15. Sexual Disorders and Paraphilias Flashcards
What is considered abnormal sexuality?
- Does not involve a human-being
- Does not involve stimulation of primary sex organs
- Is compulsive and injurious yourself or others
High-risk factors that lead to high-risk behavior
- Substance use
- Limited access to care
- Poor health literacy about STIs, STI sx, prevention
- Unassertive
- Poor communication skills
High risk behaviors
- Unprotected intercouse, oral sex and anal sex
- Many sex partners
- High-risk partners
- Sex trade work
- Self/partner use of IV grades
High-risk behavior can lead to what?
- STI
- Unwanted pregnancies
- Relationship complications
4 phases of the sexual response cycle
- Desire
- Excitement
- Orgasm
- Resolution
What are the components of Desire?
- Sexual drive (biological): genital sensations and thoughts about sex
- Motivation (psychological): willingness to offer your body for sex
- Wish fullfilment (social): hoping for sex, expectations for sex
Which component of desire can be culturally influenced?
Wish fulfillment
What is the excitement phase of the sexual response cylce?
- How long does it last?
- What changes occur?
Arousal:
- Last several minutes - hours
- Changes: vasodilation/constriction (BV in genitals engorge due to dilation) and myotonia (muscle contraction t/o body)
- Erection/vaginal lubrication
- Nipples get hard
- Increase respiration, tachycardia up to 180 bpm, increase in BP
What is the orgasm phase of the sexual response cylce?
- How long does it last?
- What changes occur?
- 3 - 25 seconds
- Peak of sexual pleasure: release of sexual tension and perinatal muscles/reproductive organs contract.
What is the resolution phase of the sexual response cylce?
- How long does it last?
- What changes occur?
- If orgasm occurs = resolution is rapid and followed by a sense of well-being; if it did not occur, can take up to 2 - 6 huors
- What happens?
- 1. Genitals disgorge with blood
- 2. Body returns to resting state
How is resolution different in M and W?
- M = Refractory period = 3- 10 minutes, 24 hours or even seceral days
- W = NO refractory period, but need time for resolution
In educating patients about sex, what is important?
Teaching them timing: teach them about sexual response cycle so they know what is important and what is not.
Male who has lack of or significantly reduced sexual fantasies and desire for sexual activity that lasts for 6 months. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person’s life.
Male Hypoactive Sexual Desire Disorder
What is Female Sexual Interest / Arousal Disorder?
Lack of or significantly reduced sexual interest/arousal with at least 3 of the following, for 6 months:
- Absent or reduced interest in sexual activity
- Absent or reduced sexual thoughts or fantasies
- None or reduced initiation of sexual activity, unreceptive to partner’s attempts to initiate
- Absent or reduced sexual pleasure in approx. 75%-100% of sexual encounters
- Absent or reduced sexual interest/arousal in response to any internal or external sexual/erotic cues
- Absent or reduced genital or non-genital sensations during sexual activity in approx. 75%-100% of sexual encounters
What is Erectile Disorder?
At least 1/3 symptoms must be experienced in 75-100% of sexual encounters, for 6 months
- Difficulty obtaining an erection
- Difficulty maintaining an erection until completion of sexual activity
- Marked decrease in erectile rigidity
Persistent or recurrent delay in, or absence of, orgasm or reduced intensity (75%-100%) for 6 months, after a normal sexual excitement phase.
Female Orgasmic Disorder
Delayed Ejaculation
Dx Criteria
1/2 sx must be experienced on almost all or all occasions, for 6 months
- Marked delay in ejaculation
- Marked infrequency or absence of ejaculation