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Behavioral Dynamicssss > Lecture 3: Human Sexuality > Flashcards

Lecture 3: Human Sexuality Flashcards

1
Q

What is included in sexuality?

A

Capacity for sexual feeling
Sexual orientation, identity, and preference
Traditionally includes perception of gender status

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2
Q

What defines biologic gender?

A

External genitalia OR chromosomes.

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3
Q

What do AFAB and AMAB mean?

A

Assigned female at birth
Assigned male at birth

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4
Q

What is intersex?

A

An individual with features of both male and female.

EX: A genetic male without any external male genitalia.

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5
Q

What do we all start out as anatomically?

A

Female

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6
Q

What is the differentiating factor at birth that allows some of us to become male?

A

Fetal androgens

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7
Q

What is gender identity?

A

Psychological aspects of behavior.

It is not always congruent with biological gender.

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8
Q

What is sexual identity?

A

How one thinks of oneself in terms of whom one is romantically or sexually attracted to.

EX: straight, lesbian, queer, bi, etc.

Does not have to align with biological gender, or sexual orientation.

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9
Q

What is sexual orientation?

A

The object of a person’s sexual impulses or attractions.

AKA

Heterosexual, homosexual, bisexual, etc…

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10
Q

What is sexual behavior?

A

True psychophysiological experience.

Specific actions and behaviors involving sexual activities.

Not always consistent with identity or orientation.

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11
Q

What is gender expression?

A

How one present’s one gender to another.

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12
Q

What is gender discordance/dysphoria?

A

Discrepancy between assigned gender and gender identity.

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13
Q

What is a transsexual?

A

Gender discordant people who make changes to their perceived gender/anatomic sex to match their identity. (e.g. dressing, grooming, hormones, surgery)

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14
Q

What is a cisgender?

A

Alignment of gender identity, expression, and biological sex.

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15
Q

What are the significant health risks to keep in mind regarding the LGBTQIA+ community?

A

Mental health
CV disease and obesity (women)
Poor physical health and loneliness (men)
Harassment (verbal/physical)

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16
Q

What are some common barriers the LGBTQIA+ community faces regarding care?

A

Lack of disclosure to providers
Lack of income for healthcare
Fear
Denial

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17
Q

What are the 4 phases of sexual response?

A

Desire/libido
Excitement and arousal
Orgasm
Resolution

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18
Q

What characterizes phase 1 of the sexual response?

A

Desire/Libido

Sexual fantasies and desire to have sexual activity.

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19
Q

What characterizes phase 2 of the sexual response?

A

Excitement and arousal

Psychological or physiological stimulation or both.

Subjective sense of pleasure.

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20
Q

What characterizes phase 3 of the sexual response?

A

Orgasm

Peaking of sexual pleasure, release, contraction of perineal muscles and pelvic organs.

Increased BP, RR, and HR.

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21
Q

What characterizes phase 4 of the sexual response?

A

Resolution

Disgorgement of blood from genitalia (detumescence), subjective sense of well-being and relaxation.

Lack of orgasm may cause extended resolution and irritability/discomfort.

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22
Q

What period occurs between phase 3 and 4 of the sexual response?

A

Refractory period.

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23
Q

What hormones are excitatory in the sexual response?

A

Dopamine
Testosterone (Both)
Estrogen (women)

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24
Q

What hormones are inhibitory in the sexual response?

A

Serotonin (increased levels = decreased desire)
Progesterone (increased levels = decreased desire)

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25
Q

What primarily drives male and female sexual desire?

A

Men = physical stimuli
Women = psychologic stimuli

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26
Q

What disorders are in regards to desire?

A

Hypoactive sexual desire disorder
Sexual aversion disorder

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27
Q

What disorders are in regards to excitement?

A

Female sexual arousal disorder
Male erectile disorder

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28
Q

What disorders are in regards to orgasm?

A

Orgasmic disorder
Premature ejaculation

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29
Q

What disorders are in regards to resolution?

