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A Reintroduction to Clinical Sexuality

Correspondence: Address correspondence to Dr. Levine at the Center for Marital and Sexual Health, 23230 Chagrin Boulevard, #350, Beachwood, Ohio 44122; e-mail, sbl2{at}case.edu.

Clinical sexuality has undergone phases of domination by psychoanalysis, behavioral sex therapy, and pharmacotherapy as its scope gradually broadened to include diverse problems of identity and function. This article provides 1) a conceptual background to guide sexual history taking; 2) an understanding of the interplay of biology, psychology, interpersonal relationships, and concepts of normality and morality (culture) in generating sexual problems; and 3) a synopsis of the sexual developmental stages of adult life. The article briefly addresses how psychiatrists may intervene in the treatment of erectile dysfunction in ways other specialists cannot. The final section suggests that sexual dysfunction induced by selective serotonin or noradrenaline reuptake inhibitors can be addressed by careful sexual history taking prior to prescribing antisexual medications.

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