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Sexual medicine is a medical specialty that deals with sexual health. At times heavily influenced by current local views on morality, with heavy cultural overlay, in broad terms this specialty is concerned with diagnosing, assessing and treating all aspects which relate to sexuality.
Issues can be divided into two main areas of concern:
- disorders of the sexual organs
- disorders of the psyche affecting sexuality
Sexual medicine has four dimensions:
- The promotional dimension (increases awareness and helps individuals have a healthy and fulfilling sex life)
- The preventive dimension (counseling)
- The curative dimension (clinical treatment of specific sexual disorders)
- The rehabilitative dimension (helps patients regain sexual health)
Disorders of the sexual organs
Congenital or acquired, these conditions refer to any pathology which interferes with the perception of satisfactory sexual health. Varied conditions include absent sexual organs, hermaphrodite and other genetic malformations, or trauma such as amputation or lacerations. Sexually transmitted disease accounts for by far the largest proportion of patients in this category. Of these, HIV and consequently AIDS represents a significant threat to populations throughout the world, but more especially Africa, and within Africa in the sub-Saharan area.
Disorders of the psyche affecting sexuality
A wide range of disorders can be mentioned in this section. While those unaffected can – and often do – mock the afflicted, such issues can be earth shattering in their consequences for the individual, resulting in depression, murder and suicide. Whole cultures have been adversely affected by adhering to specific attitudes regarding sexuality. Issues such as genital mutilation (e.g. circumcision), institutionalised rape, and honour killings can be attributed to such problems which, although accepted as "the norm" for a specific culture, would in other circumstances be regarded as deviant behaviour.
Examples of conditions which may be treated by specialists in this field include, but are not limited to:
- Erectile dysfunction
- Loss of libido
- Dyspareunia – pain on intercourse
- Failure to complete intercourse
- Sexuality issues
The anamnesis or medical history taking of issues related to sexual or reproductive medicine may be inhibited by a reluctance of the patient to disclose intimate or uncomfortable information. Even if such an issue is on the patient's mind, he or she often doesn't start talking about such an issue without the physician initiating the subject by a specific question about sexual or reproductive health. Some familiarity with the doctor generally makes it easier for patients to talk about intimate issues such as sexual subjects, but for some patients, a very high degree of familiarity may make the patient reluctant to reveal such intimate issues. When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.