Sexual Medicine Courses Curriculum. Clinical Sexology

Sexual Medicine Courses

Curriculum.

Clinical Sexology

Prof.Dr.Ramesh Maheshwari

MBBS,MD,DPM, PhD[Sexual Medicine]

WNHO Group of Institutes, Pune, India.

Contents.

1] Applied Anatomy & Physiology in Male & Female Sexual Problems

2]  Relationship Counselling: Importance, Techniques & Benefits Relationship counselling.

3] Medical History Taking in Female Sexual Problems.

4] Additional Assessments & Diagnostic Approach.

5] Adulthood and Sexual Maturity.

6] Male & Female Psychosexual Development

7] Personality Evaluation

Personality evaluation is the systematic assessment of an individual's behaviour.

8]Role of Pharmacotherapy in Sexual Health & Diseases: Indications &Contraindications

9]  Contemporary Relevance of Masters and Johnson’s Work

10]Shockwave Therapy & P-Shot (PRP) for Male Sexual Problems

11] PRP for Male & O-Shot (PRP Therapy) for Female Sexual Health.

12] Ayurvedic Pulse Diagnosis (Nadi Pariksha) in Male & Female Sexual Diseases and Panchakarma Treatments

Nadi Pariksha (Pulse

Diagnosis) 

13] TCM Acupressure Therapy for Male & Female Sexual Problems

14] Aura Quantum Healing for Sexual Health & Well-being

Aura Quantum Healing is a bioenergetic therapy that focuses on restoring sexual energy, emotional balance, and hormonal harmony by working on the human energy field

15]Sound Healing, Chakra Healing & Tantric Sex: A Holistic Approach to Sexual Wellness

Sound healing, chakra balancing, and tantric practices offer a holistic and spiritual approach to sexual health and intimacy. These methods enhance sexual energy flow, deepen connection, and improve physical, emotional, and spiritual well-being.

16]  Various Sexual; Medicine Certified Courses. PGD, Fellowship, Masters, Doctorate in Clinical Sexology & Psychosexual Medicine.

17] About Author.

1] Applied Anatomy & Physiology in Male & Female Sexual Problems.

Sexual health is a complex interplay of anatomy, physiology, hormones, psychology, and external factors. Understanding applied anatomy and physiology helps in diagnosing and managing sexual dysfunctions in both males and females.

1. Male Sexual Anatomy & Physiology

A. Anatomy of Male Reproductive System

• External Organs: Penis, Scrotum, Urethra
• Internal Organs: Testes, Epididymis, Vas deferens, Prostate gland, Seminal vesicles, Bulbourethral glands

B. Physiology of Male Sexual Function

1. Erection (Vascular & Nervous Control)
   • Initiated by parasympathetic stimulation (S2-S4)
   • Involves nitric oxide (NO) release → cGMP increase → smooth muscle relaxation → penile blood inflow
   • Carvenosal sinusoids fill with blood → erection

1. Ejaculation (Sympathetic Control, T11-L2)
   • Emission: Contraction of seminal vesicles & prostate
   • Expulsion: Rhythmic contraction of Bulbospongiosus & pelvic floor muscles

1. Detumescence (End of Erection)
   • Sympathetic-mediated vasoconstriction reduces blood flow
   • Breakdown of cGMP by phosphodiesterase-5 (PDE5)

C. Male Sexual Dysfunctions

• Erectile Dysfunction (ED): Vascular, neurological, or hormonal issues (e.g., diabetes, hypertension, low testosterone)
• Premature Ejaculation (PE): Overactive sympathetic response, psychological stress
• Delayed Ejaculation/Anorgasmia: Neurological damage, medications (SSRIs)
• Hypogonadism: Low testosterone affecting libido & erection

2. Female Sexual Anatomy & Physiology

A. Anatomy of Female Reproductive System

• External Organs: Clitoris, Labia majora & minora, Vaginal opening, Urethral orifice
• Internal Organs: Vagina, Uterus, Ovaries, Fallopian tubes

B. Physiology of Female Sexual Function

1. Arousal & Lubrication
   • Parasympathetic activation (S2-S4) leads to vasodilation → engorgement of clitoris & vaginal walls
   • Bartholin’s glands secrete lubricating fluid

1. Orgasm (Sympathetic & Somatic Control)
   • Rhythmic contraction of vaginal & pelvic floor muscles
   • Oxytocin release enhances pleasure sensation

1. Resolution Phase
   • Vasoconstriction restores normal blood flow

C. Female Sexual Dysfunctions

• Hypoactive Sexual Desire Disorder (HSDD): Low libido due to hormonal imbalance, psychological stress
• Arousal Disorders: Insufficient vaginal lubrication due to estrogen deficiency (menopause)
• Orgasmic Dysfunction: Delayed or absent orgasm due to neurological or psychological causes
• Dyspareunia (Painful Intercourse): Due to vaginal dryness, vaginismus, endometriosis

1. Role of Hormones in Sexual Function

Note- M-for Male

F- for Female

• Testosterone (M & F): Enhances libido, erection, and vaginal lubrication
• Estrogen (F): Maintains vaginal health, lubrication, and blood flow
• Progesterone (F): Modulates libido, affects mood
• Oxytocin (M & F): Enhances bonding & orgasm intensity
• Prolactin (M & F): Regulates sexual satisfaction & refractory period

               Conclusion

Understanding the applied anatomy and physiology of male and female sexual function helps in diagnosing and managing sexual dysfunctions effectively. A holistic approach—including medical, psychological, and lifestyle interventions—can significantly improve sexual health outcomes.

Male Sexual Anatomy

The male reproductive system consists of both external and internal structures that work together for sexual function, reproduction, and hormone production.

1. External Male Genitalia

A. Penis

The penis is the primary organ of male sexual function, involved in sexual intercourse, urination, and ejaculation. It consists of:

1. Glans Penis: The sensitive tip, covered by the foreskin (prepuce) in uncircumcised males.
2. Shaft: Contains erectile tissues responsible for penile erection.
3. Root: The base, attached to the pubic bone and pelvic floor muscles.

Erectile Tissues of the Penis:

• Corpora Cavernosa (2): Paired cylindrical structures responsible for penile rigidity during erection.
• Corpus Spongiosum (1): Surrounds the urethra and prevents compression during erection, forming the glans at the tip.

Blood Supply & Nerve Control:

• Arterial Supply: Internal pudendal artery → deep & dorsal penile arteries.
• Venous Drainage: Deep dorsal vein → prostatic venous plexus.
• Innervation: Pudendal nerve (S2-S4), autonomic fibers from hypogastric & pelvic plexuses.

B. Scrotum

A pouch of skin and muscle that houses the testes. Functions:

• Maintains optimal testicular temperature (2-4°C lower than body temperature).
• Contains Dartos muscle (wrinkles skin) & Cremaster muscle (raises/lowers testes).

2. Internal Male Genitalia

A. Testes (Testicles)

• Paired oval organs producing sperm (spermatogenesis) and testosterone.
• Contain seminiferous tubules (site of sperm production).
• Leydig cells: Produce testosterone under LH stimulation.
• Sertoli cells: Nourish sperm and regulate spermatogenesis under FSH control.

B. Epididymis

• A coiled structure on the posterior testis.
• Stores and matures sperm before ejaculation.

C. Vas Deferens

• A muscular duct transporting sperm from the epididymis to the urethra.
• Passes through the spermatic cord and inguinal canal.

D. Seminal Vesicles

• Paired glands posterior to the bladder.
• Secrete seminal fluid rich in fructose, prostaglandins, and clotting proteins (60% of semen volume).

E. Prostate Gland

• Surrounds the urethra below the bladder.
• Produces prostatic fluid (alkaline, contains enzymes like PSA) that enhances sperm motility.

F. Bulbourethral (Cowper’s) Glands

• Small paired glands near the base of the penis.
• Secrete a lubricating pre-ejaculate fluid that neutralizes acidic urine in the urethra.

   3. Urethra

A dual-function tube for urine and semen transport, divided into:

1. Prostatic Urethra – Passes through the prostate.
2. Membranous Urethra – Narrowest part, passes through the urogenital diaphragm.
3. Penile (Spongy) Urethra – Extends through the corpus spongiosum to the external urethral orifice.

Clinical Relevance of Male Sexual Anatomy

• Erectile Dysfunction (ED): Impairment of penile blood flow or nerve function.
• Pyronine’s Disease: Fibrous plaques in the tunica albuginea cause penile curvature.
• Prostate Enlargement (BPH/Prostate Cancer): Can obstruct urinary and ejaculatory function.
• Varicocele: Dilated testicular veins causing infertility.

Female Sexual Problems: Causes, Types, and Management

Female sexual dysfunction (FSD) is a complex condition influenced by anatomical, physiological, hormonal, psychological, and relational factors. It affects a woman’s ability to experience desire, arousal, orgasm, or pain-free intercourse.

