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Repro. Med 1 > Human Sexuality > Flashcards

Human Sexuality Flashcards

1
Q

Why is Sexual History Important

A

Part of the overall health of individuals

if ignored, a provider can miss a medical condition or psychological problem that may significantly impact quality of life

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2
Q

The World Health Organization (WHO) defines sexual health as the presence of “a state of ___, ___, ____ and ____ well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.”

A

Physical
Emotional
Mental
Social well-being

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3
Q

Sexual health requires that a pt have a ___, ___ approach to sexuality and sexual relationships, as well as the possibility of having sexual experiences that are ___, ___, and free of ____, ____ and/or ___.

A

positive
respectful

pleasurable
safe

coercion
discrimination
violence

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4
Q

Society “normal” is determined by (7) things

A 
Religion
Cultural Legacy
Social customs
Science
Medicine
Personal experiences
Community (socio-economic status, ethnicity, generation)
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5
Q

genetic, anatomical define ______

A

Biological Sex

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6
Q

____ is the terms for previously “hermaphrodite”; ambiguous genitalia

A

Intersex

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7
Q

Psychosocial meaning of maleness and femaleness define _____

Examples: ___, ___, ____, ____

A

Gender

Female, male, third gender, genderqueer

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8
Q

subjective sense of being male or female define _____

A

Gender Identity

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9
Q

how an individual chooses to present themselves in public (behaviors, clothing, etc.) define ______

___ lies between male and female expression

A

Gender Expression

Androgynous

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10
Q

Whether an individual is sexually attracted to men or women define _____

Examples: ____, ____, ___,

A

Sexual Orientation

Bisexual, asexual, pansexual (attracted to the entire spectrum of biological sexes)

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11
Q

The relationship between a person’s gender identity and their biological sex defines ______
(usually don’t match up)

A

Transgender/Cisgender

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12
Q

___ is a formally derogatory term that is now being embraced by the LGBTQIA community to describe anyone with fluid sexuality or gender identity/expression

A

Queer:

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13
Q

what does LGBTQIA stand for

A 
Lesbian
Gay
Bisexual
Transgender
Queer/Questioning
Intersex
Asexual
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14
Q

The range of human sexuality is on a scale from ___-___
with 0 being _____
and 6 bring _____

A

0-6

0= exclusively heterosexual w/ no homosexual 
6 = exclusively homosexual w/ no heterosexual
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15
Q

what are the 4 topics of human sexuality that fall on a scale

A 
Gender identity (woman--> man)
Gender Expression (feminine--> masculine)
Biological Sex (female --> male)
Sexual Orientation (heterosexual --> homosexual)
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16
Q 
To set the stage for the sex conversation you should 
Establish \_\_\_\_\_
Appropriate \_\_\_\_\_
Eye \_\_\_\_ & \_\_\_\_
Tone of \_\_\_
Allow time for \_\_\_\_\_\_
Timing is \_\_\_\_\_
Avoid \_\_\_\_
A 
Rapport
Timing
Level, eye contact 
Voice 
Response
Everything
Assumptions
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17
Q

When are appropriate times to discuss sex with your pt?

A

Probably anytime it is concerning but….

With a new patient as part of a complete evaluation

With an established patient with whom you previously have never discussed sexual matters

During discussion of presenting medical problem

**Incorporate the topic with ROS routinely

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18
Q

During the physical exam when should you reconsider the sex talk timing

A

if your patient is undressed

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19
Q

What aspects should you avoid assumptions about a persons sexual hx

A

Whether they are or are not sexually active
Sex of one’s partner
Number of partners
If married; that they are monogamous
Certain sexual behaviors are associated with specific lifestyles
All sexual activity is consensual

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20
Q

When beginning the sex conversation you should State your ___ and asking ____ to proceed

A

Intention

Permission

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21
Q

If a person declines talking about their sexual hx what are some tips?

A

Ask second more specific f/u questions to continue the conversation

Ask questions that are not directly about sex, but assess the person’s safety

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22
Q

Questions to ask about sexual activity

A

Are they ‘sexually active’?(if no, go to *)

YES:

  • Change in your level of sexual activity
  • Have you had sex in the past few months?

NO

  • Have you ever had sex with another person before?
  • If no, do you have concerns with or about your sexual function?
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23
Q

Other sex related questions that are important

A

of partners
Type of Sexual activity
Pregnancy/Contraception/STI protection or exposure

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24
Q

To be defined as Sexual Dysfunction D/o they duration must be at least _____ (time), cause ___, (for dx of primary sexual dysfxn) not be due to ___ or _____ d/o