A

Postcoital dysphoria
Postcoital headache

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30
Q

What does sexual desire depend on factor-wise?

A

Biological drive
Adequate self-esteem
Ability to accept oneself as a good person
Previous good sexual experiences
Availability in partner
Relationship in non-sexual areas with partner

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31
Q

What is hypoactive sexual desire disorder?

A

Deficiency/absence of sexual fantasies.
LACK of desire of any sexual activity.

More common in females.

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32
Q

What is sexual aversion disorder?

A

Aversion/avoidance of gential sexual contact.

33
Q

How are sexual desire disorders treated?

A

CBT, sexual therapy, couples therapy.

Dopamine agonists (Limited data)
Serotonergic drugs (Addyi)
Melanocortin agonists (Vyleesi)
Testosterone + estrogen

34
Q

What is female sexual arousal disorder?

A

Dysfunction with lubrication-swelling response until orgasm.

Essentially, difficulty maintaining sexual excitement or attaining it.

35
Q

How is female sexual arousal disorder treated?

A

Therapy referral

Testosterone (transdermal, only 10% of the dose men take)

Wellbutrin (if associated with SSRI)

Viagra (Select groups only)

36
Q

What is male erectile disorder?

A

ED/impotence.

10-20% of all men have it and is the primary complaint of men being treated for sexual disorders.

Increases in prevalence due to age.

37
Q

What help prevent ED?

A

Available sex partner
History of consistent sexual activity
Absence of vascular disease

38
Q

What suggests that ED is more psychological than physiological?

A

If erections do occur sometimes, it is most likely psychological.

39
Q

What is female orgasmic disorder?

A

Inhibited female orgasm/anorgasmia
High prevalence (30-35%)

Recurrent or persistent inhibition of female orgasm as manifested by the recurrent delay, or absence of, orgasm after a normal sexual excitement phase as judged by a clinician.

AKA lack of consistent orgasm in females.

40
Q

What are some physiological factors that may contribute to female orgasmic disorder?

A

Endometriosis, pelvic floor dysfunction, pelvic organ prolapse, uterine fibroids

Childbirth or miscarriage/abortion

Atrophy of genital tissues

Insufficient stimulation of the clitoris

41
Q

What are some treatment options for female orgasmic disorder?

A

Vacuum-pump device for clitoris

OFF-LABEL USE: viagra

OTC lubricants

Changing up sex: manual stimulation, alternate positions, controlling depth/force of penetration

42
Q

What is male orgasmic disorder?

A

Inhibited orgasm/delayed ejaculation
5% prevalence

Takes a long time to ejaculate and orgasm.

43
Q

What does lifelong male orgasmic disorder suggest?

A

Severe psychopathology:
Rigid, puritanical background
Unconscious guilts
History of abuse

44
Q

How is male orgasmic disorder treated?

A

Therapy, dopamine agonists (experimental)

45
Q

What is premature ejaculation defined as?

A

Male: Before he wishes to
Couples: Before the other person is satisfied enough

46
Q

When is premature ejaculation usually diagnosed?

A

Consistent ejaculation before or immediately after entering partner.

47
Q

What is the second most common CC in men with sexual disorders?

A

Premature ejaculation.

48
Q

What technique may help with premature ejaculation?

A

Squeezing the coronal ridge of the glans.

49
Q

What pharmcotherapy may help with premature ejaculation?

A

SSRI

50
Q

What is dyspareunia?

A

Persistent/recurrent genital pain before/during/after intercourse.

51
Q

What gender is dyspareunia more common in?

A

Females

52
Q

What commonly occurs with dyspareunia?

A

Vaginismus

53
Q

What is vaginismus?

A

Involuntary muscle constriction of the outer 1/3 of the vagina

54
Q

Who is vaginismus most common in?

A

Highly educated women
High socioeconomic groupas

55
Q

What is dilation?

A

Opening the vaginal opening with pt’s fingers or with dilators or going to physical therapy.

