Human Sexuality 1-4 Flashcards
Transmission of HIV (4)
IV drug
Blood transfusion
Vertical transmission from mother
Sexual contact*
HIV prevalence is highest in which sexuality group?
Age group?
Homosexual (Male to Male)
2nd = Heterosexual
Highest in 30-39 age group
6 most common STIs transmitted in HK
- Non-gonococcal urethritis (male)
- Non-specific genital infection (female)
- Gonococcus
- Warts
- Herpes
- Syphilis
5 most common STIs transmitted in HK - Female
Chlamydia Gonococcus Warts Herpes Primary Syphilis
5 most common STIs transmitted in HK - male
NGU Gonococcus Warts Herpes Primary Syphilis
Causes of infertility
Female:
- Anovulation
- Tubal trauma/ infection
- Abdominal or pelvic surgery
- Endometriosis
- Submucosal Fibroids
Male:
- Low sperm
Coital failure
Fertility decline sharply at what age for women
35
Most commonly neglected risk factor of identifying HPV infection
Failure of regular cervical screen
Legal age of consent in HK
16
Major contraceptive method in HK - top3
Male condom
OC pills
Coitus interruptus
Major factors for sexual dysfunction
Sexual distress:
- Anorgasmia
- Sexual pain
- Low arousal and desire
- Inadequate lubrication
Life stressors
Major cause of sexual dysfunction in menopausal women
No lubricant
5 causes of low coitus rate in menopausal women
Change in libido
Vagina: Loss of lubrication, elasticity, pain
Hormone replacement therapy
Declining health and reproduction
Life transitions: loss of partner, empty nest
Male equivalent of female menopause
PADAM
Easy fatigue Irritability Difficulty with short-term memory Loss of muscle mass, strength, energy Central obesity Loss of body hair
4 factors to attain happiness
Security
Self-esteem
Connection: interpersonal, Intimate
Autonomy
Health benefits of active sex life
- Decrease breast, prostate cancer
- Decrease heart attack
- Decrease depression rate
- Improve immunity
4 types of sexual dysfunctions
1) Lifelong
2) Generalized: all situations and all partners
3) Acquired: develop after a period of normal sexual activity
4) Situational
DMS-5 classification
- 4 male sexual dysfunctions
Male hypoactive sexual desire disorder
Erectile disorder
Premature ejaculation
Delayed ejaculation
DMS-5 classification
- 3 female sexual dysfunctions
Female sexual interest/ arousal disorder
Female orgasmic disorder
Genito-Pelvic Pain/ Penetration Disorder
Male hypoactive sexual desire disorder
- 3 criteria
In the past 6 months, more than 75% of the time:
- Absent sexual fantasy, desire, thought
- Causing marked distress or interpersonal difficulty
- Excluded medical illness or psychological disorders
Give one genetic cause of sexual dysfunction in male
Klinefelter syndrome - Ch. XXY
Small and soft testicles, Azoospermia
No masturbation, sexual urges, fantasies
Gynecomastia
Treatment of sexual dysfunction caused by Klinefelter
IVF reproduction
Microdissection of epididymis for sperm precursor
Testosterone replacement therapy
Female sexual interest/ arousal disorder
- 4 criteria
In the past 6 months
- No interest in sexual activity
- No fantasy, sexual or erotic thoughts
- No sense of pleasure during sexual act or decline to initiate sexual encounters
- Excluded other causes
Erectile disorder
- Criteria
In the past 6 months, with 1 of 3 following symptoms
- Struggle to achieve erection during sexual activity
- Struggle to maintain erection until completion of sexual activity
- Noticeable decrease in erectile rigidity
- Causing marked distress or interpersonal difficulty
How to distinguish between organic vs psychogenic cause of erectile dysfunction
Ask about Presence of morning erection
Organic: check blood glucose, lipid profile, hormones, ECG
Female sexual interest/ arousal disorder
- Treatment
- Find source of stress
- Treat underlying medical conditions
- Couple counselling
- Hormone therapy
- Zestra, Flibanserin, Eros clitoral therapy device
Erectile disorder
- Treatment
- Psychoeducation
- Treat organic causes
- Treat psychological causes (e.g. performance anxiety)
- Viagra, Prostaglandin E1
- Vacuum pump device
- Penile prosthesis
Premature ejaculation
- 4 criteria
In the past 6 months:
- Always ejaculate within 1 minute or less of vaginal penetration
- Significant sexual frustration and distress
- Excluded other non-sexual mental, medical or drug cause
Premature ejaculation
- Treatment
- Sex therapy, start/stop technique
- Local anesthetic in condom or lubricants
- SSRI (Dapoxetine) on demand
Delayed ejaculation
- 4 criteria
In the past 6 months:
- Unable to climax during sex with a partner, with delay or absent ejaculation
- Causes marked distress
- Excluded other mental, medical or drug causes
- Excluded stressors within or external to relationship
Female orgasmic disorder
- 4 criteria
In the past 6 months:
- Significant change in orgasm: reduced intensity, delay, infrequency, absence of orgasm
- Excluded other mental, medical, relationship causes
- Causing significant distress
Female orgasmic disorder
- Treatment
Hormonal replacement
Treat medical disorder and offending drugs (e.g. antipsychotics)
Sex therapy - maximize clitoral stimulus
Couples therapy
Counselling
Penetration disorder
- 4 criteria
In the past 6 months, experience difficulty towards vaginal penetration:
- Intense fear or anxiety before, during or after penetration
- Actual pain experienced in pelvis or vulvovaginal area after penetration
- Marked tightening of pelvic/ inner-abdominal muscles during attempted penetration
Penetration disorder
- Treatment
- Treat phobia
- Teach Kegel exercises
- Teach vaginal insertion with fingers or dilators
- Couples counselling
- Teach vaginal intercourse
List one gynecological disorder that commonly causes infertility
Endometriosis
