involuntary erections in the morning or during sleep (which are usually maintained by men having psychogenic ED)? Are there any physical factors causing atherosclerosis resulting in ED? Is ED a result of any medication being taken by the patient for some other illness? After these considerations, a physical exam is conducted which evaluates physical factors like response of penis on touch; hormonal imbalances like testosterone levels; flow of blood using a stethoscope; occurrence of other diseases like Peyronie's disease; and, other risk factors. After this exam, laboratory tests are conducted that show blood’s complete picture including urinalysis, lipid profile, blood glucose level, hemoglobin; liver function tests; and, other blood tests to evaluate zinc deficiency, sickle cell anemia, lupus, etc. ultrasounds are also done to check any abnormality inside the penis and the size of testicles. Doppler imaging test determines the flow of blood to the penis. A psychosocial exam is also conducted. After the identification of the cause, treatment is started. Treatment Major treatment options include psychotherapy, drug therapy, physical therapy, vacuum procedure, surgeries, and in many cases, improved life style. Improved Life Style Many men are able to overcome this disorder by quitting smoking, exercising, and reducing fat by increasing physical exertion. Changing drugs that the patient is already taking for other diseases may also be necessary. Psychotherapy Psychotherapy sessions with the physician is an important part of treatment of ED because the patient might be undergoing depression, stress, anxiety, or relationship problems at home or at workplace, that might be contributing to his not being able to arouse himself enough for an erection. His partner is also interviewed to identify her expectations of sexual intercourse. The partner can also help in devising strategies to stimulate the man’s desires through intimacy. This helps relieve stress. Drug therapy Medicine or drugs are either taken orally or are injected into the penis, corpora cavernosae or the urethra. Examples of pills to be taken orally for long period erection are Viagra, Vardenafil Hydrochloride (Levitra), and Tadalafil (Cialis). All of these drugs belong to class phosphodiesterase (PDE) inhibitors, and work by increasing the blood flow to the penis and the level of nitric oxide. Papaverine Hydrochloride, Phentolamine, and Alprostadil are drugs that are injected into the penis to engorge the blood vessels. The side effects are that these drugs may cause liver damage, pain inside penis, redness and urethral bleeding. Surgery Surgery is done to implant such a device inside the penis that causes it to erect; to reconstruct the arteries that are responsible for the flow of blood; or, to put a blockage to veins that are responsible for blood leakage from penile tissues. Financial Costs Ongoing costs of drugs and medications must be considered. The treatment procedures are expensive but pills that are readily available on medical stores are quite cheaper. Further Research Further research is being carried out in vacuum operations are inject-able drugs. Prognosis and Prevalence Rate McVary (2010) states that “30-40% of men over 40 have ED to one degree or another” (p.39). McVary gives a reference to Data from Massachusetts Male Aging Study (MMAS) which verifies that among aging men, ED has a “prevalence rate of 34.8% of moderate to complete ED” (p.39). ED is very much dependent upon the age of the patient. The prevalence rate rises with age started from 2% in men aged 40-49, 6% in men aged 50-59, 17% in men aged 60-69, and 39% in men aged 70 (McVary). Kirby, Carson and Goldstein (1999, p.2) state that the prevalence rate is difficult to identify because men are hesitant to talk about their impotence. Effects on Family and Quality of Life Kirby, Carson and Goldstein (1999, p.1) assert that although ED is not a severe form of illness, still it inflicts drastic impacts on the lives of both the patient and the partner. The relationship with the partner starts deteriorating because she is not able to attain satisfaction from the sexual act. This further leads to added stress and depression. The person goes through loss of self-esteem and reduced level of self-confidence. He may develop shame and emotional disturbances as a permanent problem. When ED stays for prolonged time in the patient’s life, it results in extreme depression which then gives rise to heart problems, increased blood pressure, heart attacks, circulatory problems, and other psychiatric disorders resulting from extreme emotional disturbance. Conclusion / Personal Opinion What I learned from this paper is that ED may be caused by psychological or physical factors and it is important for the physician to conduct psychotherapy sessions with the patient to reach the root cause. I believe that it is very likely for a man to be unable to have an erection if he is suffering from stress whether at workplace or at home. If he has many things on his mind, or he is having trouble in a relationship, or he is stressed out because of heavy workload, then there are great chances that he will not be able to get sufficiently aroused for an erection. However, physical factors cannot be ignored and physical exam is necessary to figure out the cause. I also learnt that ED affects the quality of life as well because the patient may lose self-confidence and suffer from constant anxiety and shame. His sexual relationship with the partner gets destroyed and this emotional turmoil can result in serious complications in the life to come. Hence, necessary medications and procedures must be tried so as to be able to achieve and maintain an erection through the sexual intercourse. Financial costs for the operative procedures and injections are high at present but pills are cheaper and readily available at drug stores. References Agravat, P. (2010). What is sexual and erectile dysfunction in men? A Guide to Sexual and Erectile Dysfunction in Men. UK: Troubador Publishing Ltd. Ashby, H. (2008). Female sexual dysfunction: you don’t have to live with it. Ebony, 63.4, p.66. Kirby, R.S., Carson, C.C., & Goldstein, I. (1999). Epidemiology. Erectile Dysfunction: A Clinical Guide. UK: Taylor & Francis. McVary, K.T. (2010). Contemporary Treatment of Erectile Dysfunction: A Clinical Guide. USA: Springer. MedicineNet Inc. (2011). Impotence (ED). MedicineNet.com. Retrieved April 08, 2011, from http://www.medicinenet.com/impotence_ed/page2.htm#risks Videbeck, S.L. (2010). Sexual dysfunctions. Psychiatric-Mental Health Nursing. USA: Lippincott Williams & Wilkins. Read More