1. Types of Female Sexual Problems

A. Hypoactive Sexual Desire Disorder (HSDD)

Symptoms:

• Low or absent sexual desire
• Distress due to lack of interest
• Decreased fantasies or thoughts about sex

Causes:

• Hormonal: Low testosterone, estrogen decline (menopause)
• Psychological: Stress, depression, past trauma
• Medical Conditions: Diabetes, hypothyroidism, chronic illness
• Medications: Antidepressants (SSRIs), oral contraceptives

Management:

• Hormone therapy (testosterone, estrogen)
• Cognitive-behavioral therapy (CBT)
• Stress reduction & lifestyle changes

B. Female Arousal Disorder

Symptoms:

• Difficulty achieving or maintaining genital arousal
• Insufficient vaginal lubrication
• Reduced blood flow to genital tissues

Causes:

• Hormonal: Estrogen deficiency (menopause, postpartum)
• Vascular Issues: Poor blood circulation (diabetes, hypertension)
• Neurological: Nerve damage (spinal injury, multiple sclerosis)
• Psychological: Anxiety, body image issues

Management:

• Vaginal estrogen therapy
• Lubricants & moisturizers
• Sensate focus therapy (non-penetrative intimacy techniques)

C. Orgasmic Disorder (Anorgasmia)

Symptoms:

• Delayed, infrequent, or absent orgasms
• Reduced orgasm intensity

Causes:

• Neurological: Spinal cord injury, nerve damage
• Hormonal: Low oxytocin or testosterone
• Psychological: Past trauma, anxiety, guilt
• Medications: Antidepressants (SSRIs), antipsychotics

Management:

• Sensate focus therapy & mindfulness
• Kegel exercises to strengthen pelvic floor
• Sex therapy & behavioral counseling

D. Dyspareunia (Painful Intercourse)

Symptoms:

• Pain during or after intercourse
• Burning, throbbing, or sharp pain in vaginal or pelvic area

Causes:

• Physical: Vaginal atrophy (menopause), endometriosis, pelvic inflammatory disease (PID), vaginal infections
• Psychological: Anxiety, fear of penetration
• Structural Issues: Vaginal stenosis, fibroids

Management:

• Vaginal estrogen therapy (postmenopausal women)
• Pelvic floor physiotherapy
• Lubricants & topical anesthetics
• Psychosexual counseling

E. Vaginismus (Involuntary Vaginal Muscle Contraction)

Symptoms:

• Involuntary tightening of vaginal muscles
• Pain or inability to have penetrative sex

Causes:

• Psychological: Fear of sex, trauma, negative cultural beliefs
• Physical: Pelvic floor hypertonicity

Management:

• Progressive desensitization with vaginal dilators
• Pelvic floor therapy
• Cognitive-behavioral therapy (CBT)

2. Role of Hormones in Female Sexual Function

• Estrogen: Maintains vaginal lubrication, elasticity, and blood flow. Deficiency leads to dryness & pain.
• Testosterone: Enhances libido, energy, and orgasm intensity.
• Oxytocin: Promotes bonding, relaxation, and orgasmic response.
• Progesterone: Modulates mood and libido; high levels may reduce sexual desire.

3. Psychological & Lifestyle Factors Affecting Female Sexual Health

• Emotional well-being: Stress, anxiety, depression impact libido.
• Relationship dynamics: Poor communication, unresolved conflicts affect intimacy.
• Body image & self-esteem: Negative perception can lower desire.

Female Anatomy Related to Sexual Health

The female reproductive system plays a crucial role in sexual function, pleasure, and reproduction. Understanding its anatomy is essential for diagnosing and managing sexual health issues.

1. External Genitalia (Vulva)

The external female genitalia, collectively known as the vulva, include structures involved in sexual arousal, pleasure, and protection.

A. Clitoris

• The primary organ of sexual pleasure, rich in nerve endings (~8,000, more than the penis).
• Consists of:
  • Glans Clitoris (visible tip)
  • Body & Crus (extends internally along the pubic bone)
  • Vestibular Bulbs (engorge during arousal)
• Function: Enhances arousal through touch and stimulation.

B. Labia Majora & Labia Minora

• Labia Majora: Fatty outer folds protecting the inner genitalia.
• Labia Minora: Inner folds rich in nerve endings, lubricate and swell during arousal.

C. Vestibule (Opening to the Vagina & Urethra)

• Contains the urethral opening (urine passage) and vaginal opening.
• Bartholin’s Glands: Secrete mucus for vaginal lubrication.

2. Internal Genitalia

These structures support sexual function, reproduction, and hormonal balance.

A. Vagina

• A muscular, elastic canal (~7-10 cm) extending from the vestibule to the cervix.
• Functions:
  • Allows for sexual intercourse, menstrual flow, and childbirth.
  • Secretes natural lubrication during arousal (via vaginal transudation).
  • Contains rugae (folds) that expand for penetration and childbirth.

B. G-Spot (Grafenberg Spot)

• Located 2-3 cm inside the anterior vaginal wall.
• Contains spongy erectile tissue linked to the clitoral complex.
• Stimulation may enhance orgasm intensity.

C. Uterus & Cervix

• Uterus: Muscular organ involved in pregnancy and orgasmic contractions.
• Cervix: Lower part of the uterus that secretes mucus, influencing sperm movement.

D. Ovaries

• Produce estrogen, progesterone, and testosterone, influencing libido.
• Release eggs for potential fertilization.

E. Skene’s Glands (Female Prostate)

• Located near the urethra, contribute to female ejaculation.
• Analogous to the male prostate gland.

3. Pelvic Floor Muscles & Sexual Function

• Include the pubococcygeus (PC) muscles, controlling vaginal tightness and orgasm.
• Strengthening via Kegel exercises improves sexual pleasure and reduces urinary incontinence.

Clinical Relevance

• Vaginal Dryness: Due to estrogen deficiency (menopause, postpartum).
• Dyspareunia (Painful Intercourse): From tight pelvic floor muscles, infections, or endometriosis.
• Orgasmic Dysfunction: Linked to weak pelvic muscles, nerve damage, or psychological factors.
• Vaginismus: Involuntary muscle contraction causing painful penetration.

Understanding female anatomy enhances diagnosis and treatment of sexual dysfunctions, improving overall sexual health and well-being. Would you like a deeper explanation on any part?

2]  Relationship Counselling: Importance, Techniques & Benefits

Relationship counselling 

Helps couples and individuals navigate conflicts, improve communication, and strengthen emotional bonds. It provides a structured approach to resolving relationship challenges and enhancing intimacy.

1. When is Relationship Counselling Needed?

Couples and individuals may seek counselling for:

• Communication Issues: Frequent misunderstandings, lack of active listening.
• Frequent Conflicts: Repetitive arguments over finances, family, or personal habits.
• Emotional Distance: Feeling disconnected or emotionally neglected.
• Infidelity & Trust Issues: Rebuilding trust after betrayal.
• Sexual Problems: Differences in libido, sexual dissatisfaction.
• Life Transitions: Marriage, parenting, career changes, or loss.
• Premarital Counselling: Preparing for marriage with strong relationship foundations.

2. Core Techniques in Relationship Counselling

A. Communication Enhancement

• Active Listening: Encourages understanding without judgment.
• "I" Statements: Expressing feelings without blaming (e.g., "I feel hurt when...").
• Non-Verbal Cues: Understanding body language and emotional signals.

B. Conflict Resolution Strategies

• Identifying Triggers: Recognizing past experiences affecting reactions.
• Compromise & Negotiation: Finding common ground rather than winning arguments.
• Emotional Regulation: Managing anger and frustration constructively.

C. Rebuilding Trust & Intimacy

• Forgiveness Therapy: Healing emotional wounds and moving forward.
• Quality Time Exercises: Reconnecting through shared experiences.
• Physical & Emotional Intimacy Work: Enhancing affection and closeness.

D. Cognitive-Behavioral Therapy (CBT) for Couples

• Identifies and replaces negative thought patterns affecting the relationship.
• Encourages positive behavioral changes for a healthier dynamic.

E. Gottman Method

• Focuses on "The Four Horsemen" (Criticism, Contempt, Defensiveness, Stonewalling) and how to counteract them.
• Emphasizes "Love Maps" (understanding your partner’s inner world).

F. Emotionally Focused Therapy (EFT)

• Strengthens emotional bonds by addressing deep-rooted fears and needs.

3. Benefits of Relationship Counselling

✅ Improved communication & emotional connection
 ✅ Reduced conflicts & healthier conflict resolution
 ✅ Strengthened intimacy and trust
 ✅ Greater self-awareness & understanding of partner’s needs
 ✅ Prevention of long-term relationship breakdowns

Would you like guidance on specific relationship challenges or exercises to improve your relationship?

Pre-Marriage & Post-Marriage Counselling

Marriage is a lifelong commitment that comes with emotional, financial, and social responsibilities. Pre-marital and post-marital counselling help couples build a strong foundation, navigate challenges, and maintain a healthy relationship.

1. Pre-Marriage Counselling

💍 Purpose:

• Helps couples understand each other’s expectations, values, and long-term goals.
• Identifies potential conflicts and provides tools to handle them effectively.

Topics Covered in Pre-Marital Counselling

A. Communication & Conflict Resolution

• Understanding each other’s communication styles.
• Learning active listening and healthy disagreement techniques.
• Managing anger & stress constructively.

B. Emotional & Psychological Compatibility

• Understanding each other’s emotional needs.
• Identifying personal triggers and emotional responses.
• Addressing past trauma or unresolved personal issues.

C. Financial Planning & Responsibilities

• Discussing budgeting, savings, and financial goals.
• Understanding spending habits and financial decision-making.
• Resolving financial disagreements effectively.

D. Family & Cultural Expectations

• Understanding and respecting each other’s family traditions.
• Balancing personal beliefs with cultural and family influences.
• Managing in-law relationships and family interference.

E. Sexual Compatibility & Intimacy

• Understanding sexual expectations and needs.
• Discussing concerns like libido differences or past experiences.
• Educating about emotional and physical intimacy.

F. Parenting & Future Plans

• Discussing the desire for children and parenting styles.
• Planning for family responsibilities and career balance.
• Aligning life goals and personal ambitions.

✅ Benefits of Pre-Marriage Counselling:
 ✔ Strengthens relationship foundation.
 ✔ Reduces future conflicts and misunderstandings.
 ✔ Encourages realistic expectations.
 ✔ Promotes emotional intimacy and trust.

2. Post-Marriage Counselling

💑 Purpose:

• Helps couples navigate marital challenges and prevent long-term dissatisfaction.
• Strengthens emotional connection and problem-solving skills.

Topics Covered in Post-Marital Counselling

A. Adjusting to Married Life

• Managing expectations vs. reality of marriage.
• Establishing personal space & boundaries within the relationship.
• Handling household responsibilities & workload fairly.

B. Managing Conflicts & Communication Breakdown

• Identifying common triggers of arguments (finances, responsibilities, etc.).
• Learning healthy argument techniques and avoiding blame.
• Repairing emotional distance and resentment.

C. Strengthening Intimacy & Romance

• Reigniting passion and maintaining emotional closeness.
• Understanding love languages and expressing affection.
• Addressing sexual concerns and dissatisfaction.

D. Coping with Major Life Changes

• Handling career shifts, parenting, or relocation.
• Supporting each other during emotional hardships (loss, stress, depression).
• Balancing personal ambitions with family life.

