The present study was carried out at the medicopsychological clinic of a general hospital in Tunis in close cooperation with the department of gynecology. Ligatured patients are systematically followed up if they present psychiatric symptoms ranging from ordinary complaints without any real organic cause to psychotic states requiring hospitalization and special care. Ligation of the organs which are physically involved in sex is experienced either as secondary castration entailing a type of neurosis or a narcissistic hemorrhage expressed through physical symptoms. Sexual problems may be in the foreground or else masked by a pattern of behavior mainly characterized by excessive aggressiveness directed chiefly towards the husband and children. From the psychodynamic point of view, ligation reactivates subconscious traumas and conflicts which are then expressed in the form of aggression as if part of the sexual instinct was transformed into a death instinct. (author's)