Psych Sexuality Final Exam Flashcards
______ was one of the first companies to get approval for Erectile Dysfunction drug Alista, before Viagra
Vivus
no new sexual problems for women have been discussed in ________.
literature
said they may have drugs for female sexual dysfunction and the market went wild
Vivus
Alista and Viagra were proved to _____ work on women
not
% of women have body issues
80%
skin patch found to boost ______ in women–successful
testosterone
one of the biggest companies in the world; began $100 million marketing before the patch was approved
Proctor and Gamble
Theory: sexual desire is just ______
testosterone
Clinical trials were tested on women who had surgery and had their ____ removed
uterus
patch is estrogen and testosterone patch; not told to public that ____ is included
estrogen
Viagra increases ______, not ______.
blood flow; orgasms
Alista and Viagra
drugs used for erections
occurs in non-human animals, is found in every human society even those with negative feelings about it, and attitudes about same-sex sexuality vary greatly around the world
same-sex sexual behavior
In which era did scientific approaches to understanding sex from a psychological perspective begin
Victorian era
According to Freud, a boy shifts to identifying with his father, taking on the father’s gender role, and acquiring the characteristics expected of men by society, during the ____ stage of psychosexual development?
phallic
A woman with a vaginal infection repeatedly experienced pain during intercourse, leading her to eventually stop having intercourse. This is an example of…
operant conditioning
Critical theories that explain sexual phenomena most likely discuss…
various behaviors and types of people as social constructions.
What is the most common method for measuring sexuality?
Self-reports
Enlargement and concealment are examples of …
purposeful distortion
What is a major advantage of direct observation over self-reports?
it is accurate
It has been used successfully with sexual minorities experiencing work stress from antigay prejudice and microaggressions.
acceptance and commitment therapy (ACT)
Hernando initiates sex with his wife Kiko. Although she is not very interested at first, as they begin kissing and petting each other, she becomes aroused. This pattern of sexual behavior is known as
responsive desire
One of the basic goals of Masters and Johnson’s therapy was to
eliminate goal-oriented sexual behavior.
Some women may only attain an orgasm through masturbation or hand or mouth stimulation by the partner. The notion that this is a disorder can be linked to
sexual scripts/belief there is a right way to have sex
Psychiatrist and sex therapist Helen Singer Kaplan believed that the key to defining the premature ejaculator is the absence of…
voluntary control of orgasm
Distressed married couples and those seeking sex therapy have _________ deficits. Longitudinal study proves that ineffective _________ predicts later relationship problems (likely to break up)
communication
o Criticism: verbally attacking
o Contempt: displays indicating no regard for the person (nonverbal: rolling eyes)
o Defensiveness: “it’s not my fault”
o Withdrawal (stonewalling): refuse to discuss
Poor communication techniques: Gottman’s 4 Horsemen of the Apocalypse
–>relationship satisfaction, sexual satisfaction, high orgasm frequency
positive communication
what you mean
intent
what the other person thinks you mean
impact
impact matches their intent
effective communicator
way of complaining in speaking for yourself, not your partner; focus on own thoughts and feelings; less likely to make your partner defensive; avoids mind reading
“I” language
making certain assumptions about what one is thinking; common among distressed couples
Mind reading
component of giving good messages where you give specific examples of the issue, then can give specific suggestions about what could’ve been done about it
documenting
telling your partner what you are feeling by stating your thoughts clearly, simply, and honestly
leveling
not saying things that would be deliberately hurtful to your partner or would be irrelevant
editing
to make communication clear, clear up expectations, clear up what is pleasant/unpleasant, clear up what is relevant/irrelevant, notice things that draw you closer/push you apart
purposes of leveling
you should ____ mind reading
avoid
Be a _______ listener: focus on what partner is saying/feeling
nondefensive
the goal is to balance ____ and _____
leveling and editing
actively trying to hear and understand what the other is saying
listening
offer a set of acceptable limited choices; make so that “no” is not an acceptable answer (would you want to talk about this today or tomorrow?)