E. Rebuilding Trust After Betrayal

• Dealing with infidelity, lies, or emotional disconnect.
• Working on forgiveness and rebuilding trust.
• Setting boundaries to prevent future issues.

✅ Benefits of Post-Marriage Counselling:
 ✔ Prevents minor issues from escalating into bigger problems.
 ✔ Strengthens trust and emotional connection.
 ✔ Helps couples adapt to life’s challenges together.
 ✔ Improves marital satisfaction and long-term happiness.

3]Medical History Taking in Female Sexual Problems

A. Chief Complaints (CC)

• Low sexual desire (Hypoactive Sexual Desire Disorder – HSDD)
• Difficulty with arousal (Female Arousal Disorder)
• Inability to orgasm (Anorgasmia)
• Painful intercourse (Dyspareunia)
• Vaginal tightness (Vaginismus)

B. History of Present Illness (HPI)

• Onset & Duration – When did the problem start?
• Pattern – Persistent, situational, or cyclic (e.g., menstrual-related)?
• Severity – Impact on daily life and relationship?
• Lubrication Issues – Vaginal dryness or atrophy?
• Pain Characteristics – Superficial or deep pain?

C. Medical & Gynecological History

• Menstrual Cycle – Regularity, menopause status.
• Hormonal Disorders – PCOS, thyroid dysfunction.
• Pregnancy & Childbirth – Any complications?
• Pelvic Surgeries – Hysterectomy, endometriosis surgery.
• Sexually Transmitted Infections (STIs) – History of STIs or pelvic inflammatory disease (PID).

D. Psychological & Relationship Factors

• Body image concerns, history of abuse.
• Relationship satisfaction, partner dynamics.
• Stress, anxiety, depression.

E. Past Treatments & Medications

• Hormonal Therapy – Estrogen, testosterone therapy.
• Medications Affecting Libido – Antidepressants (SSRIs), birth control pills.
• Previous Treatments – Psychotherapy, pelvic physiotherapy, lubricants.

4]Additional Assessments & Diagnostic Approach

1. Physical Examination (If Needed)

• Male: Genital examination, prostate check, penile blood flow tests.
• Female: Pelvic exam, vaginal atrophy assessment, pain localization.

B. Laboratory Tests

• Hormonal Panel – Testosterone, estrogen, prolactin, thyroid hormones.
• Blood Sugar & Lipid Profile – Diabetes and cardiovascular risk assessment.
• STI Screening – If relevant to the symptoms.

C. Psychological Screening

• Depression & anxiety scales.
• Relationship assessment questionnaires.

Key Takeaways

🔹 A comprehensive history helps distinguish between physiological and psychological causes.
 🔹 Understanding partner dynamics is crucial in managing sexual dysfunctions.
 🔹 Addressing modifiable risk factors (lifestyle, medications) can improve outcomes.

Would you like a structured questionnaire template for clinical use? 😊

Male Sexual Medicine History Taking

A structured approach to male sexual history is essential for diagnosing and managing sexual dysfunctions. It helps identify biological, psychological, relational, and lifestyle factors influencing sexual health.

1. General Guidelines for Taking Sexual History

✅ Ensure Privacy & Confidentiality – Create a non-judgmental, comfortable setting.
 ✅ Use Open-Ended & Specific Questions – Encourage honest responses.
 ✅ Normalize the Conversation – Reduce embarrassment or stigma.
 ✅ Assess Psychological & Relationship Impact – Identify emotional distress.

2. Chief Complaints (CC)

🔹 The main issue affecting sexual health. Examples:

• Low sexual desire (Hypoactive Sexual Desire Disorder – HSDD)
• Erectile dysfunction (ED) – Inability to achieve or maintain an erection.
• Premature ejaculation (PE) – Ejaculation within 1 minute of penetration.
• Delayed ejaculation (DE) – Difficulty or inability to ejaculate.
• Anorgasmia – Inability to reach orgasm.
• Pain during or after intercourse (Dyspareunia, Pyronine’s disease, Prostatitis).

3. History of Present Illness (HPI)

A. Onset & Duration:

• When did the problem start?
• Is it sudden or gradual?

B. Pattern & Severity:

• Situational vs. Generalized: Does it happen in all situations or only with a specific partner?
• Persistent or Occasional? Any triggering factors (stress, fatigue, alcohol)?
• Severity: How much does it affect your quality of life?

C. Associated Symptoms:

• Morning erections present?
• Changes in libido (low or excessive sexual desire)?
• Ejaculation issues (fast, delayed, or painful)?
• Urinary symptoms (pain, urgency, weak stream)?

D. Psychological & Emotional Impact:

• Anxiety, depression, or relationship stress?
• Performance anxiety or fear of failure?

4. Medical & Surgical History

A. Chronic Diseases:

• Diabetes mellitus – Common cause of ED due to nerve & blood vessel damage.
• Hypertension & Cardiovascular disease – Linked to poor penile blood flow.
• Neurological disorders – Parkinson’s, multiple sclerosis, spinal cord injury.
• Obesity & Metabolic Syndrome – Affects testosterone levels.
• Chronic Kidney or Liver Disease – Alters hormone metabolism.

B. Hormonal & Endocrine History:

• Testosterone Deficiency Symptoms: Fatigue, decreased muscle mass, low libido.
• Thyroid Dysfunction: Hypothyroidism linked to low libido, hyperthyroidism to premature ejaculation.
• Prolactin Levels: High levels can cause ED and low libido.

C. Past Surgeries:

• Prostate Surgery (TURP, Prostatectomy) – Can lead to erectile or ejaculatory dysfunction.
• Pelvic or Spinal Surgery – May affect nerve function.

5. Medications & Substance Use

A. Current Medications:

• Antihypertensives – Beta-blockers, diuretics can cause ED.
• Antidepressants (SSRIs, TCAs) – Can lead to delayed ejaculation or low libido.
• Hormonal Therapy (Steroids, Antiandrogens) – Can affect sexual function.
• Pain Medications (Opioids) – May reduce testosterone levels.

B. Substance Use:

• Smoking & Alcohol Consumption: Chronic use reduces testosterone & blood flow.
• Recreational Drugs (Marijuana, Cocaine, Heroin, Methamphetamine): Negative impact on libido and performance.

6. Relationship & Psychosocial History

A. Partner & Relationship Factors:

• Relationship satisfaction?
• Partner’s sexual health & expectations?
• Performance anxiety due to partner dissatisfaction?

B. Past Sexual Trauma or Abuse:

• History of emotional or physical trauma affecting sexual performance?

C. Stress & Mental Health Factors:

• Work-related stress, financial burden, or family pressures?
• History of anxiety, depression, PTSD?

7. Physical Examination (If Indicated)

A. General Examination:

• Body weight, BMI, signs of metabolic syndrome.
• Secondary sexual characteristics (hair loss, gynecomastia).

B. Genital Examination:

• Penis: Size, shape, plaques (Peyronie’s disease).
• Testicles: Size, tenderness, presence of varicocele.
• Prostate Exam (DRE): To assess BPH, prostatitis.

8. Laboratory & Diagnostic Tests (If Needed)

A. Hormonal Tests:

• Total & Free Testosterone
• LH, FSH
• Prolactin
• Thyroid Panel (TSH, T3, T4)

B. Metabolic & Cardiovascular Tests:

• Fasting Blood Sugar (Diabetes screening)
• Lipid Profile (Cholesterol levels)
• Hemoglobin A1c

C. Specific Tests for ED:

• Penile Doppler Ultrasound – Blood flow assessment.
• Nocturnal Penile Tumescence (NPT) Test – Checks for spontaneous erections during sleep.

9. Summary & Management Plan

🔹 Identify underlying causes – Organic, psychological, or mixed.
 🔹 Address modifiable risk factors – Lifestyle changes, medication review.
 🔹 Provide counseling & therapy – CBT for anxiety, sex therapy for performance concerns.
 🔹 Consider medical treatment – PDE-5 inhibitors (Sildenafil, Tadalafil), Testosterone therapy if needed.

Would you like a structured questionnaire template for clinical use? 😊

History Taking in Female Sexual Problems

A structured sexual history is essential for diagnosing and managing female sexual dysfunctions. It helps identify biological, psychological, relational, and lifestyle factors affecting sexual health.

1. General Guidelines for Taking Sexual History

✅ Ensure Privacy & Confidentiality – Conduct in a comfortable, non-judgmental setting.
 ✅ Use Open-Ended & Specific Questions – Encourage honest responses.
 ✅ Normalize the Conversation – Reduce embarrassment or stigma.
 ✅ Assess Emotional & Relationship Impact – Determine how the problem affects quality of life.

2. Chief Complaints (CC)

🔹 The main issue affecting sexual health. Examples:

• Low sexual desire (Hypoactive Sexual Desire Disorder – HSDD)
• Difficulty with arousal (Female Arousal Disorder) – Lack of lubrication, vaginal dryness.
• Inability to orgasm (Anorgasmia) – Delayed or absent orgasm.
• Pain during intercourse (Dyspareunia, Vaginismus)
• Vaginal tightness & fear of penetration (Vaginismus)

3. History of Present Illness (HPI)

A. Onset & Duration:

• When did the problem start?
• Was it sudden or gradual?

B. Pattern & Severity:

• Situational vs. Generalized: Does it happen in all situations or with a specific partner?
• Persistent or Occasional? Any triggering factors (stress, hormonal changes, trauma)?
• Severity: How much does it affect quality of life?

C. Associated Symptoms:

• Lubrication issues: Vaginal dryness, atrophy?
• Pain characteristics: Superficial or deep pain? Associated with specific positions?
• Orgasmic dysfunction: Difficulty achieving orgasm?
• Urinary symptoms: Frequency, urgency, pain while urinating?

D. Psychological & Emotional Impact:

• Stress, anxiety, or depression related to sexual function?
• Performance anxiety or fear of pain?

4. Medical & Gynecological History

A. Menstrual & Hormonal History:

• Regularity of menstrual cycles?
• Menopause status (peri/post-menopausal symptoms)?
• History of PCOS, thyroid dysfunction, diabetes?

