ABSTRACT
Sexual Desire Differences in Men and Women 69
Case Study 70
“Normal” Sexual Desire for Men 72
Classification 73
General Sexual Issues 73
Sexual Desire Disorders 74
Subtypes of HSDD 74
Lifelong and Situational 76
Case study 76
Acquired and Generalized 77
Case study 77
Epidemiology 78
Assessment 80
History 80
Physical Examination 82
Laboratory Examination 83
Hormones 83
Testosterone (T) 83
Components and Measurement (21) 83
Normal Aging Changes in the Quantity 84
Origin, Production, and Control 85
Actions 86
Effects on Sexuality 86
Changes in Effects with Age 87
DHEA and DHEAS 87
Prolactin 87
Etiology 88
Theoretical Perspectives: Biological, Psychological, and Social 88
Intimacy Difficulty 89
Endocrine Abnormalities 89
Presence of Another Sexual or Gender Disorder in a Patient or Partner 89
Sexual Dysfunctions 89
Sexual Difficulties in a Partner 90
Case Study 90
Child Sexual Abuse (CSA) 91
Paraphilias (PAs) and Paraphilia-Related Disorders (PRDs) 91
Case Study 91
Medical Disorders 91
General Comments 91
Cardiovascular Diseases (22) 92
Cancers 92
Epilepsy 92
Genetic Disorders 92
Testicular Disease 92
Secondary Hypogonadism (Resulting from
Hypothalamic-Pituitary Disorders) 92
Endocrine Disorders 92
Multisystem Disease 92
Psychiatric Disorders 93
Major Depression 93
Bipolar Disorder 93
Schizophrenia 93
Anxiety Disorders 93
Drugs 93
General Comments 93
Antipsychotics 94
Antianxiety Agents 94
Antidepressants 94
Mood Stabilizers 94
Drugs Used in Urological Practice 94
Cardiovascular Drugs 95
Cancer Chemotherapy Drugs 95
Anticonvulsant Drugs 95
“Recreational” Drugs 95
Drugs Used in Gastrointestinal Practice 96
Madonna/Prostitute Syndrome 96 Ill Partner 96
Case Study 96
Relationship Discord 97
Psychosocial Issues 97
Age-Related Hypogonadal Syndrome: (Andropause/ADAM/PADAM) 97 Terminology and Definitions 97
Diagnosis 98
Etiology 99
Treatment 99
General Considerations 99
Psychotherapy 100
Drugs 101
Testosterone 102
Follow-up Investigation 102
Forms of T (21) 102
Age-Related Hypogonadal Syndrome (Andropause/ADAM/ PADAM) 102
Testosterone Replacement Therapy (TRT): General and
Adverse Effects (24) 103
Hyperprolactinemia 104
Drug-Induced Diminished Desire 104
Summary and Conclusions 105
References 106
The problem is that God gives men a brain and a penis,
and only enough blood to run one at a time.
