Lecture 13: Female Sexual Disorders Flashcards
What are the 4 stages of sexual response?
- Desire/libido
- Arousal (lubrication + swelling)
- Orgasm (release + rhythmic contractions)
- Resolution (Detumescence of genitals)
When does the uterus return to its original position in the sexual response cycle?
Resolution stage
What hormones excite female sexual response?
- Estrogen
- Testosterone
- Dopamine
- NE
- Oxytocin
- Melanocortins (Vyleesi)
What hormones inhibit female sexual response?
- Serotonin (high levels)
- Prolactin (milk)
- Opioids (sleepy)
- Endocannabinoids (imagine weed mellowing you out, idk)
Ifeel like just memorize these and assume everything else excites
The average age of puberty for a females ranges between…
8-13
The least common sexual disorder for females is…
Orgasm difficulties
Geographically, the area with the highest rate of sexual dysfunction among females is…
SE asia
Lowest is N europe
rip asians
The MC sexual disorder for females is
Low sexual desire
Female sexual interest/arousal disorder is a problem with 1 of 2 things:
- Low sexual desire
- Abnormal arousal response
Either emotional/physical or with lubrication/swelling
In order to be diagnosed with female sexual interest/arousal disorder, you must meet 3 general criteria:
Not the 6 symptom criteria
- Occurs 75% of the time
- Occurring for over 6 months
- Causes distress
i think this applies to all sex disorders
You hear the following statements from your female patient:
- I couldn’t care less if we never have sex again
- I’m just not interested in sex. I don’t even think about it unless my partner brings it up.
- I try to be with my partner, but I feel nothing during sex.
This patient could have….
Female sexual interest/arousal disorder
6 Symptom criteria make up Female sexual interest/arousal disorder, which are:
You must mee 3/6
- Interest in sex
- Fantasizing
- Initiation of sexual activity
- Interest/arousal to stimuli
- Excitement/pleasure
- Genital/nongenital sensations
All of which are reduced or absent interest
Female genitopelvic pain/penetration disorder encompasses problems within 3 areas, which are:
- Vaginismus (involuntary spasms)
- Vulvar pain/vestibulodynia
- Dyspareunia (pain with penetration/sex)
The 3 general criteria for genitopelvic pain/penetration disorder are:
Same as female sexual interest/arousal disorder
- Occurs 75% of the time
- Occurs 6+ months
- Causes distress
You hear the following statements from your female patient:
- I have burning pain with any penetration, even a tampon
- Anytime my partner tries to enter me, I close up down there and it hurts
- I want to be with my partner, but it’s uncomfortable. I dread him being in me
You suspect she has…
Genitopelvic pain/penetration disorder
In order to be diagnosed with female genitopelvic pain/penetration disorder, you must meet at least 1 of these 3 symptom criteria, which are:
- Vulvovaginal or pelvic pain during penetration
- Fear/anxiety about vulvovaginal pain or pelvic pain in anticipation of, during, or because of penetration
- Tensing/tightening of pelvic floor muscles during penetration attempt
Must be vaginal penetration
What history is common in females with genitopelvic pain/penetration disorder?
Sexual or physical trauma/abuse
Female orgasmic disorder tends to deal with…
- Frequency
- Intensity
- Achievement
orgasmic response
You hear the following statements from your female patient:
- I still want to be with my partner, but sex just isn’t as enjoyable as it used to be
- I enjoy sex, it feels great, but I don’t respond to it like I should
- When I finish, I barely feel anything
You suspect she has…
Female orgasmic disorder
The symptom criteria (3) for female orgasmic disorder are…
- Delayed, infrequent , diminished, or absent orgasm response
- Distress or interpersonal problems 2/2 orgasmic dysfunction
- Absence of disorder or substance
The criteria to diagnose substance/medication-induced sexual disorder include: (3)
- Significant disturbance in sexual function
- Occurring during/soon after exposure to a med or substance intoxication/withdrawal
- Absence of other symptoms/signs that suggest something else
The top 2 medication classes that result in sexual dysfunction are…
- SSRIs (up to 70%)
- TCAs
NO SNRIs!!!
too much serotonin = inhibitory i think
What kind of antipsychiatrics are NOT associated with sexual dysfunction?
Dopaminergics or selective serotonergics
Mirtazapine, bupropion, venlafaxine, duloxetine
Also buspirone
Anticholinergics can reduce this part of the sexual response…
Arousal and lubrication
because they inhibit your secretions