B. Pregnancy & Childbirth History:

• Number of pregnancies, deliveries (normal/C-section)?
• Postpartum sexual difficulties (pain, decreased desire, trauma)?

C. Past Gynecological Conditions & Surgeries:

• Endometriosis, Fibroids, PID, Ovarian Cysts?
• History of hysterectomy or pelvic surgeries?

D. Contraceptive & Hormonal Therapy Use:

• Birth control pills, intrauterine devices (IUDs)?
• Estrogen or testosterone therapy?

E. Sexually Transmitted Infections (STIs) & Pelvic Infections:

• History of STIs (HPV, herpes, chlamydia, gonorrhea, HIV)?
• Any history of pelvic inflammatory disease (PID)?

5. Medications & Substance Use

A. Current Medications:

• Antidepressants (SSRIs, SNRIs) – Can cause low libido or anorgasmia.
• Hormonal Medications (Oral contraceptives, HRT, antiandrogens) – May affect sexual function.
• Pain Medications (Opioids, NSAIDs) – Can lower sexual desire.

B. Substance Use:

• Smoking & Alcohol Consumption – Chronic use reduces arousal & desire.
• Recreational Drugs (Marijuana, Cocaine, Heroin, Methamphetamine): Can cause decreased libido.

6. Relationship & Psychosocial History

A. Partner & Relationship Factors:

• Relationship satisfaction?
• Partner’s sexual health & expectations?
• Communication about sexual needs and desires?

B. Past Sexual Trauma or Abuse:

• Any history of emotional or physical trauma affecting sexual performance?

C. Stress & Mental Health Factors:

• Work-related stress, financial burden, or family pressures?
• History of anxiety, depression, PTSD?

7. Physical Examination (If Indicated)

A. General Examination:

• BMI, weight, signs of metabolic syndrome.
• Secondary sexual characteristics (hair loss, acne – signs of hormonal imbalance).

B. Pelvic Examination:

• Vaginal Dryness, Atrophy – Seen in menopause, estrogen deficiency.
• Pelvic Muscle Tenderness or Spasm – Suggests vaginismus or chronic pain disorder.
• Vaginal Discharge or Infection Signs – Suggests STIs, PID.

8. Laboratory & Diagnostic Tests (If Needed)

A. Hormonal Tests:

• Estrogen, Testosterone, Progesterone – For hormonal imbalance.
• Thyroid Panel (TSH, T3, T4) – Hypothyroidism can cause low libido.
• Prolactin Levels – High levels can cause sexual dysfunction.

B. Metabolic & Cardiovascular Tests:

• Fasting Blood Sugar (Diabetes screening).
• Lipid Profile (Cholesterol levels).
• Hemoglobin A1c.

C. Vaginal & STI Screening:

• Vaginal pH, culture (for infections).
• STI tests (HPV, chlamydia, gonorrhea).

9. Summary & Management Plan

🔹 Identify underlying causes – Organic, psychological, or mixed.
 🔹 Address modifiable risk factors – Lifestyle changes, medication review.
 🔹 Provide counseling & therapy – CBT for anxiety, sex therapy for performance concerns.
 🔹 Consider medical treatment – Estrogen therapy, lubricants, pelvic floor therapy.

Would you like a structured questionnaire template for clinical use? 

Labia minora(the inner lips)

Of the female genitalia are homologous with shaft of the penis in the male. Both the surface of the minora are highly sensitive to tactile stimulation. As source of erotic stimulation, the labia minora seem to be as important as clitoris. During coitus the entrance of the male organ into the vagina may provide considerable stimulation for the labia minora.

RESPONSES TO TACTILE STIMULTION IN FEMALE GENITAL STRUCTURES

STRUCTURENG                               %RESPONDING

Labia majora                                                     97

Labia minora                                                     97

Vestibule                                                             96

Clitoris                                                                 97

vagina                                                                   14

labia Majora (the outer lips) of the female genitalia are homologous to the skin over scrotum in the male. Both of these do not contribute to erotic responses.

Labia minora continue inward to from funnel shaped vestibule which leads to the entrance of the vagina. Vestibule is an important source of erotic stimulation.

Vagina, unlike the vestibule, is derived embryologically from endoderm and is poorly supplied with the end organs of touch and is insensitive when stimulated or stroked. Most of women do not masturbate by making deep vaginal insertion since the vaginal walls are quite insensitive to erotic stimulation.

Vagina is made of muscular tube lined with mucus membrane and is like a collapsed balloon. The length of vagina is 3inches interiorly and 3.5 inches posteriorly. on arousal the length and breadth of vagina increase.  Vagina may contribute more to the sexual arousal of the male than it does to the arousal of the female. Though vagina is considered as an organ of honor and menstrual flow outwards penis inwards there is no functional homologue in the male.

There may five or more sources of erotic satisfaction for erotic satisfaction for the females

1.  The realization that partner is being satisfied may be the psychological factor of considerable importance.

2.  Tactile stimulation coming from the full body contact with the partner.

3.  Tactile stimulation by male genitalia pressing against the clitoris, labia minora and the vestibule.

4.  Stimulation of the levator ring of muscles during the coitus.

5.  Stimulation of the nerves that lie on the perineal region

Breast

The breast of both the males and females may be more sensitive than some other parts of the body. Nipple and areola are more sensitive than the entire breast. There may be considerable amount of manual or oral stimulation of the female breast during the foreplay.

Smaller breast can produce enough of milk for the new -born . padded  bra or silicon gel implants is the solution for small breast if the female is very conscious about the size of the breast. Unequal breast can be normal variation in the females.

Cervix; there are no tactile nerve ends on the cervix of the uterus and therefore there is no evidence of erotic response.

Perineum (area between anus and vagina/scrotum )is sensitive to erotic

stimulation. Anus is erotically responsive in some individuals.

Mouth :the lips .’tongue, and the  whole interior of mouth constitute erogenous area for most individuals.

The lobe of the ear, pressure on the buttocks, the inner surfaces of the thighs nape of the neck, the soles of the feet, the palm of hands, the armpits, the navel area, of the abdominal and pubic areas are erotically sensitive under tactile stimulation.

In both sexes the organs of touch are the chief physical bases of sexual response.

. Sexual arousal reduces one’s capacity to hear, to taste, or to feel with normal acuity, At the moment of orgasm sensory capacities may completely fail. Most persons are unaware that orgasm Is more than a genital response. All parts of their body and genitalia are involved when respond sexually.

6]Male & Female Psychosexual Development

Psychosexual development refers to the psychological and emotional changes related to sexual identity, behavior, and orientation that occur across different stages of life. Sigmund Freud introduced the concept of psychosexual development in psychoanalysis, but modern perspectives incorporate biological, psychological, and social influences in understanding how individuals develop their sexual identity and function.

1. Biological Basis of Psychosexual Development

Both males and females undergo a series of hormonal, neurological, and physical changes that shape their sexual identity and behavior.

A. Prenatal Stage (Intrauterine Development)

• Sex Differentiation: At around the 6th-7th week of gestation, the presence of the SRY gene on the Y chromosome in males stimulates the formation of testes, which release testosterone. In females, the absence of SRY leads to ovarian development.
• Brain Differentiation: Testosterone influences the masculinization of the brain in males, while estrogen and the absence of testosterone allow for female brain development.
• Formation of Genitalia: By the 12th week, external genitalia develop, distinguishing male and female reproductive organs.

B. Infancy and Early Childhood (0–5 Years)

• Masturbation and Genital Curiosity: Infants and toddlers may explore their genitals, which is a normal part of development.
• Gender Identity Formation: By age 2-3, children recognize themselves as male or female and begin imitating gender roles based on observation.
• Parenting Influence: The way parents respond to early sexual behavior and gender expression can shape a child's comfort with their sexual identity.

2. Freud’s Psychosexual Stages of Development

Freud proposed five stages of psychosexual development, each centered around erogenous zones:

A. Oral Stage (0–1 Year)

• Infant derives pleasure from oral activities (sucking, breastfeeding).
• Fixation may lead to oral habits in adulthood (smoking, overeating).

B. Anal Stage (1–3 Years)

• Pleasure is derived from controlling bowel movements.
• Rigid toilet training may lead to obsessive traits, while lenient training can result in impulsive behavior.

C. Phallic Stage (3–6 Years)

• Awareness of genitalia develops.
• Oedipus Complex (Boys): Unconscious attraction to the mother and rivalry with the father.
• Electra Complex (Girls): Desire for the father and competition with the mother.
• Resolution occurs by identifying with the same-sex parent.

D. Latency Stage (6–12 Years)

• Sexual interests are dormant as children focus on intellectual and social development.
• Peer interactions and cultural influences reinforce gender roles.

E. Genital Stage (12+ Years - Puberty & Adulthood)

• Maturation of sexual interests.
• Healthy relationships depend on resolving earlier psychosexual conflicts.

3. Modern Theories of Psychosexual Development

A. Erikson’s Psychosocial Development

• Identity vs. Role Confusion (Adolescence): Individuals explore sexual identity, orientation, and gender roles.
• Intimacy vs. Isolation (Early Adulthood): Ability to form meaningful sexual and emotional relationships.

B. Biological and Hormonal Changes During Puberty

• Males: Increased testosterone, development of secondary sexual characteristics (facial hair, deep voice), first ejaculation (spermarche).
• Females: Increased estrogen and progesterone, breast development, onset of menstruation (menarche).

C. Social Learning and Gender Roles

• Cultural norms, parental influence, and media shape gender-based behaviors and attitudes toward sexuality.

4. Differences in Male and Female Psychosexual Development

5]Adulthood and Sexual Maturity

• Development of emotional intimacy and stable relationships.
• Sexual satisfaction influenced by psychological well-being and relationship dynamics.
• Aging affects libido and sexual function differently in males and females (e.g., menopause, andropause).

6. Conclusion

Psychosexual development is a complex interplay of biology, psychology, and environment. While Freud’s theory laid the foundation, modern research emphasizes the role of hormones, brain development, and social conditioning. Understanding these factors is essential for addressing sexual health, relationships, and identity formation throughout life.

