Chapter 17: sexual disorders and sex therapy

Question 1

Hypoactive sexual disorder

Answer 1

A lack of interest in sexual activity and genital sexual contact with a partner.

Question 2

Causes of hypoactive sexual disorder

Answer 2

Can be due to alcohol/drugs, Parkinson’s medication, bipolar disorder, Azlheimers or OCD.

Question 3

Female arousal disorder

Answer 3

A lack of response to sexual stimulation. Has a psychological and a physical component.

Question 4

Erectile disorder

Answer 4

The inability to have or to maintain an erection. Can be acquired or lifelong. Often increases with age.

Question 5

Premature ejaculation / rapid ejaculation

Answer 5

Ejaculating too soon and not being able to control the ejaculation. Must happen within one minute after intercourse and must cause significant psychological distress.
- Mild: 30 - 60 seconds after penetration.
- Moderate: 15 - 30 seconds after penetration.
- Severe: within 15 seconds after penetration.

Question 6

Delayed ejaculation / male orgasmic disorder

Answer 6

When the man can not have an orgasm, even though he is highly aroused and has dad a great deal of sexual stimulation.

Question 7

Female orgasmic disorder

Answer 7

When the woman is unable to have an orgasm. Situational orgasmic disorder is common, but this can also be due to inadequate sexual stimulation.
There is difference between primary orgasmic disorder and acquired orgasmic disorder.

Question 8

Dyspareunia (GPPPD)

Answer 8

Pain during intercourse. It’s a genito-pelvic pain / penetration disorder. Pain can also arise because of tight clothing. Can be caused by a high level of pelvic floor tension.

Question 9

Treatment of dyspareunia

Answer 9

There is no good treatment, but CBT is promising: a decrease of sexual distress and increase of sexual functioning.

Question 10

Vaginismus (GPPPD)

Answer 10

Not being able to have intercourse. A somatic cause has to be excluded, it’s not a pelvic floor dysfunction. Catastrophic thoughts about intercourse can lead to fear and avoidance. More often occurs in conservative areas.
It’s a genito-pelvic pain / penetration disorder.

Question 11

Vaginismus (GPPPD)

Answer 11

Not being able to have intercourse. A somatic cause has to be excluded, it’s not a pelvic floor dysfunction. Catastrophic thoughts about intercourse can lead to fear and avoidance. More often occurs in conservative areas.
It’s a genito-pelvic pain / penetration disorder.

Question 12

Causes of erectile disorder

Answer 12

• Vascular pathology.
• Diabetes and dysfunctoning of the testes.
• Injury at the lower part of the spinal cord.
• Severe stress of fatigue.
• Prostate surgery.
• Alcohol abuse.

Question 13

Causes of premature ejaculation

Answer 13

• A local infection.
• Degeneration of the nervous system (like MS)
• Most often psychological factors.
• Survival of the fastest (in sociobiology)

Question 14

Causes of delayed ejaculation

Answer 14

• MS
• Spinal cord injury
• Prostate surgery
• Psychological factors (more often)

Question 15

Causes of female orgasmic disorder

Answer 15

• Illness
• Injury to the spinal cord
• Extreme fatigue
• Psychological factors (more often)

Question 16

Causes of dyspareunia and vaginismus

Answer 16

• Disorder of the vaginal entrance
• Irritated hymen
• Scars
• Sexual assault
• Infection of the bartholin glands
• Allergic reaction
• thinning of the vagina walls (due to age)
• Prostate problems (in men)

Question 17

The effects of alcohol

Answer 17

With a low dosage the expectancy effects are high arousal and being more sociable, but a low doses causes decreased sexual desire and works as a depressant.
Long term effects can be erectile disorder, orgasmic disorder and loss of desire.

Question 18

The effects of marijuana

Answer 18

Can cause increased arousal and more enjoyable intercourse in short-term use, but can lead to erectile disorders, decrease arousal and orgasmic disorder in long-term use.

Question 19

Cocaine

Answer 19

Short term use can cause increased sexual desire, sensuality and delays the orgasm. Chronic use can lead to erectile disorders, decreased arousal and orgasmic disorder.

Question 20

(Meth)amphetamines

Answer 20

Can increase sexual desire and arousal, but can also lead to risky sexual behaviour, paranoia, violence and hallicunations.

Question 21

Opiates and narcotics (heroin)

Answer 21

Suppression of sexual desire due to decreased testosterone.

Question 22

Drugs for schizophrenia

Answer 22

May caused delayed orgasm of dry orgasm in men.

Question 23

Tranquilisers and antidepressants

Answer 23

Can increase sexual responding, due to a better mood, but can also suppress sexual desire.

Question 24

Antihistamines (allergy)

Answer 24

Can reduce vaginal lubrication.

Question 25

Antihypertensive drugs (high blood pressure)

Answer 25

Can cause erectile problems in men.

Question 26

Epilepsy drugs

Answer 26

Can cause erectile problems and decreased sexual desire.

Question 27

The effect of anxiety

Answer 27

Can increase the arousal in functioning men, but decrease this in dysfunctional men.

Question 28

Cognitive interference

Answer 28

Can distract a person form focusing on the erotic experience. Like spectatoring: judging your own sexual thoughts and behaviour.

Question 29

Demands for performance

Answer 29

Can increase arousal in functioning men, but decrease arousal in dysfunctional men. Dysfunctional men underestimate their arousal and functional men are accurate.

Question 30

Sexual excitation-inhibition

Answer 30

People who score high of sexual inhibition and low on sexual excitation are more likely to develop a sexual disorder.

Question 31

Behaviour therapy

Answer 31

Assumes that the problems are a result of prior learning and that they are kept in place by reinforcements and punishments. This can be changed by conditioning and the sensate focus exercise, in combination with education about basic anatomy and physiology.

Question 32

Cognitive behavioural therapy

Answer 32

Combines cognitive restructuring and behavioural therapy.

Question 33

Mindfulness therapy

Answer 33

Focusses on the experience in the present moment in a calm and nonjudgemental way to regulate negative emotions. Focusses on someone’s own sensation of arousal, making them subjectively aroused instead of only physically.

Question 34

Couple therapy

Answer 34

There is a reciprocal relation between interpersonal conflict and sex problems. Couple therapy can be combined with CBT.

Question 35

Stop-start technique

Answer 35

Treatment for premature ejaculation. The penis is stimulated until it’s erect and than the stimulation stops and starts again etc. This way the man learns that he can be aroused without having an ejaculation.

Question 36

Kegel exercise

Answer 36

The woman trains the pubococcygeal muscles of the pelvic floor, this can help with orgasmic disorder.

Question 37

Directed masturbation

Answer 37

The most effective form of treatment for female orgasmic disorder.

Question 38

Viagra / clialis

Answer 38

Relaxes the smooth muscles surrounding the arteries of the penis, facilitating engorgement. Female forms of viagra are not successful.

Question 39

Hypogodanism

Answer 39

Administering testosterone to people who experience problems with arousal / maintaining an erection.

Question 40

Intracavernosal injection

Answer 40

Injecting vasodilators into the corpora cavernosa of the penis. These drugs dilate the blood vessels in the penis, which can cause an erection.