FPC: sexual disorders Flashcards
What are the phases of the sexual arousal cycle?
Desire, excitement, plateau, orgasm, resolution
Desire problems are more common in?
Women
Premature orgasm is more common in?
Men
Decreased orgasm is more common in?
Women
To diagnose a psychiatric sexual dysfunction disorder, what must be true?
- It causes clinically significant distress
- Occurs during almost all sexual activity
- Symptoms are not better explained by another condition, stressors, or drugs
What are specifiers for sexual dysfunction disorders?
Lifelong vs acquired, generalized vs situational, severity
What is male hypoactive sexual desire disorder?
Persistent or recurrent deficiency in sexual thoughts and desires for sexual activity; at least 6 months duration
What is female sexual interest/arousal disorder?
Lack of or significantly reduced sexual interest/arousal persisting for at least 6 months
What is erectile disorder?
May have difficulty obtaining an erection, difficulty maintaining an erection, and/or marked decrease in rigidity; one or more of these for 6 months constitutes the disorder
What is premature ejaculation?
Persistent/recurrent pattern of ejaculation with minimal stimulation; occurs within a minute of vaginal penetration and before ejaculation is desired
What is delayed ejaculation?
Either marked delay in ejaculation or absence of ejaculation
What is female orgasmic disorder?
The delay or absence of orgasm and/or reduced intensity of orgasmic sensations
What is genito-pelvic pain disorder?
Requires at least one of the following:
1. Pain with vaginal penetration
2. Pain with penetration attempts
3. Fear/anxiety about pain
4. Tensing or tightening of pelvic floor muscles during penetration/attempts
Describe testosterone enhancement therapy.
Therapy that may be used for men with hormonal sexual dysfunction disorders; should be in conjunction with endocrinologist
Describe sildenafil.
PDE5 inhibitor that can reduce anticipatory and performance anxiety
Describe melanocortin-receptor agonists.
Modulates erectile function and sexual behavior in men
Describe intracavernosal injection.
Often used in men for diabetes-associated erectile dysfunction
What are non-medication options for men with sexual dysfunction?
Vacuum erection device, penile vibrators, various surgeries, and the stop-squeeze technique
What is the stop-squeeze technique?
Squeeze the frenulum of the penis resulting in partial loss of erection and total loss of the urge to ejaculate
What is the good enough sex model?
A model that helps guide men away from letting one negative sexual experience cause a feeling of being a sexual failure
What are some sexual dysfunction medications for women?
Androgens, estrogen, oxytocin, flibanserin, topical lubricants
What are non-medication options for sexual dysfunction in women?
Clitoral therapy device, herbal supplements, fractional CO2 for vulvovaginal atrophy
What is sensate focus?
A behavioral technique that emphasizes increased focus on pleasure brought about through touch and decreased focus on goal-oriented sex; often used in women