8]Personality Evaluation

Personality evaluation is the systematic assessment of an individual's behavioral traits, emotional responses, cognitive patterns, and social interactions. It is widely used in psychology, psychiatry, organizational behavior, and clinical settings to understand an individual's strengths, weaknesses, and psychological well-being.

1. Methods of Personality Evaluation

There are various methods used to assess personality, including psychometric tests, observational techniques, and structured interviews.

A. Self-Report Questionnaires (Psychometric Tests)

These standardized tests measure different aspects of personality using multiple-choice questions or rating scales.

• Minnesota Multiphasic Personality Inventory (MMPI-2): Used in clinical settings to assess psychological disorders.
• Big Five Personality Test (OCEAN Model): Measures Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.
• Myers-Briggs Type Indicator (MBTI): Categorizes individuals into 16 personality types based on preferences in energy, information processing, decision-making, and lifestyle.
• Eysenck Personality Questionnaire (EPQ): Focuses on three dimensions—Extraversion, Neuroticism, and Psychoticism.

B. Projective Tests

These involve ambiguous stimuli where responses reveal unconscious aspects of personality.

• Rorschach Inkblot Test: Individuals interpret inkblots, providing insight into their thought processes and emotions.
• Thematic Apperception Test (TAT): Participants create stories based on ambiguous images, revealing underlying motives and conflicts.

C. Behavioral Observations

• Directly observing an individual's interactions in real-life or controlled environments.
• Used in psychiatric assessments, educational psychology, and workplace evaluations.

D. Structured and Semi-Structured Interviews

• Clinicians or researchers ask predefined questions to evaluate personality traits, coping mechanisms, and interpersonal skills.

2. Theoretical Approaches to Personality Evaluation

A. Trait Theory

Personality is composed of stable characteristics that influence behavior across different situations.

• Big Five Model (OCEAN):
  • Openness to Experience: Creativity, curiosity.
  • Conscientiousness: Organization, responsibility.
  • Extraversion: Sociability, energy.
  • Agreeableness: Compassion, cooperation.
  • Neuroticism: Emotional instability, anxiety.

B. Psychoanalytic Theory (Freud)

Personality is shaped by unconscious conflicts between the id (instincts), ego (rationality), and superego (morality). Early childhood experiences play a critical role.

C. Humanistic Approach (Carl Rogers, Abraham Maslow)

Focuses on self-actualization and personal growth. Evaluations emphasize self-concept, motivation, and life satisfaction.

D. Social-Cognitive Theory (Albert Bandura)

Personality develops through interaction with the environment, observational learning, and self-efficacy.

3. Applications of Personality Evaluation

4. Conclusion

Personality evaluation provides deep insights into an individual's behavior, mental health, and potential. By using various scientific methods, professionals can assess personality traits and apply this knowledge in clinical, educational, and occupational settings to improve well-being and decision-making.

Masters and Johnson’s Concept of Sexual Well-being

William H. Masters and Virginia E. Johnson were pioneering researchers in human sexuality. Their work, particularly through direct laboratory observations, significantly shaped modern understanding of sexual response, dysfunction, and therapy. Their research emphasized the physiological, psychological, and relational aspects of sexual well-being.

1. Masters and Johnson’s Human Sexual Response Cycle

One of their key contributions was the four-stage model of the sexual response cycle, which is crucial for understanding normal sexual function and diagnosing dysfunctions.

A. Four Stages of Sexual Response

1. Excitement Phase:
   • Increased blood flow to genitalia (vasocongestion).
   • Erection in males; lubrication and swelling in females.
   • Psychological arousal plays a significant role.

1. Plateau Phase:
   • Heightened arousal and intensified sensations.
   • Increased heart rate, breathing, and muscle tension.

1. Orgasm Phase:
   • Rhythmic contractions of pelvic muscles.
   • Intense pleasure and peak of sexual tension.
   • Release of oxytocin promoting bonding.

1. Resolution Phase:
   • Return to a relaxed state.
   • Males experience a refractory period, while females may remain responsive to continued stimulation.

2. Sexual Well-being According to Masters and Johnson

Sexual well-being encompasses physical health, psychological factors, emotional intimacy, and relationship dynamics. Masters and Johnson’s research highlighted key factors influencing sexual health:

A. Factors Affecting Sexual Well-being

• Physiological Factors: Hormonal balance, cardiovascular health, and neurological function.
• Psychological Factors: Anxiety, depression, stress, past trauma, and body image.
• Relationship Quality: Communication, trust, and emotional connection between partners.
• Cultural & Social Influences: Societal norms, upbringing, religious beliefs, and sexual education.

3. Masters and Johnson’s Approach to Sexual Dysfunction

They were among the first to introduce behavioral sex therapy, shifting from Freudian psychoanalysis to evidence-based interventions.

A. Types of Sexual Dysfunctions

• Male Sexual Dysfunctions: Erectile dysfunction, premature ejaculation, delayed ejaculation.
• Female Sexual Dysfunctions: Orgasmic disorder, vaginismus, dyspareunia (pain during intercourse).
• Desire Disorders: Low libido or sexual aversion in both genders.

B. Sensate Focus Therapy

A cornerstone of their treatment model, Sensate Focus involves:

1. Non-demand physical touch: Reconnecting through intimate but non-sexual touch.
2. Gradual progression to sexual touch: Reducing performance anxiety and pressure.
3. Focusing on sensations rather than goals: Enhancing mindfulness and reducing distractions.

This approach is effective in treating sexual anxiety, erectile dysfunction, and anorgasmia by promoting relaxation, trust, and intimacy.

4. The Role of Communication in Sexual Well-being

Masters and Johnson emphasized open communication between partners as a critical factor in maintaining sexual health. Techniques include:

• Discussing preferences and boundaries.
• Expressing needs without fear of judgment.
• Engaging in mutual problem-solving for sexual difficulties.

9] Contemporary Relevance of Masters and Johnson’s Work

Their research remains foundational in sex therapy, relationship counseling, and medical approaches to sexual dysfunction. While modern sexology has expanded with neuroscience and LGBTQ+ inclusivity, their principles of understanding physiology, reducing performance anxiety, and improving intimacy are still widely applied.

Conclusion

Masters and Johnson redefined sexual health by combining medical science with psychological therapy. Their holistic approach to sexual well-being—addressing physiological, emotional, and relational factors—continues to guide research and therapy in clinical sexology today.

8] Role of Pharmacotherapy in Sexual Health & Diseases: Indications & Contraindications

Pharmacotherapy plays a significant role in managing sexual dysfunctions, hormonal imbalances, infections, and reproductive health issues. Medications are used to enhance sexual performance, restore physiological function, and treat underlying conditions contributing to sexual disorders.

1. Role of Pharmacotherapy in Sexual Health

Pharmacotherapy addresses sexual dysfunctions in both males and females, including:

• Erectile dysfunction (ED)
• Premature ejaculation (PE)
• Hypoactive sexual desire disorder (HSDD)
• Female sexual arousal disorder (FSAD)
• Dyspareunia (painful intercourse)
• Hormonal imbalances affecting libido and function

Other uses include treatment of sexually transmitted infections (STIs), infertility, and reproductive health regulation.

2. Major Drug Classes in Sexual Health

A. Phosphodiesterase Type 5 (PDE5) Inhibitors (For Erectile Dysfunction)

• Examples: Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra), Avanafil (Stendra).
• Mechanism: Inhibits PDE5 enzyme, enhancing nitric oxide (NO) action, leading to smooth muscle relaxation and improved penile blood flow.
• Indications: Erectile dysfunction, pulmonary hypertension.
• Contraindications:
  • Use with nitrates (severe hypotension risk).
  • Severe cardiovascular disease.
  • Uncontrolled hypertension.
  • Retinitis pigmentosa (risk of vision impairment).
  • Liver or kidney impairment (dose adjustment required).

B. Dopamine Agonists (For Low Libido & Hyperprolactinemia)

• Examples: Cabergoline, Bromocriptine.
• Mechanism: Lowers prolactin levels, enhancing dopamine activity and increasing sexual desire.
• Indications:
  • Hyperprolactinemia (which causes low libido and erectile dysfunction).
  • Hypoactive Sexual Desire Disorder (HSDD) in men and women.
• Contraindications:
  • Cardiovascular disease (risk of arrhythmia).
  • Psychiatric disorders (dopaminergic effects may trigger psychosis).

C. Testosterone Replacement Therapy (TRT) (For Hypogonadism & Low Libido)

• Examples: Testosterone injections, patches, gels, oral formulations.
• Mechanism: Increases testosterone levels to improve libido, erectile function, and energy.
• Indications:
  • Male hypogonadism (low testosterone levels).
  • Andropause (age-related testosterone decline).
  • Delayed puberty in males.
• Contraindications:
  • Prostate cancer or breast cancer (testosterone can stimulate tumor growth).
  • Severe heart failure or liver disease.
  • Polycythemia (high RBC count) (risk of clotting).

D. Selective Estrogen Receptor Modulators (SERMs) & Estrogen Therapy (For Female Sexual Health & Menopause)

• Examples: Estradiol, Conjugated Estrogens, Raloxifene, Ospemifene.
• Mechanism: Improves vaginal lubrication, enhances sexual response, and reduces atrophic vaginitis.
• Indications:
  • Menopausal symptoms (vaginal dryness, low libido).
  • Dyspareunia (painful intercourse).
  • Osteoporosis prevention (SERMs like Raloxifene).
• Contraindications:
  • Breast or endometrial cancer (estrogen-sensitive tumors).
  • History of thromboembolism (DVT/PE).
  • Liver disease.

E. Flibanserin (Addyi) & Bremelanotide (Vyleesi) (For Female Hypoactive Sexual Desire Disorder - HSDD)

• Flibanserin (Addyi): Affects serotonin and dopamine levels to increase sexual desire.
• Bremelanotide (Vyleesi): A melanocortin receptor agonist that enhances sexual arousal.
• Indications:
  • Pre-menopausal women with HSDD.
• Contraindications:
  • Hypotension or cardiovascular disorders (Flibanserin can cause severe low BP).
  • Liver impairment.
  • Use with alcohol (risk of severe hypotension).