A

6 months
Distress
Medical
Non-sexual mental

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25
Types of male sexual dysfunction d/o
Male Hypoactive Sexual d/o Male Erectile Disorder: (difficulty getting an erection or keeping one) Premature Ejaculation: (reach climax or come before you want to) Delayed ejaculation Substance/Medication-Induced Sexual Dysfunction
26
Types of Female sexual dysfunction d/o
Female Hypoactive Sexual d/o Female Sexual Interest/Arousal D/o: (trouble getting sufficiently lubricated for sexual intercourse) Female Orgasmic D/o: (Able to reach orgasm) Genito-Pelvic Pain/Penetration D/o: (pain during intercourse? Do you ever have trouble w/ tightening/tensing of your pelvic floor muscles making sex difficult or not possible? (vaginismus) (vulvar vestibulitis) Substance/Medication-Induced Sexual Dysfunction
27
DSM 5 version of Gender Identity disorder
Gender Dysphoria
28
DSM 5 version of Male orgasmic d/o
Delayed Ejactulation
29
DSM 5 version of premature ejaculation (trick question )
Premature (early) ejaculation
30
DSM 5 version of male erectile d/o
Erectile d/o
31
DSM 5 version of Female sexual arousal d/o
Female Sexual Interest/Arousal d/o
32
DSM 5 version of Hypoactive sexual desire d/o
Male hypoactive sexual desire d/o Female sexual interest/arousal d/o
33
S/S of sexual abuse
``` depression self-mutilation anxiety PTSD fear of intimacy sexual acting out sexual dysfunction ```
34
Types of sexual dysfunction d/o/
Lifelong type Acquired Type Generalized Type Situational Type
35
Dysfunction is present during all sexual situations describes _____
Generalized Type
36
Pts who struggle w/ sexual dysfunction their whole lives describes _____
Lifelong type
37
Pts in which nml sexual functioning preceded the d/o describes ____
Acquired Type
38
Dysfunction is tied to particular situations describes ____
Situational Type
39
5 Contextual Factors of sexual dysfunction
``` Partner factors Relationship factors Indiviual vulnerability factors Cultural/Religious factors Medical Factors ```
40
Partner Factors include .....
Sexual problems? | Health status?
41
Relationship Factors include....
Poor communication | Discrepancies in sexual desire
42
Individual Vulnerability Factors include.... (5)
``` Poor body image History of sexual or emotional abuse Psychiatric comorbidity or stressors (Depression, anxiety) External stressors such as job loss Bereavement ```
43
Cultural/Religious Factors include....
Religious prohibitions | Attitudes and beliefs toward sexuality
44
Medical Factors include....
Chronic dz | Injury
45
____ is D/o in which people experience pain/dysfunction in one or more phases of sexual response cycle (excitation, plateau, orgasm, resolution)
Sexual dysfunctions
46
Sexual dysfunction Affects up to ___ of men and ___ of women at some point in their lives
30% men | 50% women
47
Sexual dysfunction is very distressing, and often lead to ___, ___, ___, and _____ Often these dysfunctions are interrelated; many pts w/ one dysfunction experience _____ as well
sexual frustration, guilt, loss of self-esteem, and interpersonal problems Another
48
3 causes of sexual dsyfunction
Biological Psychological Sociocultural
49
Biological causes of sexual dysfunction include: (5)
``` Hormone interactions/deficiencies Chronic illness Meds/Drugs Vascular problems Genetic predisposition ```
50
Psychological causes of sexual dysfunction include: (7)
``` Anxiety depression anger Other psychological d/o Cultural beliefs attitudes memories ```
51
Sociocultural causes of sexual dysfunction include: (3)
Situational pressures: Divorce, death, job stress, infertility, and/or relationship difficulties Cultural standards can impact the development of these d/o Trauma of sexual molestation/assault is very likely to produce sexual dysfunction
52
A person’s sex drive is determined by a combo of ___, ___, ____ factors→ any of these may ↓ sexual desire
biological psych sociocultural
53
Most cases of low sexual desire or sexual aversion are caused primarily by ___ and ___ factors
sociocultural and psychological
54
Male Hypoactive Sexual Desire D/O is characterized by: You should be r/o other ___ 1st
Lack of interest in sex and little sexual activity; DDx **Physical responses may be normal when sex does occur
55
Male Hypoactive Sexual Desire D/O is prevalent in ___ % of men
16%
56
Male Hypoactive Sexual Desire D/O must be present for ____ (time) and must cause ______
6 months | significant distress
57
Types of Male Hypoactive Sexual Desire D/O include...
Lifelong vs Acquired Generalized vs Situational Severity (mild/moderate/severe)
58
Male Hypoactive Sexual Desire D/O is Often associated w/ ____ concerns
ED/ejaculatory
59
Female Sexual Interest/Arousal Disorder is Characterized by (5)
Lack of/significantly ↓ sexual interest and thoughts Absent or ↓ initiation of sexual activity Absent or ↓ response to erotic cues Absent or ↓ pleasure in 75% of encounters Lack of or ↓ vasocongestion and lubrication
60
Female Sexual Interest/Arousal Disorder Criteria:
