Female Sexual Dysfunction 2 Flashcards

Identify the multifactorial causes of FSD.

1
Q

What are the components of sexual desire?

A
  • Biological: Drive
    • spontaneous sexual interest, relative but declines with age
  • Cognitive: Expectations, beliefs, and values
    • is sex “acceptable”?
  • Emotional: Motivation
    • interpersonal
    • willingness to engage, most important!
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2
Q

What is the differential diagnosis for female sexual dysfunction?

A
  • Hormonal endocrine dysfunction
    • estrogen
    • testosterone
  • Vascular disease
    • atherosclerosis
    • trauma
    • hypoestrogenism
  • Muscular disease
    • pelvic prolapse
    • vaginismus
  • Neurologic disease
    • trauma
    • diabetes
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3
Q

What are some common findings in female sexual interest/arousal disorder?

A
  • Absent/decreased sexual interest
  • Absent/decreased erotic thoughts or fantasies
  • Absent/decreased activity in:
    • initiationof sexual activity or responsiveness to a partner’s attempts to initiate it
    • excitement and pleasure
    • response to sexual cues
    • sensations during sexual activity,
    • whether genital or non-genital
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4
Q

What are medications that impact desire and arousal?

A
  • Psychotropics
  • Cardiovascular . Antihypertensives
  • Hormonal medications
  • Histamine blockers
  • Antifungals
  • Indomethacin
  • Anticholinergics
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5
Q

What are some cardinal features of sexual aversion disorder?

A
  • Persistent/recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner.
  • Causes marked distress or interpersonal difficulty.
  • Not better accounted for by another Axis I disorder (except another Sexual Dysfunction).
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6
Q

What are some important features of orgasmic disorder, including the DSM definition?

A
  • 5-15% of women never have an orgasm (anorgasmia)
  • Usually the result of sexual inexperience, performance anxiety or past experiences that have led to inhibition of the sexual response
  • Unlike men, in women, orgasm is a learned, not an automatic response
  • Hormones not implicated
  • DSM V definition:
    • absence, infrequency or delay of orgasm
    • reduced intensity of orgasm
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7
Q

What is the treatment for orgasm disorder?

A
  • Viagra (subjective vs objective arousal)
  • Vibrator/Masturbation therapy
  • Kegel Exercises
    • strengthen PC muscle, contract/relax 5 seconds, 10-15 times 3x/day…up to 200 repetitions per day)
    • greater ease in achieving orgasm, increased intensity of orgasm, increased lubrication, heightened control over sensation during penetration, and protection against urinary incontinence and bladder prolapse.
  • EROS Therapy Device
  • Sexual Therapy/Psychotherapy
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8
Q

What is dyspareunia and vaginismus?

A
  • Dyspareunia = Recurrent/persistent genital pain associated with sexual intercourse in either a male or a female.
  • Vaginismus = Recurrent/persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with sexual intercourse.
    • most common in pre-menopausal women
    • may be fear-based particularly with women who have a history of
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9
Q

What are the DSM V criteria for gento-pelvic pain/penetration disorder?

A
  • Inability to have vaginal intercourse/penetration
  • Vulvovaginal or pelvic pain during vaginal intercourse/penetration attempts
  • Fear or anxiety either about vulvovaginal or pelvic pain or vaginal penetration
  • Tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
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