limited choices
“uh huh,” “okay,” nodding head
feedback
repeating in your own words what you think your partner meant, then clear up confusion created with the initial message if it is distorted
paraphrasing
One aspect is self-disclosure: telling personal things about yourself
o Associated with sexual satisfaction
o Stimulates reciprocity
technique of good communication
are better at reading nonverbal cues; more likely to inquire about upsetting situations another is in and use comforting messages; more likely to talk about feelings and relationships; more self-disclosing; use speech to establish relationships; more concerned with the quality of the relationship in which sex occurs
women
more likely to discuss sports, careers, and politics; more likely to interrupt; capable of being self-disclosing when talking to a woman; use speech to exert control, preserve independence and enhance their status
men
Research shows that gender differences are _____, assumes gender differences are the same for all ethnic and social classes
small
the way we say our words; tone of voice, expression on the face, position of the body, whether you touch the other person; emphasis on certain words
nonverbal communication
technique in communication of telling your partner that, given their POV, you can recognize why they think a certain way; try to understand each other’s viewpoint
- Understanding partner’s preferences of sexual tools (foreplay) causes satisfaction
- Causes progress; don’t have to agree with other
Validation
checking out assumption (“am I right about that?”), then following with an open-ended question (“what can we do to make things better?”)
drawing your partner out
communicate positive things about sex; positive reinforcement
- Say when a kiss is good; recognition of strengths can enrich it
- Use frequent verbal and nonverbal feedback
accentuate the positive
In stable marriages, positive: negative ratio for interactions is _:1 or higher
5
Gottman: The Magic Ration
positive communication
- Don’t: have a rigid body saying “let’s get this over with” during sex; do: guide the other’s hand/demonstrate
- Distressed couples differ more from nondistressed in nonverbal communication than verbal
nonverbal communication dos and don’ts
agreed set of rules so the arguments may help and won’t hurt
- Basic rules of ____: don’t be sarcastic/ insulting, don’t bring up names of former lovers, don’t play amateur psychologist (diagnosing partner), don’t threaten to tell your parents/run home, don’t bring children into the argument, don’t dump everything on them at once (stored grievances), don’t hit and run (bring up a serious issue when it’s a bad situation to discuss—having to leave in 5 minutes), and don’t focus on who’s to blame (look for solutions)
fighting fair
We should make sure our message clearly matches our intent and not make assumptions about the meaning of ______ messages
ambiguous
Relationship/marital programs were developed in the
1980s
is not common in society
directness
are effective with all groups: middle-class White, Black, Hispanic, low-income, and LGBTQ couples
Relationship education programs
Problem with verbal/nonverbal sexual communications
often unclear
_____ signals: “I want to have sex now.” ___ signals: dressing nicely
direct; indirect
Better Marriages, Couple Communication, PAIRS (Practical Application of Intimate Relationship Skills), and Prevention and Relationship Education Program (PREP, which is delivered by the U.S. military to military couples)
Relationship/marital programs
_____ relationship education is effective in improving relationship satisfaction and communication skills; found improvements in well-being and reductions in intimate partner violence
couple
Most of these programs are educational (not couple therapy); focus on developing better communication and problem-solving skills with activities for practice; can also focus on info and skills on how to improve a couple’s ability to manage their lives (children/finances)
relationship/marital programs
- Experience of counseling psychologists
- Research comparing distressed and nondistressed couples
What was the finding?
Distressed couples have communication deficits
- Longitudinal research
- Communication of engaged couples measured
o Self-report of negativity in their communication styles
o Videotaped interaction (where they discussed the top problem in their relationship)
o Coded for criticizing, denial, withdrawal
What were the results when following up 5 years later?