F. Antidepressants & Anxiolytics (For Psychosexual Disorders & Premature Ejaculation)

• Examples: SSRIs (Paroxetine, Sertraline), SNRIs (Duloxetine), Trazodone, Bupropion.
• Mechanism: Regulate serotonin and dopamine to reduce sexual anxiety and improve ejaculatory control.
• Indications:
  • Premature ejaculation (PE) (SSRIs delay ejaculation).
  • Sexual dysfunction due to anxiety/depression.
  • Trazodone: Used off-label for erectile dysfunction in psychiatric patients.
• Contraindications:
  • Serotonin syndrome risk when combined with other serotonergic drugs.
  • Bupropion is contraindicated in seizure disorders.

G. Local Anesthetics (For Premature Ejaculation)

• Examples: Lidocaine-prilocaine cream, Dapoxetine (short-acting SSRI).
• Mechanism: Reduces penile sensitivity, delaying ejaculation.
• Indications: Premature ejaculation.
• Contraindications:
  • Allergic reactions to local anesthetics.
  • Use with PDE5 inhibitors in patients with cardiovascular disease.

H. Antimicrobial & Antiviral Therapy (For STIs & Reproductive Infections)

• Examples:
  • Antibiotics: Azithromycin, Doxycycline (for chlamydia, gonorrhea, syphilis).
  • Antivirals: Acyclovir, Valacyclovir (for herpes simplex virus - HSV).
  • Antifungals: Fluconazole (for candidiasis).
• Indications:
  • Treatment and prevention of STIs.
  • Reduction of HIV transmission risk (Pre-exposure prophylaxis - PrEP).
• Contraindications:
  • Allergy to specific antibiotics.
  • Renal impairment (dose adjustment needed for antivirals).

3. Risks & Considerations in Sexual Pharmacotherapy

1. Cardiovascular Risks: PDE5 inhibitors and testosterone therapy can increase cardiovascular strain.
2. Psychological Effects: Flibanserin and antidepressants can cause mood alterations.
3. Drug Interactions: PDE5 inhibitors with nitrates, antidepressants with MAOIs, and testosterone with anticoagulants require caution.
4. Hormonal Side Effects: Testosterone therapy can lead to gynecomastia, mood swings, and infertility.

4. Conclusion

Pharmacotherapy plays a critical role in managing sexual dysfunctions, STIs, hormonal imbalances, and reproductive health issues. However, careful consideration of indications, contraindications, and potential side effects is essential to ensure safety and effectiveness. A holistic approach, combining medications, counseling, lifestyle modifications, and psychosexual therapy, leads to optimal outcomes in sexual health management.

10]Shockwave Therapy & P-Shot (PRP) for Male Sexual Problems

Shockwave therapy and Platelet-Rich Plasma (PRP) therapy (P-Shot for men, O-Shot for women) are regenerative treatments gaining popularity in sexual medicine. These therapies aim to improve sexual function by enhancing blood flow, stimulating tissue regeneration, and promoting nerve repair.

1. Shockwave Therapy for Sexual Dysfunction

A. What is Shockwave Therapy?

Shockwave therapy, also known as Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT), uses acoustic waves to stimulate tissue repair and increase blood flow in the genital region.

B. Mechanism of Action

• Stimulates angiogenesis (new blood vessel formation).
• Increases nitric oxide (NO) production, improving blood circulation.
• Reduces fibrosis and plaque formation (useful in Peyronie’s disease).

C. Indications for Shockwave Therapy

D. Contraindications

• Severe cardiovascular diseases (risk of excessive vasodilation).
• Active infections or malignancies in the treatment area.
• Blood clotting disorders.

E. Benefits & Side Effects

✅ Non-invasive, pain-free, no downtime.
 ✅ Long-term improvement in sexual function.
 ❌ Temporary redness or discomfort in the treated area.
 ❌ Multiple sessions required (typically 6-12 sessions).

2. P-Shot (PRP Therapy) for Male Sexual Health

A. What is the P-Shot?

The Priapus Shot (P-Shot) involves injecting Platelet-Rich Plasma (PRP)—derived from the patient’s own blood—into the penis to improve sexual function and tissue health.

B. Mechanism of Action

• PRP contains growth factors that stimulate new tissue growth and increase penile blood flow.
• Enhances nerve function and collagen production.
• May increase penile sensitivity and improve erectile function.

C. Indications for P-Shot in Males

D. Contraindications

• Active infections or STIs.
• Blood clotting disorders (e.g., hemophilia).
• Severe cardiovascular disease.

E. Benefits & Side Effects

✅ Uses the body’s natural healing process—safe with minimal side effects.
 ✅ May improve penile girth and strength of erections.
 ❌ Mild pain, bruising, or swelling at the injection site.
 ❌ Results vary—multiple sessions may be needed.

11] PRP for Male & O-Shot (PRP Therapy) for Female Sexual Health

A. What is the O-Shot?

The Orgasm Shot (O-Shot) is a PRP-based treatment injected into the vaginal and clitoral area to enhance blood flow, sensitivity, and lubrication.

B. Mechanism of Action

• Stimulates tissue regeneration in vaginal walls and clitoral region.
• Enhances blood flow, improving natural lubrication.
• Strengthens pelvic floor muscles, improving bladder control.

C. Indications for O-Shot in Females

D. Contraindications

• Pregnancy.
• Vaginal infections or STIs.
• Uncontrolled diabetes (delayed healing).

E. Benefits & Side Effects

✅ Minimally invasive, uses natural healing factors.
 ✅ Improves both sexual pleasure and urinary health.
 ❌ Temporary swelling or sensitivity at the injection site.
 ❌ Multiple sessions required for optimal results.

4. Comparison of Shockwave Therapy vs. PRP Therapy (P-Shot/O-Shot)

5. Conclusion: Which Therapy is Best?

• Shockwave Therapy is ideal for men with vascular ED, Peyronie’s disease, and pelvic pain.
• P-Shot (PRP) works best for men with ED due to nerve or tissue damage.
• O-Shot (PRP) is beneficial for women experiencing low libido, vaginal atrophy, or incontinence.

Combination Therapy for Optimal Results

Many clinics combine Shockwave Therapy + PRP Therapy for enhanced results, particularly in men with severe ED or women with menopausal vaginal dryness.

Final Verdict:

Both therapies represent non-surgical, regenerative approaches to sexual health, improving function naturally and safely.

12]Ayurvedic Pulse Diagnosis (Nadi Pariksha) in Male & Female Sexual Diseases and Panchakarma Treatments

Nadi Pariksha (Pulse Diagnosis)

is a key diagnostic method in Ayurveda used to assess an individual’s dosha imbalance (Vata, Pitta, Kapha), pranic energy, and organ health. It is particularly effective in identifying sexual dysfunctions, reproductive disorders, and hormonal imbalances in both men and women.

1. Nadi Pariksha (Pulse Diagnosis) in Sexual Diseases

A. How Nadi Pariksha Works in Sexual Health

• The pulse is examined at the radial artery (wrist), where different levels (superficial, middle, deep) correspond to the three doshas.
• Vata pulse: Irregular, fast, feeble → Indicates nervous or psychological sexual dysfunction.
• Pitta pulse: Strong, warm, bounding → Suggests excessive heat, inflammation, or hormonal imbalance.
• Kapha pulse: Slow, steady, deep → Related to metabolic disorders, obesity, or stagnation in reproductive health.

B. Common Sexual Disorders Diagnosed Through Nadi Pariksha

For Men

For Women

2. Panchakarma Therapies for Sexual Dysfunction

Panchakarma is a detoxification and rejuvenation therapy that balances the doshas and restores sexual health.

A. Key Panchakarma Therapies for Male & Female Sexual Problems

3. Ayurvedic Herbal Treatments Based on Pulse Diagnosis

A. For Erectile Dysfunction & Low Libido (Klaibya) in Men

• Ashwagandha (Withania somnifera) – Improves strength, testosterone, and stamina.
• Shilajit – Rejuvenates sexual function, increases sperm count.
• Kapikacchu (Mucuna pruriens) – Boosts dopamine, enhances libido.
• Safed Musli (Chlorophytum borivilianum) – Natural aphrodisiac, improves sperm quality.
• Gokshura (Tribulus terrestris) – Enhances testosterone and penile blood flow.

B. For Premature Ejaculation

• Jatiphala (Nutmeg) – Natural nervine tonic, delays ejaculation.
• Shatavari – Strengthens reproductive health.
• Brahmi & Gotu Kola – Reduce stress-related PE.

C. For Female Sexual Dysfunction & Reproductive Health

• Shatavari (Asparagus racemosus) – Enhances female libido, vaginal lubrication.
• Lodhra (Symplocos racemosa) – Regulates menstrual cycles, treats PCOS.
• Yashtimadhu (Licorice) – Balances estrogen levels.
• Kumari (Aloe Vera) – Detoxifies reproductive organs.
• Bala & Atibala – Strengthen the uterus and vaginal tissues.

4. Vajikarana Therapy (Ayurvedic Aphrodisiac & Rejuvenation Therapy)

Vajikarana is a specialized Ayurvedic therapy that enhances sexual vigor, reproductive function, and hormonal balance.

A. Vajikarana Diet & Lifestyle

✅ Include milk, ghee, almonds, figs, dates, saffron, sesame seeds.
 ✅ Practice Yoga & Meditation (Mool Bandha, Ashwini Mudra, Bhramari Pranayama).
 ✅ Use warm herbal oils (Ashwagandha oil, Bala Taila) for genital massage.
 ❌ Avoid excessive alcohol, processed foods, late-night stress.

B. Vajikarana Herbal Formulations

• Vrishya Ghrita (Medicated Ghee) – For sexual rejuvenation.
• Swarna Bhasma + Ashwagandha Churna – For testosterone boost.
• Shukra Vardhini Ras – Enhances semen quality.
• Kaunch Beej Pak – Strengthens male sexual function.

5. Conclusion

Ayurvedic Pulse Diagnosis (Nadi Pariksha) is a precise tool to assess sexual dysfunctions and reproductive disorders by identifying dosha imbalances. Panchakarma therapies, along with Vajikarana treatments and herbal medicines, offer a holistic, natural approach to restoring sexual wellness, fertility, and overall vitality in both men and women.

