Female sexual physiology

Question 1

List some common sexual problems in women

Answer 1

lack of interest in sex, sex not pleasurable, inability to achieve orgasm, painful intercourse

Question 2

Differentiate sexual behavior, sexual desire, and sexual arousal

Answer 2

• sexual behavior: activities that enhance arousal, increases likelihood of orgasm
• sexual desire: neural processing of stimuli, incentive motivation, dopamin activation
• sexual arousal: sexual desire + general arousal, genital responses

Question 3

Describe the Masters and Johnson progressive model of female sexual responses

Answer 3

four phases of physiologic sexual response- excitation, plateau, orgasm, resolution

probably more typical of men than women

Question 4

Describe the Kaplan triphasic model of female sexual responses

Answer 4

independent components rather than progressive stages

sexual desire, vasocongestion, muscular contractions

Question 5

Describe the Basson circular model of female sexual responses

Answer 5

• Sexual responses include the need for emotional intimacy, commonly start from a sexually neutral phase.
• Once sexual activities commence, increasing arousal leads to desire for continuing sexual activities.
• Previous positive sexual activity enhances the likelihood of further need for emotional intimacy and also increases the likelihood of future sexual activity

Question 6

Describe the effect of menstrual cycle and social circumstances on sexual behaviors

Answer 6

• greatest sexual desire midway through menstrual cycle, near time of ovulation
• opportunity is a stronger determinant of likelihood of intercourse

–> sexual desire is hormonally mediated, but sexual intercourse is more situation dependent

Question 7

______ may be the hormonal cause of the refractory period after orgasm

Answer 7

prolactin

Question 8

What frequency of sexual interaction is considered normal in monogamous partners?

Answer 8

Almost any frequency of sexual interaction may be “normal” provided that the individuals concerned feel satisfied.

Question 9

What sexual problems are associated with the onset of menopause?

Answer 9

decreased lubrication, painful intercourse, lack of clitoral response, decreased sexual desire

Question 10

What is the most effective therapy for post-menopausal hormone replacement?

Answer 10

combination of estrogen and testosterone

Testosterone is now being viewed as a sexual support hormone in both women and men

Question 11

List some medications that impair sexual function in women

Answer 11

oral contraceptives
anti-depressant medications 
antihypertensives
psychotropic drugs
tranquilizers
anticancer agents

Question 12

The levels of unbound _____ may reflect the degree of decreased sexual interest in women taking hormonal contraceptives

Answer 12

testosterone

Question 13

Which antidepressants cause the most sexual side effects? Least?

Answer 13

most: SSRIs fluoxetine, paroxetine, sertraline
least: bupropion, mirtazapine

Question 14

List the criteria for diagnosis of female sexual interest/ arousal disorder

Answer 14

3 out of 6 are absent or decreased:

1. sexual interest,
2. erotic thoughts or fantasies,
3. initiation of sexual activity or responsiveness to a partner’s attempts to initiate it,
4. absent excitement and pleasure,
5. response to sexual cues, and
6. sensations during sexual activity, whether genital or non-genital

Are experienced for at least 6 months ….for 75-100% of the time, ….and causes significant distress

Question 15

Sexual problems in women very often have a _____ component

Answer 15

psychosomatic

Question 16

In older women, what questions should be addressed with sexual function complaints?

Answer 16

changes in urination

affects on sex life, mental health

Question 17

What treatment options can be offered to post menopausal women with sexual function complaints?

Answer 17

localized estrogen creams
lubricants
vibrators/ dilators