Lecture 5: Sexual Disorders and Gender Variations Flashcards
sexual dysfunction
persistent inability to function normally in some area of the sexual response cycle
sexual dysfunction checklist
- longer than 6 months
- causes significant distress or impairment, is not due to another nonsexual psychiatric problem
lifelong
some people suffer from sexual dysfunction for their entire lives
acquired
others may have had normal sexual functioning before the disorder developed
global
in some cases, the dysfunction occurs during all sexual situations
situational
in other people it may be linked to certain situations
sexual response cycle
- desire phase
- excitement phase
- plateau phase
- orgasm phase
- resolution phase
desire phase
interest in or urge to have sex in response to sexual fantasies or environmental cues
male hypoactive sexual desire disorder
reduced interest in sex and engaging in little sexual activity
female sexual interest/arousal disorder
lack of normal interest in sex and usually feeling little excitement during sex
excitement phase
psychological experience of sexual arousal
erectile disorder
failing to attain or maintain an erection during sex
plateau phase
high but stable level of excitement
orgasm phase
peak of sexual pleasure where tensions are released
premature ejaculation
man ejaculating within one minute of sex and before he wishes to ejaculate
delayed ejaculation
man being unable to ejaculate or having very delayed ejaculation during sex
female orgasmic disorder
woman failing to reach orgasm, having very delayed orgasm, or having orgasms of very low intensity
resolution phase
decreased arousal
- sexual dysfunction never during resolution phase
sexual pain disorder
marked by physical discomfort during sex
genito-pelvic pain/penetration disorder
2 types:
- vaginismus: muscles of vagina contract during arousal, preventing penis from entering; might be caused by learned fear or by an infection of the vagina
- dyspareunia: experiencing pelvic or vaginal pain during sex, caused by injury during childbirth, scar from episiotomy or variety of factors
biological factors involved in sexuality
genetic sex, hormonal functioning, brain structure
- hormones: prolactin in both genders, estrogen in females, testosterone in males
social factors involved in sexuality
relationships with sexual partners, culture
psychological factors involved in sexuality
attitudes and expectations toward sex
performance anxiety
fear of performing inadequately and a related tension that is experienced during sex
spectator role
state of mind that some people experience during sex, focusing on sexual performance to such an extent that performance and enjoyment are reduced
principles of modern sex therapy
- assessing and conceptualizing the problem – medical and past-life examination
- mutual responsibility
- education about sexuality
- emotional identification
- attitude change
- elimination of performance anxiety and spectator role
- increasing sexual and communication skills
- changing destructive lifestyles and couple interactions
- addressing physical and medical factors
disorders of desire
- affectual awareness: visualizing sexual scenes in order to discover negative emotions or feelings of anxiety
- self-instructive training: replacing negative thoughts and statements with constructive ones
erectile disorder treatment
- reducing performance anxiety and increasing stimulation by tease technique
- taking drugs to increase blood flow to penis (sildenafil – viagra)
premature ejaculation treatment
- stop-start/pause procedure: penis is stimulated until man almost reaches orgasm, followed by a break to let arousal subside
- SSRIs because it decreases sexual arousal
delayed ejaculation treatment
- reducing performance anxiety and increasing stimulation
- drug therapy can be used when nerve damage is a causal factor
female orgasmic disorder treatment
- cognitive-behavioral techniques, increasing body awareness, self-exploration
- directed masturbation training: teaching how to masturbate step by step to reach orgasm
genito-pelivic pain/penetration disorder treatment
- practicing tightening and relaxing the muscles until woman has control
- behavioral treatment to overcome fear of penetration
- pain management procedures and sex therapy
- medical procedures are sometimes needed
paraphilias
having sexual fantasies or behaviors related to objects or situations outside the usual norm
paraphilic disorder
when paraphilia causes distress or impairment, interferes with daily life, or when it may cause harm
paraphilic disorder checklist
at least 6 months and significant distress or impairment
transvestic disorder (transvestism/cross-dressing)
being sexually aroused by dressing up in clothes of the opposite sex
fetishistic disorder
being sexually aroused by nonliving objects or nongenital body parts, usually while ignoring all other stimuli
fetishistic disorder treatment
- masturbation satiation: the patient has to masturbate for a long time fantasizing about the paraphilic object, person will become bored
- orgasmic reorientation: teaches patients to respond to new, more appropriate sources of sexual stimulation
exhibitionist disorder
being sexually aroused by exposing one’s genitals to someone who is unsuspecting
voyeuristic disorder
being sexually aroused by spying on people being naked or having sex
frotteuristic disorder
being sexually aroused by touching or rubbing against nonconsenting people
pedophilic disorder
being sexually aroused by physically non-matured children
sexual masochism disorder
being sexually aroused by being made to suffer
autosomatic asphyxia
a type of sexual masochism disorder
- people may accidentally experience a fatal loss of oxygen by hanging, choking, or strangling themselves while masturbating
hypoxiphilia
a type of sexual masochism disorder
- people strangle or choke themselves to increase their sexual pleasure
sexual sadism disorder
being sexually aroused by the suffering of others, either physical or psychological
transgender
individuals whose gender identity is different from the gender they were assigned at birth
gender dysphoria
extreme distress or impairment experienced by some transgender people due to the incongruence between their gender and the one they were assigned at birth
gender dysphoria checklist
for 6 months or more, causes significant distress or impairment
gender dysphoria treatment
- biological procedures: effective way to improve symptoms
- psychotherapy: build awareness of needs and feelings, reduce anxiety, depression and anger, improve self-image and develop coping skills
- cognitive-behavioral: transgender education programs/support programs