13]TCM Acupressure Therapy for Male & Female Sexual Problems

Traditional Chinese Medicine (TCM) uses acupressure therapy as a non-invasive method to restore Qi (energy) flow, balance Yin-Yang, and improve blood circulation in the body. In sexual medicine, acupressure helps treat erectile dysfunction (ED), premature ejaculation (PE), low libido, female arousal disorders, and hormonal imbalances.

1. TCM Perspective on Sexual Dysfunction

According to TCM theory, sexual dysfunction arises due to imbalances in:

• Kidney Qi Deficiency → Weak sexual energy, ED, infertility.
• Liver Qi Stagnation → Stress-related sexual issues, low libido.
• Spleen & Blood Deficiency → Fatigue, weak erections, irregular menstruation.
• Dampness & Phlegm Accumulation → Obesity-related ED, vaginal discharge.

Key Meridian Pathways Involved in Sexual Health

1. Kidney Meridian → Governs reproductive energy & libido.
2. Liver Meridian → Regulates stress, hormone balance.
3. Spleen Meridian → Supports energy, blood flow to sexual organs.
4. Conception Vessel (Ren Mai) → Controls female reproductive health.
5. Governing Vessel (Du Mai) → Affects male sexual performance.

2. Acupressure Points for Male Sexual Dysfunction

How to Apply Acupressure

• Press each point for 1-2 minutes using circular motion.
• Apply firm, but gentle pressure with fingers or thumbs.
• Massage daily for optimal results.

3. Acupressure Points for Female Sexual Dysfunction

How to Apply Acupressure

• Use firm, slow pressure for 1-2 minutes.
• Perform 2-3 times daily for maximum effect.
• Combine with deep breathing & relaxation techniques.

4. Additional Techniques to Enhance Results

A. TCM Herbal Therapy

• For Men: Ginseng, Epimedium (Horny Goat Weed), Cistanche, Goji Berry.
• For Women: Dong Quai, Shatavari, Maca Root, Rehmannia.

B. Qigong & Tai Chi for Sexual Health

• Strengthens pelvic muscles & improves sexual energy flow.
• Recommended Practices: Mula Bandha (Root Lock), Kegel Exercises.

C. Dietary Support (TCM Nutrition)

• Yang-Boosting Foods (For ED & Low Libido): Walnuts, Ginger, Black Sesame.
• Yin-Nourishing Foods (For Female Hormonal Balance): Soy, Almonds, Avocados.

5. Conclusion

Acupressure therapy in TCM provides a natural, non-invasive approach to treating male and female sexual dysfunctions by restoring Qi balance, promoting blood flow, and enhancing hormonal function. Combined with herbal medicine, Qigong, and a TCM-based diet, it can significantly improve sexual performance, desire, and reproductive health.

14]Aura Quantum Healing for Sexual Health & Well-being

Aura Quantum Healing is a bioenergetic therapy that focuses on restoring sexual energy, emotional balance, and hormonal harmony by working on the human energy field (Aura), chakras, and quantum vibrational frequencies. This method integrates Quantum Physics, Energy Medicine, and Biofield Healing to address sexual dysfunctions, emotional traumas, and reproductive health in both men and women.

1. Understanding the Aura & Its Role in Sexual Health

A. What is the Aura?

The Aura is an electromagnetic energy field surrounding the body, consisting of seven layers that correspond to physical, emotional, mental, and spiritual health. Imbalances in the Aura affect sexual function, emotional intimacy, and hormonal regulation.

B. Key Aura Layers & Sexual Energy

2. Chakra Healing & Sexual Energy Flow

In Quantum Healing, balancing the chakras (energy centers) is crucial for sexual vitality and reproductive health.

Healing Method:

• Reiki & Quantum Touch for chakra realignment.
• Sound Healing (Binaural beats, Solfeggio Frequencies) to activate sexual chakras.
• Crystal Healing (Carnelian, Rose Quartz, Red Jasper for sexual energy).

3. Quantum Healing Methods for Sexual Dysfunction

A. Biofield Therapy for Sexual Energy Blockages

• Scanning the aura to detect energy imbalances in the sexual meridians.
• Energy Clearing Techniques (Pranic Healing, Qi Healing) to remove negative sexual imprints.

B. Quantum Frequency Healing

• 432 Hz & 528 Hz frequencies for sexual healing & DNA repair.
• Theta & Gamma Waves for enhanced libido & deep connection.

C. Quantum Meditation for Sexual Rejuvenation

• Tantric Breathwork to circulate sexual energy.
• Visualization of golden light to clear sexual energy blockages.

D. Past Life Regression & Trauma Healing

• Clears karmic sexual traumas affecting intimacy.
• Activates higher consciousness sexual awakening.

4. Aura Healing for Male & Female Sexual Problems

A. Male Sexual Dysfunctions

B. Female Sexual Dysfunctions

5. Conclusion

Aura Quantum Healing offers a holistic and energy-based approach to enhancing sexual health, emotional intimacy, and spiritual connection. By balancing aura layers, chakras, and vibrational frequencies, it helps in removing sexual blockages, healing past traumas, and rejuvenating sexual energy naturally.

15]Sound Healing, Chakra Healing & Tantric Sex: A Holistic Approach to Sexual Wellness

Sound healing, chakra balancing, and tantric practices offer a holistic and spiritual approach to sexual health and intimacy. These methods enhance sexual energy flow, deepen connection, and improve physical, emotional, and spiritual well-being.

1. Sound Healing for Sexual Health

A. How Sound Healing Works

Sound healing uses vibrational frequencies to restore balance to the body's energy centers (chakras). Specific frequencies help clear blockages in the Root, Sacral, and Heart Chakras, which are directly linked to sexual energy and intimacy.

B. Frequencies for Sexual Healing

C. Sound Healing Techniques

• Tuning Fork Therapy: Applying specific frequencies to sexual chakras.
• Crystal Singing Bowls: Using vibrations to clear energy blockages.
• Binaural Beats & Solfeggio Frequencies: Listening to meditative sounds to activate sexual energy.
• Mantras & Chanting: Repeating “LAM” (Root Chakra) & “VAM” (Sacral Chakra) for sexual vitality.

2. Chakra Healing & Sexual Energy Flow

A. Role of Chakras in Sexual Health

Chakras are energy centers that regulate sexual function, pleasure, and emotional intimacy. Blocked chakras lead to sexual dysfunction, low libido, and relationship disharmony.

B. Chakra Balancing Techniques

1. Crystals:
   • Red Jasper, Garnet → Root Chakra (Grounding & Libido)
   • Carnelian, Moonstone → Sacral Chakra (Arousal & Fertility)
   • Rose Quartz, Green Aventurine → Heart Chakra (Emotional Bonding)

1. Aromatherapy:
   • Ylang Ylang, Sandalwood, Jasmine for sensual energy.

1. Breathwork (Pranayama):
   • Deep diaphragmatic breathing to channel sexual energy.

1. Kundalini Yoga:
   • Activates spinal energy flow for heightened pleasure.

3. Tantric Sex: The Spiritual Path to Deep Intimacy

A. What is Tantra?

Tantra is an ancient spiritual practice that integrates mind, body, and soul for deep sexual connection, healing, and enlightenment. Unlike conventional sex, Tantric sex focuses on energy flow, prolonged intimacy, and full-body orgasms.

B. Benefits of Tantric Practices

✔ Enhances orgasmic pleasure through slow, mindful connection.
 ✔ Boosts libido and sexual confidence.
 ✔ Strengthens emotional & spiritual intimacy.
 ✔ Helps overcome erectile dysfunction & premature ejaculation.
 ✔ Balances masculine (Shiva) and feminine (Shakti) energies.

C. Tantric Practices for Sexual Wellness

D. Tantric Sex Rituals for Sexual Healing

1. Sacred Space Preparation
   • Use candles, incense, crystals, and soft music.

1. Foreplay as a Meditative Experience
   • Focus on breathing and deep touch, not immediate climax.

1. Tantric Lingam & Yoni Massage
   • Lingam (Penis) Massage: Activates male sexual energy & prevents premature ejaculation.
   • Yoni (Vagina) Massage: Releases sexual trauma & enhances orgasmic sensitivity.

1. Cosmic Union (Karezza Technique)
   • Slow penetration without climax focus, creating long-lasting energy waves.

4. Combining Sound, Chakra, and Tantra for Maximum Sexual Energy

• Before Sex: Listen to 639 Hz (Heart Chakra) & 417 Hz (Sacral Chakra) frequencies.
• During Tantra Practice: Use slow breathing techniques, eye gazing, and sacred touch.
• Post-Intimacy Healing: Meditate with Solfeggio frequencies (528 Hz for DNA Repair).

5. Conclusion

Sound Healing, Chakra Balancing, and Tantric Sex are powerful holistic techniques to enhance sexual vitality, emotional intimacy, and spiritual fulfillment. By integrating energy-based practices, individuals and couples can experience deeper connection, heightened pleasure, and long-lasting sexual well-being.

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16] Various Sexual; Medicine Certified Courses. PGD, Fellowship, Masters, Doctorate in Clinical Sexology & Psychosexual Medicine

WNHO Institute of Sexology 

Run Under Government Recognized Startup

Reg Under WNHO Educational Trust Accreditation CTAA[UK] Membership No.10666084 & Ex. Institutional Certification from the American College of Sexologist [ACS] now ABS [ American Board of Sexology. [USA]

Reg. No. E-8927(P). Govt Startup No. DIPP 3274 India.

SKILLS EMPOWERMENT, SELF EMPLOYMENT.

Course Coordinator- Prof.Dr. Ramesh Maheshwari.

 Application Form, Fellowship in Sexology & Psycho-sexual Counselling & Psychotherapy.

                     Application PG Diploma in Sexology

Sex Therapy and Counselling online distance learning & Skill Empowerment.

Dear Sir,                                                                           Date:

I would like to enroll for the above course. I enclose details about fees paid. [……………………………………………] in favor of WNHO Healthcare Pvt. Ltd. Pune for full fees of Rs.80,000/- As Special Concessional rate.