Helps with vaginismus

56
Q

What are the common medical causes of ED?

A

CVD
DM
Neurologic disease
Surgical procedures

57
Q

How is ED diagnosed?

A

Lab studies: BG, A1c, hormone assays, liver, thyroid, lipids

Noctural penile tumescence

Doppler of pudendal artery

58
Q

What disease causes dyspareunia in men?

A

Peyronie’s disease

Abnormal fibrous penile tissue

59
Q

What psych medication classes are known for affecting sexual function?

A

Antipsychotics (decrease dopamine)
Antidepressants (increase serotonin)
Antianxiety (can improve if inhibited by anxiety, but also increases serotonin)

60
Q

What general medications are known for affecting sexual function?

A

Anticholinergics (Dry mucous membranes and impotence)

Antihistamines

61
Q

What hormonal medications are known for affecting sexual function?

A

Contraceptives (Abnormal levels of estrogen, progesterone, and LH)

Anti-androgen therapy (lower testosterone)
AKA spironolactone, or OCPs.

62
Q

According to the DSM-V-TR, what is the criteria to be diagnosed with a sexual disorder?

A

Disorder must be experienced at least 75% of the time.

6 month duration

Significant distress due to disorder

No other factor that better explains symptoms

63
Q

What falls under sexual interest/arousal disorder?

A

Female hypoactive desire dysfunction
Female arousal dysfunction

64
Q

What disorder is not included in the DSM-V?

A

Sexual aversion disorder

65
Q

What falls under genitopelvic pain/penetration disorder?

A

Dyspareunia and vaginismus

66
Q

What is persistent genital arousal disorder?

A

A defect in sensory nerves

67
Q

How is persistent genital arousal disorder treated?

A

SSRIs, psychotherapy, topical or injected anesthetic agents

68
Q

What are the therapy options for sexual disorders?

A

Dual-sex therapy
Behavior therapy
Group therapy
Analytically oriented sex therapy

69
Q

What are paraphilias?

A

Way too much love.

Recurrent, intense, sexually arousing fantasies, urges, or behaviors involving one or more of the following:

Nonhuman objects
Suffering/humiliation of oneself/partner
Children/nonconsenting parties
6 months+

70
Q

What is exhibitionism (Paraphilia)?

A

Achievement of arousal by exposing genitalia to strangers, usually a childhood behavior carried into adult life.

Masturbation replaces actual sexual activity.

71
Q

What is tranvestism (Paraphilia)?

A

Recurrent cross-dressing in a HETEROSEXUAL MALE.

Not a part of homosexuality or transsexuality.

72
Q

What is voyeurism (Paraphilia)?

A

Attaining arousal watching an unsuspecting person or people.
Usually the person is doing something sexual or naked.

Masturbation replaces actual sexual activity.

73
Q

What is pedophilia (Paraphilia)?

A

Use of a child to achieve sexual arousal and often gratification.

Contact is frequently oral, but includes any sexual contact.

More common with men.

74
Q

What is incest (Paraphilia)?

A

Sexual relationship with a person, usually a child, in IMMEDIATE family.

Usually prevented by cultural norms.

75
Q

What is sexual sadism (Paraphilia)?

A

Inflicting pain upon the sexual object as a means of arousal.

76
Q

What is sexual masochism (Paraphilia)?

A

Erotic pleasure being achieved by being humiliated, enslaved, or physically bound/restrained.

77
Q

What is fetishism (Paraphilia)?

A

Erotic fantasies and sexual urges or behavior involving non-living objects (ex: female undergarments)

78
Q

What is frotteurism (Paraphilia)?

A

Sexual arousal derived from touching or rubbing against a non-consenting person.

Commonly in crowded public areas.

79
Q

How are paraphilias treated?

A

Pharmacotherapy and psychotherapy.

Behavioral therapy
SSRIs
Gonadotropin ANTAgonists, progesterone therapy.

Behavioral Dynamicssss (21 decks)

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