Those who divorced had worse communication patterns before marriage (from the self-reports and the videotaped interactions)
o These are rules for good communication in the US and other Western nations
o Different norms in other countries (Japan)
the importance of cultural context
- Women and men are from different linguistic communities
- Implies huge gender differences in communication, great difficulty in cross-gender communication
- The data: gender similarities
- Yes, we can communicate
Tannen, You Just Don’t Understand: Women and Men in Conversation
a dysfunction that develops after a period of normal functioning
aquired sexual disorder
a problem with sexual response that causes a person mental distress (sexual dysfunction)
o Ex: inability to get an erection, inability to orgasm
sexual disorder
one that has been present ever since the person became sexual
lifelong sexual disorder
- desire disorders
- arousal disorders
- orgasmic disorders
- pain disorders
(first 3 correspond to components of the sexual response cycle)
categories of sexual disorders
disorder when individual’s sexual desire is very low and they are not interested in sexual activity
- Characteristics: lack of/sharply reduced interest or a lack of responsive desire
- Common for women: 10-16%, half as many men
- for women over 65, 50%
Hypoactive sexual desire (HSD/Inhibited sexual desire)
one partner wants sex less frequently than the other does, creating conflict
Discrepancy of sexual desire
hypoactive sexual desire (libido) and discrepancy of sexual desire
desire disorders
include female sexual arousal disorder and male erectile disorder (ED)
arousal disorders
DSM’s change of changing hypoactive sexual desire diagnosis into combining female low sexual desire with female arousal disorder
Female sexual interest/arousal disorder
a lack of response to sexual stimulation (lack of lubrication)
o Involves subjective, psychological, and physiological
o 10% of women
o Frequent during and after menopause
Female sexual arousal disorder (FSAD)
inability to have an erection or maintain one
- Man may not engage in sex; can cause depression
- lifelong vs. acquired vs. situational
- Common in 60s
Erectile disorder
frigate, impotence
terms we don’t use anymore
man has never been able to have an erection that is satisfactory for intercourse
Lifelong erectile disorder
man has difficulty getting or maintaining an erection but has erections sufficient for intercourse at other times
Acquired erectile disord
include premature ejaculation, male orgasmic disorder, and female orgasmic disorder
orgasmic disorders
when a man has an orgasm and ejaculates too soon; according to International Society for Sexual Medicine:
o Ejaculation that always occurs before 1 minute of penetration
o Inability to delay ejaculation
o Destress about the problem
o 15% of men
o Many stop having sex and dating
Premature ejaculation (PE)
man is unable to have an orgasm/it is delayed, even though he has a solid erection and stimulation
o Problem can range from occasional problems to never having an orgasm
o Rare—10%
o Intercourse can go on too long—man fakes orgasm
Delayed ejaculation (male orgasmic disorder)
inability to have an orgasm
o Can be lifelong, acquired, or situational
o 20% of women
o Can self-define disorder
Female orgasmic disorder (anorgasmia)
woman has orgasms in some situations but not others (common pattern of female orgasmic disorder)
Situational orgasmic disorder
include painful intercourse and vaginismus
pain disorders
(painful intercourse): genital pain experienced during intercourse; mostly in females
o 8% of women, 2% of men
o About pain, not about sex
dyspareunia
DSM-5-TR merged dyspareunia + vaginismus because they tend to occur together (vaginismus can result in dyspareunia)
Genito-pelvic pain/penetration disorder
spastic contraction of the outer third of the vagina
o Sometimes entrance to vagina is closed and woman can’t have sex
o Not common
Vaginismus
diseases associated with the heart and circulatory system (vascular pathology)
o Diabetes mellitus—circulation problems, peripheral nerve damage, low testosterone levels; ED can be a sign of developing diabetes
o Hypogonadism—under functioning of the testes so testosterone levels are low
o Disease/injury to the spinal cord (location of erection reflex center), severe stress/fatigue, prostate surgery
Erectile disorder causes
physical factors, psychological factors, combined cognitive and physiological factors, and interpersonal factors
causes of sexual disorders
organic factors (diseases/injuries) and drugs
physical causes
mostly psychological
o Local infection like prostatis (physical)
o Genes from monkeys “survival of the fastest”
premature ejaculation causes
erection problems are often caused by
diabetes
mostly psychological, some medical/surgical conditions
o Multiple sclerosis, spinal cord injury, prostate surgery
causes of delayed ejaculation
mostly psychological
o Severe illness, general ill health, extreme fatigue, injury to the spinal cord
causes of female orgasmic disorder
organic factors
o Women: disorders of the vaginal entrance (painful scars), disorders of the vagina (vaginal infections), pelvic disorders (pelvic inflammatory disease)
o Men: poor hygiene (washing foreskin), allergic reaction (creams), prostate problems
o Painful intercourse
causes of painful intercourse and vaginismus
dyspareunia is often caused by
vaginal infection