I give below the information requested by you.

(Please use block letters and tick wherever applicable)

1. Name in full: ……………………………………….…………………………
2. Sex:     Male: (    )       Female  (   )
3. Address: ……………………………………………………………………Pin Code ……………………….

            Mobile No: ……………………..   Clinic……………….………

Email: ………………………………………………………………………….................................

1. Qualifications: …………………………………………………Reg. No. ……………………………

In past attended: Sexuality Training Programmed (   ), Seminars (   ), Workshops (   ), No previous exposure (   ). I understand this is purely a correspondence course dealing with the essentials on sexuality concerns and problems seen in routine practice. Yours faithfully,

Please enclose: 

• Photocopies of Degrees and Registration Certificate
• Self-Attested passport size photograph

      Signature

Please mail with 

Net Banking- WNHO Healthcare Pvt. Ltd. Payable Pune: Or RTGS/NEFT IFSC: HDFC0000962. For International Students- $1500. USD HDFC Swift Code is HDFCINBB- PNE.

Registered Office Course Fascinator Dr. Ramesh Maheshwari, WNHO Health Care Pvt.Ltd,2014 Sadashiv Peth, Dhanvantari Building, Office no.-3,

Tilak Road, Opposite ICICI Bank, Pune, Maharashtra, India. Pin Code 411030

Ph. 020 24463540 /WhatsApp- 9822006427/9604715783.

WNHO Institute of Sexology

Run Under Government Recognized Startup

Reg Under WNHO Educational Trust Accreditation CTAA[UK] Membership No.10666084 & Ex. Institutional Certification from the American College of Sexologist [ACS] now ABS [ American Board of Sexology. [USA]

Reg. No. E-8927(P). Govt Startup No. DIPP 3274 India.

SKILLS EMPOWERMENT, SELF EMPLOYMENT.

Course Coordinator- Prof.Dr. Ramesh Maheshwari.

 Application Form, PG Diploma in Sexology & Psycho-sexual Counselling & Psychotherapy.

                     Application Masters in Sexology

Sex Therapy and Counselling online distance learning & Skill Empowerment.

Dear Sir,                                                                           Date:

I would like to enroll for the above course. I enclose details about fees paid. [……………………………………………] in favor of WNHO Healthcare Pvt. Ltd. Pune for full fees of Rs.12,0000/- As Special Concessional rate.

I give below the information requested by you.

(Please use block letters and tick wherever applicable)

1. Name in full: ……………………………………….…………………………
2. Sex:     Male: (    )       Female  (   )
3. Address: ……………………………………………………………………Pin Code ……………………….

            Mobile No: ……………………..   Clinic……………….………

Email: ………………………………………………………………………….................................

1. Qualifications: …………………………………………………Reg. No. ……………………………

In past attended: Sexuality Training Programmed (   ), Seminars (   ), Workshops (   ), No previous exposure (   ). I understand this is purely a correspondence course dealing with the essentials on sexuality concerns and problems seen in routine practice. Yours faithfully,

Please enclose: 

• Photocopies of Degrees and Registration Certificate
• Self-Attested passport size photograph

      Signature

Please mail with 

Net Banking- WNHO Healthcare Pvt. Ltd. Payable Pune: Or RTGS/NEFT IFSC: HDFC0000962. For International Students- $1500. USD HDFC Swift Code is HDFCINBB- PNE.

Registered Office Course Fascinator Dr. Ramesh Maheshwari, WNHO Health Care Pvt.Ltd,2014 Sadashiv Peth, Dhanvantari Building, Office no.-3,

Tilak Road, Opposite ICICI Bank, Pune, Maharashtra, India. Pin Code 411030

Ph. 020 24463540 /WhatsApp- 9822006427/9604715783

WNHO Institute of Sexology

Run Under Government Recognized Startup

Reg Under WNHO Educational Trust Accreditation CTAA[UK] Membership No.10666084 & Ex. Institutional Certification from the American College of Sexologist [ACS] now ABS [ American Board of Sexology. [USA]

Reg. No. E-8927(P). Govt Startup No. DIPP 3274 India.

SKILLS EMPOWERMENT, SELF EMPLOYMENT.

Course Coordinator- Prof.Dr. Ramesh Maheshwari.

 Application Form, Doctorate in Sexology & Psycho-sexual Counselling & Psychotherapy.

                     Application Doctorate in Sexology

Sex Therapy and Counselling online distance learning & Skill Empowerment.

Dear Sir,                                                                           Date:

I would like to enroll for the above course. I enclose details about fees paid. [……………………………………………] in favor of WNHO Healthcare Pvt. Ltd. Pune for full fees of Rs.150,000/- As Special Concessional rate.

I give below the information requested by you.

(Please use block letters and tick wherever applicable)

1. Name in full: ……………………………………….…………………………
2. Sex:     Male: (    )       Female  (   )
3. Address: ……………………………………………………………………Pin Code ……………………….

            Mobile No: ……………………..   Clinic……………….………

Email: ………………………………………………………………………….................................

1. Qualifications: …………………………………………………Reg. No. ……………………………

In past attended: Sexuality Training Programmed (   ), Seminars (   ), Workshops (   ), No previous exposure (   ). I understand this is purely a correspondence course dealing with the essentials on sexuality concerns and problems seen in routine practice. Yours faithfully,

Please enclose: 

• Photocopies of Degrees and Registration Certificate
• Self-Attested passport size photograph

      Signature

Please mail with 

Net Banking- WNHO Healthcare Pvt. Ltd. Payable Pune: Or RTGS/NEFT IFSC: HDFC0000962. For International Students- $1500. USD HDFC Swift Code is HDFCINBB- PNE.

Registered Office Course Fascinator Dr. Ramesh Maheshwari, WNHO Health Care Pvt.Ltd,2014 Sadashiv Peth, Dhanvantari Building, Office no.-3,

Tilak Road, Opposite ICICI Bank, Pune, Maharashtra, India. Pin Code 411030

Ph. 020 24463540 /WhatsApp- 9822006427/9604715783

WNHO Institute of Sexology 

Run Under Government Recognized Startup

Reg Under WNHO Educational Trust Accreditation CTAA[UK] Membership No.10666084 & Ex. Institutional Certification from the American College of Sexologist [ACS] now ABS [ American Board of Sexology. [USA]

Reg. No. E-8927(P). Govt Startup No. DIPP 3274 India.

SKILLS EMPOWERMENT, SELF EMPLOYMENT.

Course Coordinator- Prof.Dr. Ramesh Maheshwari.

 Application Form, Fellowship in Sexology & Psycho-sexual Counselling & Psychotherapy.

                     Application Fellowship in Sexology

Sex Therapy and Counselling online distance learning & Skill Empowerment.

Dear Sir,                                                                           Date:

I would like to enroll for the above course. I enclose details about fees paid. [……………………………………………] in favor of WNHO Healthcare Pvt. Ltd. Pune for full fees of Rs.90,000/- As Special Concessional rate.

I give below the information requested by you.

(Please use block letters and tick wherever applicable)

1. Name in full: ……………………………………….…………………………
2. Sex:     Male: (    )       Female  (   )
3. Address: ……………………………………………………………………Pin Code ……………………….

            Mobile No: ……………………..   Clinic……………….………

Email: ………………………………………………………………………….................................

1. Qualifications: …………………………………………………Reg. No. ……………………………

In past attended: Sexuality Training Programmed (   ), Seminars (   ), Workshops (   ), No previous exposure (   ). I understand this is purely a correspondence course dealing with the essentials on sexuality concerns and problems seen in routine practice. Yours faithfully,

Please enclose: 

• Photocopies of Degrees and Registration Certificate
• Self-Attested passport size photograph

      Signature

Please mail with 

Net Banking- WNHO Healthcare Pvt. Ltd. Payable Pune: Or RTGS/NEFT IFSC: HDFC0000962. For International Students- $1500. USD HDFC Swift Code is HDFCINBB- PNE.

Registered Office Course Fascinator Dr. Ramesh Maheshwari, WNHO Health Care Pvt.Ltd,2014 Sadashiv Peth, Dhanvantari Building, Office no.-3,

Tilak Road, Opposite ICICI Bank, Pune, Maharashtra, India. Pin Code 411030

Ph. 020 24463540 /WhatsApp- 9822006427/9604715783.

About the Author 

Brief Biodata 

Dr. Ramesh Maheshwari. MBBS, DPM[CPS], MD, DHPh [UK] & PhD in Sexology.

1] Honorary Consultant in Sexual Medicine OPD at ABMH [ Aditya Birla Memorial Hospital, Chinchwad, Pune, for 15years]

2] Honorary Assist. Professor at D. Y. Patil Medical College, Pimpri, Pune.

3] Director of WNHO Institute of Sexology 

4] President of WNHO Organization trust under proposed Patronship from [Health Ministry of State & Central Ministry of Health]

5] Director of WNHO Health Care Pvt. Ltd, Pune is the Government recognized Startup. DIPP No.3274.

6] Working as a full-time Sexologist at WNHO Clinic, Sadashiv Peth, Tilak Road, Pune. for 25 years.

7] Life membership of CSEPI No.-298. & Life Member of Indian Medical Association, Delhi. Membership No- IMA: MAH/5272/1/21/51753/96-97L and

 Indian Medical Council registration no. MMC-5240.

8] Director of WNHO Institute of Sexology, Pune, India.

Web site – www.wnhohealthcare.com/www.sexologyinstitute.co.in

Email: wnhohealthcarepvt.ltd@gmail.com c/c drrameshm2@gmail.com 

Phone- 9822006427/ 09604715783.

The author has always been academic research-and had presented several National & International

papers.  So far, he has presented 50 papers at National

& International conferences. He is an honorary professor

at WNHO Institute of Sexology, Pune. And also,   a senior   Sexual Medicine Consultant at WNHO Clinic, Tilak Road, Pune. He also provides health education to schools and     colleges. He is president of Lions Club of Pune Digital, International. He is Chairman of WNHO [Western Natural Health Organization. He a is practicing Sexual Medicine Consultant for 35 years at WNHO Clinic Pune India.