Introduction à l'étude des troubles de la sexualité à Yaoundé : A propos de 34 cas observés en consultation au dispensaire médico-social d’Eug-Essono

Abstract

Human sexuality is a taboo. Very few studies have been carried out on this subject in the world, and particularly in Africa. Is it to say that sexual disorders are not frequent here ? It could be true for some sexual d e v iations but sexual disorders are not only deviations. There are other disorders bound only to sexual act, for example sexual insufficiencies for which people began to consult physicians. But are physicians well armed to face sexual problems of their patients ? The aim of our study is to give a contribution to help physicians who are usually c o n fronted with problems of sexual difficulties in their daily consultations Therefore, our specifici objectives arc ; - to identify the nature of sexual disorders found through daily consultations of an urban welfare center in Yaounde ; - to determine their aetiologies ; - and to draw conclusions and recommendations in the light of our results and findings. M E T H O D O L O G Y T h i s study was carried our between May to July 1982 in an urban welfare center in Yaounde. Vie examined 34 patients {23 men and 11 women) who complained of sexual problems. RESULTS A N D DISCUSSIONS Characteristics of our cases : It appears from our results thcit the mean age of the total number of our subjects is around 28 years and most of them (41.17 %) belong to the age group of 23 to 27 years. Therefore they are.young patients, who are n o r ma l l y sexually active. The Bamilekes predominate over other ethnie groups. We attribute that (for w ;reat part) to the fact that they are more numerous among the general population. Our subjects, in the majority of cases have a low educational level (primary education : 41.17 % and secondary education : 11.76 %) . This low educational level was a handicap to describe intelligently their sexual disorders. These patients belong to modest and less remunerative occupations . is a condition to the installation of depression which stresses psychogenic sexual disorders. Our patient are all Christians (catholics : 67.6% and protestants : 3 2.35 %) . But it would appear that moslems rarely consult modern physicians for their sexual disorders. As regards marital status of cur patients, we noticed a high percentage of bachelors amongst them. This can constitute a problem in the psychotherapy of these patients, which needs the presence of both partners (MASTERS and JOHNSON, 1971). Nature of the disorders presented : These disorders are and present several clinical aspects in man and in women. In men, there are secondary. impotence (58.06 %) , premature ejaculation (19.35 %) , primary impotence(9. 67 %) , anejaculation (6.45 %), delayed ejaculation (3.22 %) and painful ejaculation (3,22 %) . The secondary impotence in the majority of cases (21.73 %), associated with ejaculation disorders.In these cases we could attribute this impotence to the frustration created by ejaculation disorders (mostly premature ejaculation) . In women, sexual disorders are cyspareunias 52.63 %), vaginismus (21.05 %), frigidity (15.78 %) and anorgasmia (10.52 *) . The dyspareunia is isolated (36.36 %) or associated to other sexual disorders (5*1.55 ‘-j) which it can cause (vaginismus, frigidity, or anorgasmia). Aetiological factors In men, psychological factors (60.64 %) predominate over the other organic causes (39.75 %). There are abnormally active masturbation, the age of onset of first sexual intercourse, perverse intercourse lived through, psychiatric diseases, ejaculation disorders, non satisfied perverse sexual behavior, the responsability of the partner, the lack of sexual education. The organic causes incriminated are the history of abdominal surgical operations, the uro-genital infections and diseases, trauma of the pelvis and the head, haemorrhoids, the use of stimulants and contraceptive sheats, hypogonadisme and hypertension. In women, the organic causes are more evident (72.-11 «%) : they are infections of the genital organs and the pelvis, endometriosis and uterine fibroids, the history of obstetrical trauma, the use of stimulants, Amongst the psychological factors (27.58 %) we note none satisfied perverse sexual behavior, the history of rape, and delivery event. CONCLUSIONS - RECOMMENDATIONS sexual disorders actually exist and we cannot be ignorant of them any longer. They are of various aetilogies and the organic factor must not hide the concomitant psychogenic origin.The treatment of sexual disorders due to organic factors depend on the'aetiology of every disorder for example we have to treat causative disease. The hormono therapy,.praised up to, is used only in the cases of evident hormonal insufficiency.The treatment of sexual dysjonctions due to psychogenic origin is codified new for a certain number of them : impotence, premature ejaculation, frigidity, vaginismus and dyspareunie4.. This phycho-therapy is based on systematic desentisization and needs the cooperation of the couple. However, our study is not claiming to exhaust all aspects of sexual disorders. Many fields need to be explored : epidemiology, biology etc... Therefore, our immediate recommendations are : 1°/ The lifting of taboo tha hovers the human sexuality in order to understand and treat sexual disorders. 2°/ An extensive evaluation of the sexual disorders in our set. 3°/ The reinforcement of the teaching of sexology in our Faculty of Medecine. 4°/ Sexual education, elaborated and well adapted to cur set. All these in order to prevent all consequences of sexual disorders among society : non consumed marriages,infertility, divorce, suicides, etc...