at low doses increases desire, at high doses decreases erection, arousal, orgasm
Short term pharmacological effects of alcohol
expectation that it will loosen people up, making them more sociable and sexually uninhibited
Expectancy effects of alcohol
have erectile disorder, orgasmic disorder, and loss of desire; negative effects on interpersonal relationships, contributing to sexual disorders
Long-term effects of chronic alcohol abuse
increases sexual desire and makes sexual interactions more pleasurable; smaller amounts enhance sexual desire; larger amounts inhibit sexual functioning; chronic users have decreased sexual desire; concerns that it contributes to risky sexual behavior and may affect testes size and hormones
effects of marijuana
women—increase sexual desire/pleasure; (boosts products of androgens); men—moderate doses increase sexual desire while creating erection problems
Effects of cannabinoids
o Increases sexual desire, sensuality, and delays orgasm
o Chronic use: loss of sexual desire, orgasmic disorders, erectile disorders
o Most negative effects when injected
effects of cocaine
increased sexual desire and arousal
effects of amphetamines
Engage in risky behaviors, lead to paranoia, hallucinations, and violent behavior
effects of crystal methamphetamine
suppress effects on sexual desire and response
o Long-term use of heroine—decreased testosterone levels in males
effects of opiates/narcotics (morphine, heroine)
effect sexual functioning because they alter neurotransmitter levels/ functioning of the central nervous system
o Schizophrenia drugs cause dry orgasm
o Tranquilizers/antidepressants improve sexual responding as they help the person, but SSRIs can cause problems with arousal and delayed orgasm
o Wellbutrin has few sexual side effects
effects of psychiatric drugs
antihistamines reduce vaginal lubrication; antihypertensive drugs can cause erection problems; epilepsy drugs cause erection problems/decreased sexual desire
effects of prescription drugs
immediate causes, prior learning, emotional factors, behavioral or lifestyle factors, and problems with sexual excitation/inhibition
Psychological Causes
various things that happen in the act of lovemaking itself that inhibit the sexual response
Immediate psychological causes
refers to thoughts that distract the person from focusing on the erotic experience
Cognitive interference
anxiety (fear of failure), cognitive interference (problem of attention/spectatoring), failure to communicate (verbally/nonverbally), and ineffective stimulation (simple ignorance cured by education)
Immediate psychological causes
________ experiment: model of sexual dysfunction: how anxiety, positive/negative emotions, and cognitive interference act together to produce sexual disorders—dysfunctionals overthink and take positive stimuli for functionals and make it bad
David Barlow
_____: performance-related distractions; _____: appearance-related distractions
men; women
the things people learned/experienced earlier (childhood, adolescence, adulthood) that now inhibit their sexual response
prior learning
- First sexual act: traumatic (laughed at when no erection, leads to erectile dysfunction)
- Seductive behavior/child abuse by adults can lead to problems with sexual desire, arousal, or aversion
- Growing up in a strict home where sex is bad—want to get sex over with/no enjoyment
- Family punishes child for masturbation—adult can’t orgasm through masturbation
- Teaching double standard—woman’s sexual response in inhibited because she was taught that no nice lady is interested in sex
things people can experience in childhood
child sexual abuse and sex-negative family resulting in a child who grows into an adult with sexual problems is an example of
prior learning
disgust, depression
emoptional factors
Barlow’s model of sexual dysfunction (cognitive-affective model) argues that people with sexual disorders tend to rate ____ on negative affect (anxiety/negative mood) and ____ on positive affect (joy and excitement) in sexual situations
high; low
Smoking, alcohol consumption, and obesity lead to…
higher rates of sexual disorders
By _____ and reducing their body mass index, obese men reduced the incidence of erectile disorder
exercising
the _______________ can be used to maximize effectiveness of therapies for disorders
Sexual excitation-inhibition model
People who are low on sexual excitation, high on sexual inhibition, or both are likely to develop ______
sexual disorders
we function well sexually when we are physiologically aroused and interpret that as sexual arousal (instead of anxiety/nervousness)—people with sexual disorders interpret as anxiety
Cognitive-physiological model of sexual functioning and dysfunction
women who were told they were aroused got more aroused
experiment for Combined Cognitive and Psychological Factors
can lead people away from sex—want surface level relationship like talking about the weather
fear of intimacy
relationship conflict, fear of intimacy
relationship factors
- Progress in a dating relationship to a certain degree of closeness then lose interest
- Can be a result of disappointing intimate relationships with parents in childhood
fear of intimacy
categories of disorders have 3 flaws: treat male sexuality and female sexuality as equivalent, when they differ; ignore the relational context of sexuality and desires for emotional intimacy; ignore differences among women and naturally occurring variations in women’s sexuality.
