16 Sexual Dysfunctions

Question 1

In Canada, sex education is regulated on the (provincial/federal) level.

Answer 1

Provincial

Question 2

This sexual dysfunction can be an early warning sign of cardiovascular disease

Answer 2

Erectile dysfunction

Question 3

Hormones’ role in desire…

Answer 3

Is overstated

Not just driven by testosterone

Question 4

Effects of cardiovascular disease on sexuality

Answer 4

• ED

* vaginal lubrication and arousal (can also be affected by cardiovascular disease treatments)

Question 5

Organic factors in low desire

Answer 5

• hypothyroidism (low thyroid hormone levels)

* anemia (decrease in red blood cells due to low iron

Question 6

Childbirth and desire loss:

Answer 6

• blood loss > low iron
• elevated prolactin from breastfeeding > vaginal dryness
• lack of sleep > where is the energy to sex?

Question 7

Examples of central nervous system dysfunction impacting sexual functioning

Answer 7

Multiple sclerosis, spinal cord injuries

Question 8

Diabetes and sexual functioning

Answer 8

• reducing blood flow to genitals
• eventually deteriorating nerve function
• men: can cause ED
• women: can cause lubrication and sensation problems

Question 9

Most common organic cause of sexual difficulties, at current time?

Answer 9

Drugs!!

Question 10

According to Masters & Johnson in the 1970s, __% of organic causes of sexual difficulties were…

Answer 10

Psychogenic

Question 11

But ultimately, what can we say about causes of sexual dysfunction?

Answer 11

They arise from psychological and biological factors, often including medication and often not. We can’t create a false dichotomizations between the factors.

Question 12

Common drugs that impact sexuality negatively

Answer 12

Drugs for cardiovascular disease, arthritis, cholesterol, cancer
Most psychiatric drugs, especially antidepressants
Recreational drugs! Incl. long term use…

Question 13

Hormonal contraceptives linked to lower desire

Answer 13

Depo
Diane/Ginette (acne med used off-label for contraceptive)
Potentially all hormonal contraceptives, but it’s not well researched

Question 14

How did the sexual revolution change sex psychology?

Answer 14

Not pathologizing high desire/high levels of sexuality anymore

Disorders of low desire entered the DSM

Question 15

How common is true, pure lack of desire in relationships?

Answer 15

RARE! Usually impacted my many interrelated factors that are self-perpetuating, but can be treated

Question 16

How do antihistamines and decongestants influence women’s sexuality?

Answer 16

Drying out mucous membranes, including the vagina!!!!

Question 17

Chemotherapy causes vaginal dryness

Answer 17

Huh!

Question 18

Diverse causes of enrecytle dysfunction!!!!!

Answer 18

Cardiovascular disease, diabetes
Psychotropic drugs
Antihypertensive drugs
Stress and interpersonal conflict

Question 19

Medication that can be used to treat premature ejaculation

Answer 19

SSRIs! SSRIs help reduce sensation

Question 20

The most underreported sexual dysfunction in men is

Answer 20

Delayed ejaculation

Question 21

Secondary DE can be caused by

Answer 21

Anti-depressants or anti-psychotic drugs

Question 22

DSM doesn’t mention having sex-related pain…where is this addressed?

Answer 22

In men, sex-related pain can be cased by diseases:

• STIs
• prostate/testes disease, tumours
• other diseases which can be treated by urologists

Question 23

Sex-related pain in women is called…

Answer 23

Genito-pelvic pain/penetration disorder

Question 24

Genito-pelvic pain/penetration disorder has 2 major psychological elements:

Answer 24

Dyspareunia and vaginismus

Dyspareunia: Pain and/or fear of pain

Vaginismus: muscular component of pain

Question 25

Causes of dyspareunia

Answer 25

• endometriosis
• STIs
• vagina infections
• dry intercourse

Question 26

Treatment for dyspareunia

Answer 26

Requires good assessment

Treating underlying disease

Question 27

Vaginismus causes

Answer 27

• 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

Question 28

Treatment of vaginismus

Answer 28

• addressing factors causing fear
• graduated plastic dilators
• relaxation training
• pelvic floor exercises

Question 29

Episiotomy, aka perineotomy

Answer 29

Surgical incision of perineum and posterior vaginal wall

Performed during second stage of labor to quickly enlarge vagina for baby to come thru