chapter 16 Flashcards
four categories of causes of sexual problems
- intrapsychic
- interpersonal/relational
- cultural/psychosocial
- organic
intrapsychic factors in development of sexual problems
- childhood experiences with sexuality
- parents relationship to each other and to the child
- anxieties as one grows up
interpersonal/relational factors in dev of sexual problems
- inadequate communication
- conflict resolution
- cheating, jealousy, distrust
cultrual/psychosocial factors in dev of sexual probs
- religious teachings
- family based teachings
- school based sex ed
- sources of misinfo (media)
organic factors in dev of sexual probs
- hormones (hypothyroidism, anemia)
- ## neuro disorders and central nervous system injuries (spinal cord, MS, diabetes)
psychogenic
stemming from psychological causes
drug related causes of sexual probs
- most psychiatric drugs (SSRIs, SNRIs)
- drugs used to treat cardiovascular diseases, arthritis, cancer, high cholesterol
- alcohol/rec drugs
- hormonal contraceptives (depo provera)
iatrogenic
originating from medical/surgical/pharma causes
prevailing discourse on ED remains:
a) dualistic (mind vs body)
b) holistic (mind-body interaction)
a)
quality of sexual/erotic contact as a factor in the dev of sexual probs
- feeling aroused
- ## adequacy of sexual stim
HSDD (sexual disorder)
- hypoactive sexual desire disorder
- since been removed from DSM5
DSM 5 sexual dysfunctions for women
- sexual interest/arousal disorder
- orgasmic disorder
- genito-pelvic pain/penetration disorder
DSM 5 sexual dysfunctions for men
- erectile disorder
- hypoactive sexual desire disorder
- premature (early) ejaculation
- delayed ejaculation
ED
- erectile disorder
- difficulty maintaining erection
- causes: anything that interferes with blood flow (meds), communication probs, interpersonal conflict, history of sexual abuse
- options: erectogenic drugs (viagra), sex therapy
phosphodiesterase type 5 inhibitors
- PDE-5 inhibitors
- erectogenic drug that works by helping dilate arteries of penis
premature (early) ejaculation (causes, treatment, definition)
- most common sexual dysfunction affecting men
- determined by IELT
- diagnosis: if one ejaculates within 60 second of penetration 75% of the time for a period of 6 months+ and it causes distress/impairment
- causes: many (rushed ejac when mastrbating, performance anxiety, etc)
- treatment: self (distractions/numbing creams/etc), therapy (prescribed off label meds to to reduce sexual pleasure)
IELT (hint: premature ejaculation)
- intra-vaginal ejaculatory latency time
- during from moment of vaginal penetration until ejaculation into the vagina
delayed ejaculation
- most under reported male sexual difficulty
- aka anorgasmia (inability to have an orgasm)
- can be primary or secondary (late onset)
- causes: use of psychotropic drugs (antidepressants) and antipsychotics, organic
- treatment: pay attention to arousal, withdrawal from meds, try new stim
orgasmic disorder in women
- aka anorgasmia (persistant inability to orgasm)
- causes: lack of knowledge/understanding of body, pharmacological side effects (anti depressants, anti psychotics)
- treatment: psychoeducational counselling, bibliotherapy
bibliotherapy
use of readings and written assignments in psycho therapy
dyspareunia
- pain during intercourse/sex
- causes: diseases (STIs, cancer, peyronie’s disease)
- treatment: treat underlying diseases, conducted by urologists
genito pelvic pain/penetration disorder (causes, treatment and assessment for both types)
- two main elements: pain/fear of pain, significant muscular component
- causes for pain: endometriosis, ovulation, STIs, yeast infection, improperly healed incisions, cancer
- causes for muscular component: mindset abt sex, education, abuse/assault
- for diagnosis, its important for the doctor to determine where the pain is and stimulate it to determine the cause
- treatment: treating underlying causes of the pain, dilators, pelvic muscle exercises
old term for the anticipation of pain during sex
vaginismus
spectatoring (masters and johnson)
monitoring one’s own sexual performance rather than simply enjoying giving/receiving pleasure
masters and johnson sex therapy main idea
- eliminate obstacles to sexual functioning so ‘normal’ sexual response could be restored
masters and johnson major therapy innovation (hint: sfe)
- sensate focus exercises
- sex therapy exercises that involve couple focusing on sensation of touching and being touched by each other
- first no genital/erotic zone touching, then head to toe incl. genitalia, then non demand genital pleasuring (no intercourse)
