Sexual medicine is the branch of medicine that deals with sexual disorders and their treatment. It can thus take place at the organic and psychological level.
What is sexual medicine?
Roughly, sexual medicine can be divided into the two areas of organic and psychological or psychiatric treatment. It deals with all disorders of a sexual nature. First, sexual medicine deals with sexual problems such as physical disorders in men and women, finding sexual identity, and dealing with and living with a sexual inclination and deviation from the social norm. Sexual medicine can be used alone or in conjunction with another health condition. For example, many men in middle to old age suffer from erectile dysfunction, but the root cause may be incipient heart disease. In these cases, sexual medicine is used concomitantly with cardiac treatment. At this point, however, psychological counselors already come into play. In addition to sexual problems that can be regulated by medication or psychological treatment, sexual medicine also covers the area of potentially dangerous paraphilias. Their treatment usually extends into the psychiatric realm, as these are serious disorders that include, for example, necrophilia or pedophilia.
Treatments and therapies
Fortunately, the majority of sexual medicine does not deal with dangerous paraphilias related to crimes, but with sexual disorders that can be treated by medication, psychology, or a combination of the two. Common cases in the drug division of sexual medicine deal with libido and sexual desire, potency or fertility. In women in particular, sexual medicine and gynecology are sometimes closely related, for example when it comes to questions about female sexuality before and during pregnancy and after childbirth. In the case of such problems, medications can help the person concerned to feel sexual desire again, to give a boost to declining potency or to become pregnant together with a partner. In addition to drug therapies, surgical procedures are sometimes considered. However, since human sexuality is also significantly influenced by the psyche, there is the psychological branch of sexual therapy, which can be used to accompany sexual medicine and treat some problems on their own without medicinal and surgical procedures. In the psychological spectrum, sexual medicine often covers a person’s sexual identity and finds out what their sexual orientation is when they are unsure of themselves. In some cases, the psychological branch of sexual medicine also leads to the organic branch, such as when a patient wants a surgical sex change because they feel they are the wrong biological sex. The psychological branch of sexual medicine thereby merges into the psychiatric branch, which deals with the handling of paraphilias that result in the affected person not only suffering himself, but also harming other members of society as a result.
Diagnosis and methods of investigation
Different methods are used for diagnosis and treatment in the medical as well as in the psychological field of sexual medicine. If it is a physical problem, the affected patient is first also physically examined. As with any problem that may be psychological, an organic cause must first be ruled out. In addition, sexual problems can also indicate other underlying diseases, so that sexual medicine can lead to the discovery of a previously undetected physical disease. The first step is to examine the patient’s general health, take a blood count, check blood pressure and test for deficiency symptoms. Sex-specific examinations of the reproductive organs may also be performed. Women, for example, are familiar with the examination of the cervix by a gynecologist with a smear test, but an ultrasound image or palpation examinations can also provide information. In order to find out what sexual problems the patient is suffering from and where they might come from, a medical history must also be taken in sexual medicine – as in every other aspect of medicine.In the psychological field, similar work is done, using several methods to treat a recognized problem in psychological sexual medicine. Since sexual problems often stem from a person’s childhood and early experiences, most psychologists in the field of sexual medicine work with Freudian deep analysis. Furthermore, methods such as mindfulness can help the patient get to know himself and his own sexual sensations better. The choice of method depends on which psychological schools a sex therapist follows and what problem is present in his client. In the case of paraphilias with the risk of harming other people through them, the person concerned is usually given psychiatric care and treated differently depending on how dangerous they are to society. There are paraphilias with which the affected person can live well – he remains free of punishment for the rest of his life, because he has learned to direct his sexual needs in healthy ways. In other cases, on the other hand, sexual medicine must consist of permanently monitoring the affected person, since the risk is too high that he could harm an uninvolved third party. However, this type of treatment is only necessary in rare cases. As a rule, mentally based sexual problems can be well treated by simple and effective psychotherapy.
