Structural analysis in the treatment of sexual disturbances

Abstract

Physiological conception of the constituents of the copulative cycle shows that normal intercourse is based on the interaction of several independent innervation systems which join one another in the increasing dynamic integwity throughout the copulative cycle. This physiological conception defines four determinants, characterized by a) anatomo-physiological structure b) the final effect. These determinants are: 1) The neuro-humoral determinant. It includes some specific subcortical structures of the diencephalo-hypophyseal area and the entire system of the endocrine glands. This complex provides for the necessary quantitative level of sexual pressure (libido) and corresponding excitability of the nerve centres that participate in sexual performance. 2) The psychological determinant. It consists of the cortical structures and, most important, the combination of conditioned reflexes in the sexual sphere. It ensures qualitative direction of libido, effects erection before immissiorl and fulfills other minor tasks, mainly to effect the overt manifestations of sexual behavior specific for the human race, conforming more or less with the requirements of certain ethnic and social strata of society and with the needs of a particular situation with regard to place and time. 3) The erection determinant. It is based on purely functional anatomo-physiological structures of the lower level, consisting of the spinal and extra-spinal erection centers and the peripheral vascular function of cavernous bodies in the penis. This erection determinant serves mainly the mechanical function of intercourse. 4) The ejaculatory determinant. It is the most complicated and widely dispersed component and includes ejaculatory and orgastic effects. It is located on several levels, from the prostate with its own intra- and extra-mural anatomic ganglia up to the paracentral lobuli of the cortex. This determinant is responsible for the biologically most important function of the entire copulative cycle: the discharge of the sperm.