Bronner Gila, Etran Einat, Schachter Benny, Lavee Sari, Galin Arkadi, Raviv Gil
Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel Hashomer.
Harefuah. 2009 Sep;148(9):595-9, 658.
Increasing awareness and medical studies of sexual dysfunction (SD) unveil the multi-dimensional nature of SD and the need for a multidisciplinary treatment approach.
To describe the psychosexual contribution to the multidisciplinary model for the assessment and treatment of SD.
The psychosexual contribution will be demonstrated by 4 case reports and data of subjects applying for sex therapy during 2004-8.
A total of 822 women (age 35 +/- 12.0 years) and 813 men (age 38 +/- 13.2 years) applied for sex therapy; 44% were referred by a physician, 37% found information on the internet or in other media resources. The most frequent SDs in women were: hypoactive sexual desire disorder (HSDD] (29.7%), sexual pain (28.5%) and anorgasmia (20.9%); and in men: erectile dysfunction (44.2%), premature ejaculation (24.5%) and HSDD (17.5%). Co-morbid relationship distress was found in 217 of the cases (26.5%).
Subjects, referred by a physician or on their own initiation, present a variety of SDs, stemming from a combination of physical, psychological and interpersonal contributing factors. The presenting sexual problem is frequently the tip of the iceberg of hidden psychological problems, relationship distress or partner's SD. The overall goal of treatment is increased pleasure and satisfaction, rather than achieving a perfect genital response. Therefore, successful treatment outcome depends on multi-professional assessment and successful resolution of the issues that accompany the sexual complaint, sharing the process with patients and their partners.
对性功能障碍（SD）的认识不断提高以及医学研究揭示了SD的多维度性质和多学科治疗方法的必要性。
描述性心理在SD评估和治疗多学科模型中的作用。
通过4个病例报告以及2004年至2008年申请性治疗的受试者数据来展示性心理的作用。
共有822名女性（年龄35±12.0岁）和813名男性（年龄38±13.2岁）申请性治疗；44%由医生转诊，37%通过互联网或其他媒体资源获取信息。女性中最常见的SDs为：性欲减退障碍（HSDD）（29.7%）、性交疼痛（28.5%）和性高潮障碍（20.9%）；男性中为：勃起功能障碍（44.2%）、早泄（24.5%）和HSDD（17.5%）。217例（26.5%）存在共病的关系困扰。
由医生转诊或自行前来的受试者呈现出多种SDs，其源于身体、心理和人际因素的综合作用。所呈现的性问题往往是隐藏的心理问题、关系困扰或伴侣SD的冰山一角。治疗的总体目标是增加愉悦感和满意度，而非实现完美的生殖器反应。因此，成功的治疗结果取决于多专业评估以及成功解决伴随性主诉的问题，并与患者及其伴侣分享治疗过程。
