Abstract

SANCHEZ BRAVO, Claudia; CORRES AYALA, Norma Patricia; CARRENO MELENDEZ, Jorge  and  HENALES ALMARAZ, Consuelo. Profiles of the indicators related with male sexual dysfunctions: erectile dysfunction, male orgasmic disorder and precocious ejaculation. Salud Ment [online]. 2010, vol.33, n.3, pp.237-242. ISSN 0185-3325.

The systematic study of sexuality is relatively recent if we consider the works of Freud and Kinsey and the studies performed during the first half of the XXth century. The fact of undertaking the sex problem has allowed an even deeper understanding of this phenomenon, by all means complex. Later on, Masters, Johnson and Kolodny created the model of human sexual response and its alterations. Kaplan's works as well as Labrador and Crespo's are directed to conceptualize the etiology of sexual dysfunctions as phenomena evolving from both recent and remote causes, i.e., they can be explained as multi-causal events. At the Department of Psychology of the National Institute of Perinatology (INPerIER), we have detected a high proportion of couples with problems in their sexual lives. The prevalence of sexual dysfunction found was 52% in women and 38.8% in men. Therefore, we decided to initiate a line of investigation on human sexuality, to which this work belongs. The aim was to identify the frequency, difference, relation and combination of three sexual dysfunctions: erectile dysfunction, male orgasmic disorder and precocious ejaculation, as well as some intervening factors that were divided in two types. a) Personality factors, including gender role: prescriptions, norms and expectations according to rules set by the society which are introjected by the individual. When the expression of masculinity and femininity polarizes reaching machisms and submissive behavior, this can result in a negative influence for the development of sexuality. Another personality factor is the level of self-esteem, which greatly determines the conduct of individuals and is defined as the personal judgment of value towards oneself; it is expressed in the form of attitudes of the individual towards himself. b) The existence of some sexual background such as the report of having suffered child traumatic experience of sexual abuse; availability of sex information; presence or absence of sex fears; masturbation during adolescence and absence or presence of conjugal problems. It must be said that the division of intervening factors into types allowed us to propose profiles for the indicators related with the presence of the aforementioned male sexual dysfunctions. These dysfunctions are described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Material and methods This was a non-experimental, one-sample, retrospective, transversal, multivariate-correlational field study of independent observations, with samples allocated in two groups. Samples We got non-probabilistic samples from couples of patients recently accepted for service at the institution, according to pre-established quotas. Sample size consisted of 200 men, with 100 men showing no sexual dysfunction (group 1) and 100 men with evidence of sexual dysfunction (group 2). Results of erectile dysfunction, male orgasmic disorder and precocious ejaculation are presented here; they were compared with the same number of participants showing no sexual dysfunction. Participants were limited to individuals who met the following criteria: age range, 22 to 45 years old; elementary school as the minimum schooling; no history of mental illness or chronic disease that could condition the presence of male sexual dysfunctions. Socio-demographic factors controlled in this study included age, civil status and schooling; the classification variable was set to be the presence of male sexual dysfunctions. Instruments For the classification of groups, in order to detect the type of dysfunction present, and for the sake of capturing sexual background data, we used the male version of the questionnaire of sexuality, based on the codified clinical history for female sexuality. For the measurement of gender role, we used the Inventory of Masculinity-Femininity (IMAFE), which measures four orientations: male, female, machismo and submission. For the measurement of self-esteem we used Coopersmith Self-Esteem Inventory, and the validation technique suggested by Lara, Verduzco, Acevedo and Cortés. Participants were approached at the external consultation area at the INPerIER. Instruments described above were applied as well as clinical histories obtained in one single session, individually, once the participant had signed the informed consent letter required by the Committee of Ethics of the INPerIER. Results The most frequent dysfunction detected was precocious ejaculation, which was present in 48 participants. Thirty four men were reported with erectile dysfunction and 15 men showed male orgasmic disorders. In a previous article, we presented the results of hypoactive sexual disorder, the sexual dysfunction more frequently found (55 male participants reported it). In this case we observed that out of 100 participants studied, the overall number of dysfunctions found was 152, including hypoactive sexual disorder, which can be interpreted as one and a half dysfunctions per man. For the sake of establishing the relationship of each sexual dysfunction with personality factors, we estimated the ETA coefficient. In the case of the relation between sexual dysfunctions and sexual background we calculated Cramer's V. Once we established the relations between the personality factors and the background that were used to develop profiles, we performed a discriminant analysis, which included all variables we found related and we came out with the following results: For erectile dysfunction we found a relation with three variables: negative relation with femininity and self-esteem, and positive relation with conjugal problems. In the case of the male orgasmic disorder, we found a relation with five variables: negative relation with femininity and self-esteem, and positive relation with child sexual traumatic experience, masturbation and conjugal problems. In the case of precocious ejaculation, we detected a relation with four variables: negative relation with masculinity, femininity and self-esteem, and positive relation with conjugal problems. The relations that became evident in every dysfunction showed that in this proportion, the discriminant variables provided us with an approximate explanation. Discussion The frequency of sexual dysfunctions can be described as high. The analysis of the results made evident that two factors are always present in these sexual dysfunctions: a tendency to show low self-esteem and the presence of conjugal problems. Alongside the different dimensions of gender roles, there is a decrease of the masculinity features in the case of precocious ejaculation; the reduction of femininity features is found in the three dysfunctions under study. There is a tendency to inhibition of both the sexual expressions and the affective expressions (femininity features), which are found combined in the case of precocious ejaculation, combined as well with a decrease of the masculinity features. When it comes to the sexual background, we observed that the history of child sexual traumatic experience is a risk indicator for the orgasmic disorder, as well as the report of practicing masturbation during adolescence. We can infer from this that this can be due to the type of masturbation limited to a biological discharge and not to the exploration addressed to a self-knowledge of the body. Another indicator present only in the orgasmic disorder is the fear of sexuality. It can be observed that the sexual dysfunction that presents more indicators is the male orgasmic disorder. For what we explained here, it becomes relevant to develop integral intervention plans for the adequate exploration of indicators related to these dysfunctions.

Keywords : Male sexual dysfunctions; gender role; self-esteem; sexual background.

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