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Understanding Normal Human Sexuality: A Comprehensive Overview

This text delves into the essential aspects of normal human sexuality, covering the physiological and psychological phases of sexual response. It outlines the key stages—desire, excitement, orgasm, and resolution—while emphasizing the importance of subjective experiences in sexual satisfaction. The article also addresses sexual history-taking, including factors influencing sexual dysfunction and individual desires. Additionally, it explores childhood and adult sexual activities, highlighting the impact of societal attitudes, personal experiences, and relationship dynamics on human sexuality.

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Understanding Normal Human Sexuality: A Comprehensive Overview

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  1. Normal Human Sexuality By: MaryamSorayani,MD Psychiatry resident Roozbeh hospital maryam.sorayani@gmail.com 1392/9/28

  2. To be noticed… • Normal sexual behavior brings pleasure to oneself and one's partner • Involves stimulation of the primary sex organs including coitus • It is devoid of inappropriate feelings of guilt or anxiety and is not compulsive

  3. Physiological Responses • The sequence of responses may not occur in a linear progression, but may overlap and fluctuate for example, many women in monogamous relationships find that, over time, desire follows arousal that results from sexual stimulation by a partner • A person's subjective experiences are as important to sexual satisfaction as the objective physiologic response

  4. Phase I: Desire • A psychological phase and doctors’ fundamental concern is with motivations, drives, and personality • Characterized by sexual fantasies and the conscious desire to have sexual activity

  5. Phase II: Excitement • Brought on by psychological stimulation (fantasy or the presence of a love object), physiological stimulation (stroking or kissing), or both • Consists of a subjective sense of pleasure and objective signs: - penile erectionin men - vaginal lubrication in women

  6. Phase III: Orgasm • Peaking sexual pleasure, with release of sexual tension • Rhythmic contractionof the perineal muscles and pelvic reproductive organs • Ejaculation in men

  7. Phase IV: Resolution • A subjective sense of well-being, general relaxation, and muscular relaxation • Men have a refractory period that may last from several minutes to many hours • No refractory period in women, who are capable of multiple and successive orgasms • If orgasm occurs, resolution is rapid; if it does not occur, resolution may take 2 to 6 hours and be associated with irritability and discomfort

  8. Taking a Sexual History

  9. Identifying data • Age • Sex • Occupation • Relationship status • Sexual orientation

  10. Current functioning • Unsatisfactory to highly satisfactory ...if unsatisfactory, why? Feelings about partner satisfaction • Dysfunctions? • Onset—lifelong or acquired • If acquired, when? • Did onset coincide with drug use , life stresses ? • Generalized—occurs in most situations or with most partners • Situational • Only with current partner • In any committed relationship • Only with masturbation • In socially proscribed circumstance (e.g., affair) • In definable circumstance (e.g., very late at night, in parental home, when partner initiated sex play)

  11. Current functioning • Frequency—partnered sex (coital and non coital sex play) • Desire/Excitement/Orgasm/Resolution • Description of typical sexual interaction • Manner of initiation or invitation (e.g., Verbal or physical? Does same person always initiate?) • Presence, type, and extent of foreplay (e.g., kissing, caressing, manual or oral genital stimulation) • Coitus? Positions used? • Verbalization during sex? If so, what kind? • After play? (whether sex act is completed or disrupted by dysfunction); typical activities (e.g., holding, talking, return to daily activities, sleeping) • Feeling after sex: Relaxed, tense, angry, loving • Sexual compulsivity

  12. Childhood sexuality • Parental attitudes about sex • Learning about sex • Childhood sex activities • Genital self-stimulation before adolescence • Sexual play or exploration with another child (playing doctor)

  13. Adolescence • Puberty • Sense of self as feminine or masculine • Sex activities • Masturbation • Homosexual activities • Dating • Experiences of kissing, necking, petting • Orgasm • First coitus…safe sex

  14. Adult sexual activities • Premarital sex • Sex play experienced • Safe sex • First coitus • Cohabitation • Engagement

  15. Adult sexual activities • Marriage (s) • Sexual interaction • First sexual experience with spouse • Honeymoon • Effect of pregnancies and children on marital sex • Extramarital • Postmarital masturbation • Group sex • Areas of conflict in marriage • Sex after widowhood, separation, divorce • orgasms in sleep,noncoital sex play

  16. Special issues • History of rape, incest, sexual or physical abuse • Spousal abuse (current) • Chronic illness (physical or psychiatric) • Substance abuse or dependency • History or presence of sexually transmitted diseases • Fertility problems • Abortions, miscarriages, or unwanted or illegitimate pregnancies • Gender identity conflict • Paraphilias

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