DISFUNGSI SEKSUAL

7 Kategori ganggguan Menurut DSM

IV
1. Gang hasrat seksual
2. Gang rangsang seksual
3. Gang Orgasme
4. Gang nyeri seksual
5. Disfungsi seksual krn kondisi medis
6. Disfungsi seksual akibat zat
7. Disfungsi seksual yang tidak ditentukan
2

 Premature (early) ejaculationalso

referred to as rapid ejaculationis

the most common type of sexual
dysfunction in men younger than 40
years

Definition
occurrence of ejaculation earlier than

both sexual partners wish.

 In almost all or all (75-100%) sexual activity,

the experience of a pattern of ejaculation

occurring during partnered sexual activity
within 1 minute after vaginal penetration and
before the individual wishes it
The symptoms above have persisted for at
least 6 months
The symptoms above cause significant
distress to the individual
The dysfunction cannot be better explained
by nonsexual mental disorder, a medical
condition, the effects of a drug or medication,
or severe relationship distress or other
significant stressors

Severity
Mild (occurring within approximately 30

seconds to 1 minute of vaginal

penetration)
Moderate (occurring within
approximately 15-30 seconds of vaginal
penetration)
Severe (occurring before sexual activity,
at the start of sexual activity, or within
approximately 15 seconds of vaginal
penetration)

Duration
Lifelong (present since first sexual

experience)
Acquired (developing after a period
of relative normal sexual functioning)

Biolog
y

Psycholo
gy

Cultur
al

Etiology
Pscychologic factors
Evolutionary factrors
Psychoanalytic
Lifelong ejaculation---Traumatic

disturbances (incest, sexual assault)

Acquired ejaculation---Erectile
dysfunction

Pathophysiology
Mechanism of ejaculation
Emission
Expulsion

 Emission
During the emission phase, semen (e.g.,

sperm and seminal fluids) is deposited

into the posterior urethra through
contractions of the smooth muscles of
the vasa deferentia, seminal vesicles,
and prostate. At the same time, the
internal sphincter of the urinary bladder
is closed, thereby preventing retrograde
passage of the semen into the bladder.

 Expulsion
During expulsion, the semen is forcefully

propelled along the urethra and out of

the penis by clonic contractions of the
striated bulbar muscles of the urethra
and contractions of the striated muscles
of the pelvic floor (mainly
bulbospongiosus muscles).

Neurotransmitter
Serotonin (5 hydroxytryptamine, 5-

HT)
5-HT resceptors

Diagnosis
Check other medical conditions (i.e

angina, erectile dysfunction)

History taking include :

Traumatic sex episodes

Comparison with peer friends
Work or school
Attitude toward sex
Partner condition (i.e. Dyspareunia)
Nonsexual problems of relationship (i.e.
does the couple fight ?)

DD
Partner Sexual response
Psychotropic drug
Preejaculate

Treatment
Consultation : Psychologist, sex

therapist, psychiatrist
SSRI : Daily treatment can be
performed with paroxetine (2040
mg), clomipramine (1050 mg),
sertraline (50100 mg), and
fluoxetine (2040 mg).

References
Deem S G. Premature Ejaculation.

2014. [online]. Accessed in

http://emedicine.medscape.com/art
icle/435884-treatment#aw2aab6b6b4
Balon R, Sergraves T R. Handbook of
Sexual dysfunction. Taylor & Francis
Group, 2005.

Thank You