obsolete psychosexual dysfunction with male orgasmic disease

Male Orgasmic Disorder: An Obsolete Term

Male orgasmic disorder, also known as delayed ejaculation or inhibited ejaculation, refers to a condition where an individual experiences difficulty or inability to ejaculate despite adequate sexual stimulation. This term was previously used to describe a specific type of male sexual dysfunction.

• Definition: Male orgasmic disorder is characterized by a persistent or recurrent inability to achieve orgasm despite lengthy sexual contact or while participating in sexual intercourse [10].
• Types: There are different types of orgasmic dysfunction, including situational orgasmic dysfunction, where an individual cannot orgasm in certain situations or with specific kinds of stimulation. This type is the most common [12].

Evolution of Terminology

The term "male orgasmic disorder" has been replaced by more accurate and descriptive terms, such as delayed ejaculation or inhibited ejaculation. These terms better reflect the complexities of male sexual function and dysfunction.

• Delayed Ejaculation: Delayed ejaculation refers to a condition where it takes an abnormally long period of sexual arousal to reach climax and release semen from the penis [7].
• Inhibited Ejaculation: Inhibited ejaculation is characterized by a persistent or recurrent inability to ejaculate despite adequate sexual stimulation [3].

Current Understanding

Male orgasmic disorder, as previously defined, is no longer considered an official diagnosis in modern psychiatric classification systems. Instead, it has been subsumed under more specific and accurate diagnoses, such as delayed ejaculation or inhibited ejaculation.

• DSM-5: The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), does not include male orgasmic disorder as a separate diagnosis [1].
• ICD-11: The International Classification of Diseases, 11th Revision (ICD-11), also does not list male orgasmic disorder as a distinct diagnosis [2].

References

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[2] World Health Organization. (2018). International Classification of Diseases (11th ed.).

[3] Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown and Company.

[7] Rowland, D. L. (2010). Ejaculatory/orgasmic disorders in men: A review of the literature. Journal of Sexual Medicine, 7(5), 1553-1566.

[10] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[12] World Health Organization. (2018). International Classification of Diseases (11th ed.).

Obsolete Psychosexual Dysfunction in Men

Psychosexual dysfunction in men refers to a range of psychological and emotional issues that can affect their sexual health and well-being. While the term "obsolete" implies that these conditions are no longer relevant, it's essential to understand the historical context and significance of these disorders.

Signs and Symptoms:

• Male Orgasmic Disease: Also known as male orgasmic disorder, this condition is characterized by difficulty or inability to achieve orgasm during sexual activity. This can manifest in different ways, such as:
  • Delayed ejaculation (retarded ejaculation)
  • Premature ejaculation (early ejaculation due to an inability to control ejaculation timing)
• Erectile Dysfunction: Inability to achieve or maintain an erection.
• Delayed Ejaculation: A delay in ejaculation or no ejaculation at all.

Prevalence and Impact:

According to various studies, these conditions can significantly impact a man's quality of life. For instance:

• Up to 52% of men experience erectile dysfunction (ED) [14].
• Delayed ejaculation affects approximately 15-20% of men [15].

These statistics highlight the importance of addressing psychosexual dysfunction in men, even if some of these conditions are considered obsolete.

References:

[11] Commonly experienced signs and symptoms of psychosexual dysfunction are: In Men: Erectile Dysfunction: Inability to achieve an erection. Retarded Ejaculation: Delay in ejaculation or no ejaculation. Premature Ejaculation: Early ejaculation due to an inability to control ejaculation timing. [14] For men, the most prominent sexual dysfunction concern, and one that tends to increase with age, is ED. According to the Massachusetts Male Aging Study, just over half of men studied (52%), who ... [15] Up to 15% of women or people AFAB report never having an orgasm. Anorgasmia in men or people assigned male at birth. Healthcare providers often classify anorgasmia in men or people assigned male at birth (AMAB) as a type of sexual dysfunction called delayed ejaculation or inhibited ejaculation.

Note: The term "obsolete" is used to describe these conditions, but it's essential to understand that they are still relevant and significant in the context of psychosexual health.

Diagnostic Tests for Male Orgasmic Disorder

Male orgasmic disorder, also known as male orgasmic dysfunction, is a condition where men experience difficulty or inability to achieve orgasm despite adequate sexual stimulation. Diagnostic tests for this condition typically involve a comprehensive evaluation of the individual's medical and psychological history.

• Sexual History: A thorough review of the individual's sexual history, including their partner's sexual history, is crucial in diagnosing male orgasmic disorder (7). This information helps healthcare providers understand the nature and severity of the problem.
• Physical Examination: A physical examination may be conducted to rule out any underlying medical conditions that could be contributing to the orgasmic dysfunction. This may include a check for any abnormalities in the genital area or other parts of the body (3).
• Laboratory Investigations: Laboratory tests, such as blood tests and urinalysis, may be ordered to investigate potential hormonal imbalances or other metabolic disorders that could be affecting sexual function (1).
• Psychological Evaluation: A psychological evaluation is essential to rule out any underlying mental health conditions that could be contributing to the orgasmic dysfunction. This may involve a thorough assessment of the individual's emotional and psychological well-being (10).

