16 Sexual Dysfunctions Flashcards
In Canada, sex education is regulated on the (provincial/federal) level.
Provincial
This sexual dysfunction can be an early warning sign of cardiovascular disease
Erectile dysfunction
Hormones’ role in desire…
Is overstated
Not just driven by testosterone
Effects of cardiovascular disease on sexuality
- ED
* vaginal lubrication and arousal (can also be affected by cardiovascular disease treatments)
Organic factors in low desire
- hypothyroidism (low thyroid hormone levels)
* anemia (decrease in red blood cells due to low iron
Childbirth and desire loss:
- blood loss > low iron
- elevated prolactin from breastfeeding > vaginal dryness
- lack of sleep > where is the energy to sex?
Examples of central nervous system dysfunction impacting sexual functioning
Multiple sclerosis, spinal cord injuries
Diabetes and sexual functioning
- reducing blood flow to genitals
- eventually deteriorating nerve function
- men: can cause ED
- women: can cause lubrication and sensation problems
Most common organic cause of sexual difficulties, at current time?
Drugs!!
According to Masters & Johnson in the 1970s, __% of organic causes of sexual difficulties were…
Psychogenic
But ultimately, what can we say about causes of sexual dysfunction?
They arise from psychological and biological factors, often including medication and often not. We can’t create a false dichotomizations between the factors.
Common drugs that impact sexuality negatively
Drugs for cardiovascular disease, arthritis, cholesterol, cancer
Most psychiatric drugs, especially antidepressants
Recreational drugs! Incl. long term use…
Hormonal contraceptives linked to lower desire
Depo
Diane/Ginette (acne med used off-label for contraceptive)
Potentially all hormonal contraceptives, but it’s not well researched
How did the sexual revolution change sex psychology?
Not pathologizing high desire/high levels of sexuality anymore
Disorders of low desire entered the DSM
How common is true, pure lack of desire in relationships?
RARE! Usually impacted my many interrelated factors that are self-perpetuating, but can be treated
How do antihistamines and decongestants influence women’s sexuality?
Drying out mucous membranes, including the vagina!!!!
Chemotherapy causes vaginal dryness
Huh!
Diverse causes of enrecytle dysfunction!!!!!
Cardiovascular disease, diabetes
Psychotropic drugs
Antihypertensive drugs
Stress and interpersonal conflict
Medication that can be used to treat premature ejaculation
SSRIs! SSRIs help reduce sensation
The most underreported sexual dysfunction in men is
Delayed ejaculation
Secondary DE can be caused by
Anti-depressants or anti-psychotic drugs
DSM doesn’t mention having sex-related pain…where is this addressed?
In men, sex-related pain can be cased by diseases:
- STIs
- prostate/testes disease, tumours
- other diseases which can be treated by urologists
Sex-related pain in women is called…
Genito-pelvic pain/penetration disorder
Genito-pelvic pain/penetration disorder has 2 major psychological elements:
Dyspareunia and vaginismus
Dyspareunia: Pain and/or fear of pain
Vaginismus: muscular component of pain
Causes of dyspareunia
- endometriosis
- STIs
- vagina infections
- dry intercourse
Treatment for dyspareunia
Requires good assessment
Treating underlying disease
Vaginismus causes
- history of trauma
- persistent negative messages about sex and sexuality
- many women with vaginismus have poor sex education and little accurate info about their own sexuality
Treatment of vaginismus
- addressing factors causing fear
- graduated plastic dilators
- relaxation training
- pelvic floor exercises
Episiotomy, aka perineotomy
Surgical incision of perineum and posterior vaginal wall
Performed during second stage of labor to quickly enlarge vagina for baby to come thru
