4. Sexual Dysfunction Flashcards
What is sexual dysfunction?
A disturbance in sexual desire and in the psychophysiological changes that characterise the sexual response cycle and cause marked distress and interpersonal difficulty.
Which aspects of sexuality may be affected by dysfunction?
Sexual desire/ interest, sexual arousal, orgasm, pain, and others.
How can sexual desire be affected in sexual dysfunction?
Lack or loss of sexual desire.
How can sexual arousal be affected in sexual dysfunction?
Men may have erectile dysfunction, women may have sexual arousal disorder.
How can orgasms be affected in sexual dysfunction?
Men may have rapid ejaculation or inhibited orgasm, women may have orgasmic dysfunction.
How can pain cause sexual dysfunction?
May have dysparenunia (pain during sexual intercourse) and women may have vaginismus (tightening of muscles on penetration).
How may sexual dysfunction present?
Overtly, negative investigations for pain or discharge, or covertly, never happy with offered method of contraception.
Why might sexual dysfunction go unreported?
Reluctance due to taboo or embarrassment, although this is decreasing.
What should be considered in a consultation regarding sexual dysfunction?
Empathy of reassurance, be aware of embarrassment or stigma, ask both open and specific questions, avoid labels, interview partner etc.
How should a clinical interview on sexual dysfunction be structured?
Detailed description of the problem - onset and progression. Establish relationship with partner and relevant past relationships. Medical history and drug use, mental health history. Family and psychosexual history. Significant life events. sexuality. Cultural aspects. Coping mechanisms and support networks.
What factors may lead to sexual dysfunction?
Precipitating factors, predisposing factors, perpetuating factors with self and partner.
Give examples of precipitating factors that could cause sexual dysfunction.
Physical, psychological, life events, partner’s problems.
Give examples of predisposing factors that could cause sexual dysfunction.
False beliefs and concepts, unrealistic expectations, poor communication skills, physical vulnerability, early sexual trauma.
Give examples of self perpetuating factors that could cause sexual dysfunction.
Loss of confidence, spectating, guilt and shame, anger and frustration.
Give examples of partner perpetuating factors that could cause sexual dysfunction.
Breakdown in communication, pressure to perform, criticism and hostility, guilt and self-blame.