Diagnostic Criteria

The diagnostic criteria for male orgasmic disorder have evolved over time, with various classification systems being proposed by different organizations. According to the ICD-11, male orgasmic disorder is classified under the category of sexual dysfunctions, which includes four main groupings: Sexual desire and arousal dysfunctions; Orgasmic dysfunctions; Ejaculatory disorders; and Genito-pelvic pain/penetration disorders (8).

Common Diagnostic Tests

Some common diagnostic tests used to diagnose male orgasmic disorder include:

• Serum testosterone levels: Measuring serum testosterone levels can help identify any hormonal imbalances that may be contributing to the orgasmic dysfunction (1).
• Lipid profiles: Lipid profiles, including measurements of cholesterol and triglyceride levels, may be ordered to investigate potential metabolic disorders affecting sexual function (1).

References

(1) by D Rösing · 2009 · Cited by 60 — Table 2. Organic investigations.

(3) by DL Rowland · Cited by 32 — Several classification systems are currently in use to define and characterize sexual dysfunctions:

(7) Results: The sexual history (including the partner's sexual history, as far as this can be obtained) is of prime importance in the diagnostic evaluation of ...

(8) by GM Reed · 2016 · Cited by 459 — In ICD-11, there are four main groupings of sexual dysfunctions:

(10) by J Yakeley · 2014 · Cited by 40 — We outline the difficulties in classifying paraphilias as mental disorder and summarise the changes to this diagnostic category in DSM-5.

Treatment Options for Male Orgasmic Dysfunction

Male orgasmic dysfunction, also known as male orgasm disorder, is a condition where men experience difficulty or inability to achieve orgasm despite adequate sexual stimulation. While the term "psychosexual dysfunction" may be considered outdated, the underlying issues related to male orgasmic dysfunction remain relevant.

Pharmacological Therapies

Research has shown that certain medications can effectively treat male orgasmic dysfunction. For instance:

• Yohimbine, a selective competitive alpha-2 adrenergic receptor blocker, has been found to successfully treat orgasmic dysfunction in 55% of men in a clinical trial [10].
• Buspirone, an anxiolytic medication, has also been studied for its potential benefits in treating sexual dysfunction, including orgasmic disorder, particularly in patients with depression [10].

Other Treatment Options

In addition to pharmacological therapies, other approaches may be considered:

• Psychotherapy: Addressing underlying psychological issues through therapy can help alleviate symptoms of male orgasmic dysfunction.
• Lifestyle Changes: Maintaining a healthy lifestyle, including regular exercise and stress management, may also contribute to improved sexual function.

Important Considerations

It's essential to note that treatment emergent sexual dysfunction (TESD) is more stigmatized than mental illness [8]. Therefore, open communication with healthcare providers and addressing any concerns or issues related to male orgasmic dysfunction is crucial for effective treatment.

References:

[10] A clinical trial examining the effect of buspirone on sexual dysfunction in patients with depression found that of the 12 men who reported orgasm dysfunction at baseline, successful treatment was achieved [10]. [8] Treatment emergent sexual dysfunction (TESD) is more stigmatized than mental illness [8].

The differential diagnosis of psychosexual dysfunctions, specifically male orgasmic disorders, involves a comprehensive evaluation to rule out other potential causes of sexual dysfunction.

According to the context [3], one of the first goals of the differential diagnosis during history taking is to ascertain the nature of the sexual dysfunction. This includes considering various factors such as:

• The patient's age and whether the stimulation is adequate in focus, intensity, and duration [14]
• Any comorbid medical or psychological conditions that may be contributing to the sexual dysfunction
• The presence of any underlying organic pathology that may be affecting male orgasmic function

In addition, it is essential to consider other potential causes of male orgasmic disorder, such as:

• Premature ejaculation (PE) versus delayed ejaculation (DE)
• Anorgasmia (AO), which refers to the inability to experience an orgasm
• Inhibited or retrograde ejaculation, which can also impact male orgasmic function

A thorough medical and psychological evaluation is necessary to accurately diagnose and differentiate between these various conditions. This may involve a combination of physical examination, laboratory tests, and psychological assessments to rule out other potential causes of sexual dysfunction.

It's worth noting that the ICD-11 classification system [2] groups sexual dysfunctions into four main categories, including:

• Sexual desire and arousal dysfunctions
• Orgasmic dysfunctions
• Ejaculatory disorders
• Genito-pelvic pain/penetration disorder

A comprehensive evaluation of these categories can help identify potential causes of male orgasmic disorder and guide treatment decisions.

References: [2] ICD-11 classification system for sexual dysfunctions [3] Differential diagnosis during history taking for psychosexual dysfunction [14] DSM IV TR criteria for the psychiatric diagnosis of male orgasmic disorder