Present at least 6 mo, causes significant distress, not better explained by another non-sexual factor (stressors, major depression, drugs, partner violence, DM, thyroid disorder)
61
Types of Female Sexual Interest/Arousal Disorder
Lifelong vs Acquired Generalized vs Situational Severity (mild/moderate/severe)
62
Female Sexual Interest/Arousal Disorder is frequently associated w/: (3)
lack of orgasm pain during sex/relationship difficulties mood disorders
63
Premature Ejaculation is characterised by ____
Persistent reaching of orgasm and ejaculation w/ little sexual stimulation
64
___% of men experience rapid (premature) ejaculation at some time
~30%
65
Premature ejaculation seems to be typical of ___, ___ men or may be related to ___, ____, ____
young, sexually inexperienced men Anxiety Hurried masturbation experiences Poor recognition of arousal
66
Premature ejaculation Criteria
present for 6 mo causes significant distress occurs > 75% of occasions Not better explained by other dx or reason
67
Premature ejaculation is graded as: Mild (____), moderate (____) or severe (____) ** answers are times
30 sec-1 minute 15-30 sec prior to sexual activity or w/in 15 sec
68
Premature ejactualtion is Often associated w/ ___
erectile disorder
69
Delayed Ejaculation is Characterized by:
repeated inability to reach orgasm or by a very delayed orgasm after normal sexual excitement
70
Delayed Ejaculation Criteria
Duration of 6 months causes significant distress not better explained by another dx (MS, DM, CNS & CVD, drugs)
71
Prevalence of Delayed Ejaculation
uncertain, but <1% of the population has sx >6 mo
72
Delayed Ejaculation May cause ____and contribute to ____
psychological distress | delayed conception
73
Female Orgasmic D/O is characterized by
Marked delay or absence of orgasm or significantly ↓ intensity of orgasmic sensations
74
Female Orgasmic D/O Occurs in __% of encounters _% of women never experience orgasm in their lifetime
75% ~10%
75
Female Orgasmic D/O criteria
Present 6 mo | Causes significant distress
76
Female Orgasmic D/O Prevalence varies from __-___%, depending on ___, ___, ___, and ____
10-42 | Age, culture, duration and severity of sx
77
In the presence of Female Orgasmic D/O you should R/o ___, ___, other factor such as (___) Do not dx if significant ____/____ factors are present
drugs/substances non-sexual d/o partner violence relationship/context
78
Genito-Pelvic Pain/Penetration D/O has been described by Previously used terms still seen frequently which include
Vaginismus | Dyspareunia
79
Vaginismus is:
Involuntary contractions of the muscles of the outer ⅓ of vagina;
80
Dyspareunia is:
Generic severe pain in genitalia during sexual activity (*superficial vs. deep, immediate or delayed)
81
Genito-Pelvic Pain/Penetration D/O is only given to (Men/Women)
WOMEN
82
Genito-Pelvic Pain/Penetration D/O is characterized by ____ | Also, ask about type/quality of pain, can it be reproduced during ____
Persistent or recurrent difficulties w/ vaginal penetration marked pain during attempts/intercourse marked fear/anxiety about penetration marked tensing or tightening of pelvic floor muscles gynecologic exam
83
Genito-Pelvic Pain/Penetration D/O guidelines:
Present for 6 mo cause significant distress not due to a nonsexual mental d/t relationship issues (partner violence) or other stressors, drugs, or medical condition
84
Evaluate for underlying medical condition such as (6)
``` Lichen sclerosis PID VVS vulvovaginal atrophy Vaginal infections Cystitis ```
85
Genito-Pelvic Pain/Penetration D/O Frequently occurs w/ other ___ (especially lack of desire/interest) and/ or ___
sexual dysfunctions | relationship distress
86
Vulvar Vestibulitis Syndrome (VVS) Most likely caused by a ___
"neuro-inflammatory" condition
87
Vulvar Vestibulitis Syndrome (VVS) is characterized by In more severe cases the pain is present during ___ and ____
“Burning" pain at the opening (vestibule) of the vagina normal daily activities, as well as during sex
88
Careful exam for Vulvar Vestibulitis Syndrome (VVS) may reveal ____ and ___ of the tissue at the opening of the vagina
erythema | unusual sensitivity
89
Vulvar Vestibulitis Syndrome (VVS) Can be tx w/:
estrogen cream, lidocaine application, vestibuloplasty
90
Significant disturbance in sexual fxn (noted during H&P/labs) develops during intoxication, w/drawal, or after exposure to a med/drug
Substance/Medication Induced Sexual Dysfunction
91
Substance/Medication Induced Sexual Dysfunction Criteria
Substance or drug can produce these sx Not better explained by another sexual dysfunction that is not drug-induced or persists >1 mo after cessation Causes significant distress
92
Major etiologies of Substance/Medication Induced Sexual Dysfunction (6)
``` EtOH Opioid Sedative Hypnotic or Anxiolytic Amphetamine Cocaine ```
93
Specific classes implicated to cause Substance/Medication Induced Sexual Dysfunction
``` Antidepressants antipsychotics antihypertensives hormones CV drugs cytotoxic GI ```
94
Most cases of Substance/Medication Induced Sexual Dysfunction resolve after ____
discontinuing use

Repro. Med 1 (9 decks)

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