Coping with barriers to education and treatment in human sexuality.

The 366 patients attending a special clinic for help with sexual health problems at the H.P. Medical College Hospital in Simla India were analyzed during the 1976 through December 1979 period. During its 1st year the clinic registered an attendance of only 30 patients but in the subsequent years an average attendance of about 112 patients/year were recorded. A majority of patients who attended the clinic were young (82.1%) indicating that the sexually active group was more anxious to obtain help. The patients belonged to various socioeconomic strata. Only male patients came to the clinic on their own accord. Women only accompanied their husbands and did this only when the clinic authorities required the absolute cooperation of both spouses for dealing with the problem. It is not uncommon for men to feel insecure and threatened when women strive for sexual equality or make sexual demands upon men. A growing need exists to remove this disparity. Almost a third of the patients (104 or 28.4%) complained of a whitish emission before or after urination which they ascribed to as loss of seminal fluid leading consequently to loss of vigor and manhood. This comprised the largest group of patients who were both married and unmarried. No hormones or medicines were prescribed to this group. They were given sex education along with a schedule of relaxing exercises for the perineal muscles. Over 76.8% of these patients reported relief from their symptoms after this treatment. 66 patients complained of wet dreams. Of these 80.9% were unmarried. Proper sex counseling along with purely symptomatic treatment is all that was required to help this group of patients. 15.6% of the total patients complained of premature ejaculation despite a firm erection. No physical abnormality was detected in all but 8 cases. This group of patients was taught genital hygiene and exercises to recondition the emission reflex. Almost equal numbers of patients (12.2%) were worried about their masturbating habits (12.2%) or problems concerned with contraceptive usage (12.8%). Individual and group discussions were held for this group. 6.81% of the patients complained of no or very weak errections. Of the 20 married patients 3 were known diabetics and 1 had a spinal injury. The patients were managed according to the underlying cause of the problem. Those patients without evidence of any organic disease were treated with sex counseling. On the basis of the experience at this clinic it is believed that the majority of sex problems can be managed with proper and timely sex education and guidance.