Indian Journal of Psychiatry, 2002,44(4),375-376 SEXUAL DYSFUNCTION IN AN ADULT FEMALE WITH OBSESSIVE SEXUAL THOUGHTS: A CASE REPORT SUNIL AWANA & SHIVANANOA JENA ABSTRACT We report a case of an adult married Muslim female from an orthodox background having sexual obsessions about males other than her husband and her 7 year-old son. She developed diminished sexual desire to have sex with her husband as a result of her obsessions. The role of sexual obsessions in sexual dysfunction in females is discussed. Key Words: Obsession, compulsion, obsessive-compulsive disorder, sexual dysfunction CASE REPORT objective and subjective sadness No compulsions, psychotic phenomena, phobias were observed. Mrs. I, a 30-year-old married Muslim A diagnosis of Obsessive-compulsive Disorder female.presented to our adult psychiatry OPD with (OCD) with depressive features was made , complaint of having inappropriate sexual thoughts. according to DSM-IV criteria. Eleven years ego, shortly after marriage, she She was put on tablet clomipramine 75 mg/ found her husband to be less attractive than she day. As she did not show any improvement, and earlier thought of. She observed that on seeing she did not tolerate anticholinergic side-effects of other males or their shoes and undergarments, the medicine, she was admitted to psychiatric she would get thoughts of having sex with them. ward. Capsule velnafaxine 75 mg HS and tablet The thoughts were excessive, intrusive, alprazolam- SR 0.5 mg BD were given in place of unnecessary, and uncontrollable. They were clomipramine. The venlafaxine was increased to associated with sexual arousal and lubrication of 150 mg/day after 3 days She started showing vagina. There was a gradual decline in the sexual reduction in frequency of sexual obsession, desire over the last 3 years from 1-2/day, until 3 depressive and anxiety symptoms, 8 days after years ago, to 1-2/week, recently. Six months ago, hiking its dose. Finally, she was discharged after she developed sadness, anxiety symptoms, 21 days of hospitalisation. After 1 week of insomnia, anorexia when she had sexual thoughts discharge, venlafaxine was increased to 225 mg/ about her son, and she decided to consult a doctor. day, and she stopped having sexual thoughts,2 She had no past medical or psychiatric history weeks after discharge. or family history of psychiatric illness She was well adjusted pre-morbidly On physical DISCUSSION examination, no abnormality could be found On MSE, there were sexual obsessive thoughts, She was prescribed venlafaxine as several pathological guilt, hopelessness, death wishes, reviews mentioned its efficacy in OCD (Ninan, 375