A fulfilled sexual life is one of the basic building blocks of a healthy life. The mental health status of the individual is closely related to the sexual life. Disruptions in sexual life lead to dissatisfaction in life by direct effect and pave the way for various mental illnesses.
Sexuality is a multidimensional concept, and the sexual cycle consists of several stages. Disturbances that may occur in one or more of these stages appear as sexual problems or sexual dysfunction. These stages are sexual desire, sexual arousal and orgasm . There may be different sexual disorders associated with each of these stages; Lack of sexual desire, sexual aversion disorder, erectile dysfunction in men, sexual arousal disorder in women, premature ejaculation (management of ejaculatory disorder), lack of orgasm. Apart from this, problems with sexual intercourse (vaginismus, pain during intercourse) are other common sexual dysfunctions. On the other hand, a few of these problems often coexist in the individual. For example, in a patient with erectile dysfunction, it is common to develop a lack of sexual desire over time. It is also surprizing for one partner to develop a sexual dysfunction over time when the other spouse has sexual dysfunction.
The treatment of sexual dysfunctions is psychotherapy, drug treatment is not useful except in a few special cases. This is because the cause of the problem is purely psychological. This psychological cause is mainly related to one of the spouses. (personality traits, past traumatic life experiences) or problems in the relationship of the couple. On the other hand, sexual dysfunctions are among the most common mental problems. Although the source of the problem is psychological, many people .(physicians or non-physicians) who work outside the mental health field offer inappropriate treatment for these problems.
It is more appropriate for psychiatrists or psychologists to have adequate training specific to this field in order to undertake the treatment of individuals or couples with sexual dysfunction. Otherwise, wrong or inadequate treatment experiences may happen. Every unsuccessful treatment attempt makes the solution of the problem even more difficult. It decreases the success chance of subsequent treatment . For this reason, it is very to choose the right psychiatrist to solve the problem.
Sexual therapy is the main Psychotherapy in the treatment of sexual dysfunction. In this therapy, both cognitive-behavioral therapy and couple therapy techniques work well . In addition, individual psychodynamic psychotherapy is also effective.
Psychotherapy of sexual dysfunctions is an individual program. However in some special cases, it can become couple therapy when the problem affects the other spousal.
Although it varies according to the problem, it is aimed to solve the sexual problem in a process that lasts an average of 8-10 sessions. The home exercises, which are given as homework in sexual therapy should be performed gradually.
Behavioral techniques used in these exercises are essential for this therapy. It’s also important for patient to take note of these and to make changes to the problem. And reviewing them together with the therapist during the sessions. Otherwise, even fixing the problem won’t be enough. This solution will not be permanent. It is very important to understand the problem of getting a detailed life story and sexual tory by interviewing the spouses separately in the first sessions. A sexual-psychoeducation session follows home exercises.