A New View of Women’s Sexual Problems and Their Causes
- Sexual Problems Due to Sociocultural, Political, or Economic Factors
- Sexual Problems Relating to Partner and Relationship
- Sexual Problems Due to Psychological Factors
- Sexual Problems Due to Medical Factors
A New View new categories of sexual disorders for women
the medicalizing of sex problems (viagra)
Tiefer’s criticism of previous work
Kerrywants to make sure she doesn’t get vaginismus, what should she do to prevent it?
washing and drying her vulva thoroughly when bathing
behavior therapy, cognitive behavior therapy, mindfulness therapy, acceptance and commitment therapy, couple therapy, and biomedical therap
therapies for sexual disorders
developed a behavior therapy model because they saw sexual disorders as learned behaviors rather than symptoms of psychiatric illness: goal was to eliminate a goal-oriented sexual performance (doesn’t lead to failure if don’t achieve)
Masters and Johnson
Drake observes a clear discharge from his urethra and experiences mild discomfort when he urinates. Of the following, Drake is most likely experiencing
Chlamydia
Why should people with herpes be especially careful to use safe sex practices?
Herpes infection increases one’s risk of becoming infected with HIV.
The early stage of human immunodeficiency virus (HIV) infection lasts as long as
the person is feeling well and the T cell count stays around 1,000.
a combination of the behavioral exercises by Masters and Johnson and cognitive therapy; used by many sex therapists
- Use cognitive restructuring (therapist helps client restructure their thought patterns, helping them to become more positive) as a technique
o Therapist challenges client’s negative attitudes (distrusting feelings towards men)
- Address cognitive interference: identify presence of thought, replace with erotic thoughts (out with the bad, in with the good)
- mindfulness therapy
Cognitive Behavior Therapy
system of training people in mindfulness practices; goal is to help people regulate their own negative emotions; effective
Mindfulness Therapy
Increases a women’s focus on their own sensations of arousal, amplifying their subjective sense of arousal and improving their sexual functioning
mindfulness therapy
Online therapy program combining ____ and ______ training was effective (Pursuing Pleasure)
CBT; mindfulness
technique of focusing one’s attention on experiences in the present moment in a calm, nonjudgmental way
Mindfulness
helps clients to learn to stop avoiding and struggling with their challenging emotions and thoughts and instead accept that they are having these feeling; focus on identifying core values
- Uses mindfulness practice
- Used for women wanting a better sexual quality of life, problematic porn use, and sexual minorities experiencing work stress. All were successful.
Acceptancy and Commitment Therapy
assumption that there is a reciprocal relationship between interpersonal conflict and sex problems; relationship is treated with the goal of reducing tensions between the partners; therapists use a combination of cognitive behavior and couple therapy focusing on assessing their sexual scripts
Couple Therapy
- Sexual and performance anxiety reduction (sensate focus exercises); behavior therapy
- Education and cognitive intervention (overcome “all or nothing” thinking); cognitive
- Script assessment and modification (break out of script); cognitive therapy techniques
- Conflict resolution and relationship enhancement; couple therapy
- Relapse prevention training
5-part model in treating men with ED
treatment of premature ejaculation; woman stimulates the man using her hand and stops until the erection goes away, then starts again until erection; man learns that he can an erection and be aroused without having orgasm
Stop-start technique
treatment for women with primary orgasmic disorder; helps orgasms
masturbation
helps women having trouble orgasming; exercise and strengthen the pubococcygeal muscle (entrance of vagina; muscle that stops urine); enhance arousal and facilitate orgasm from awareness of genitals; stimulate partner more by gripping the penis tightly
Kegel exercises
helps women having trouble orgasming; use of a self-help book to treat a disorder; effective for orgasmic disorders in women; effective for couples with a mixture of sexual disorders
Bibliotherapy
widely publicized breakthrough for the treatment of erectile disorder; block an enzyme which relaxes the smooth muscles in the arteries of the corpora cavernosa, allowing blood to flow in and create an erection; produces erection when man is sexually stimulated; lasts a few hours
Viagra
works like Viagra but lasts 24-36 hours
Cialis
work like Viagra; effective in treating ED from removal of prostate
Levitra and Zydena
hypogonadism (testosterone deficiency in men)
testosterone treatment
Pfizer found that ____ does not work for women’s orgasms
Viagra
showed no actual increase in sexual desire in women–unsuccessful; must be taken daily
- FDA rejected in 2010, then approved it in 2015 due to the “pink Viagra campaign”
Flibanserin
Promising approach for women—testosterone(T)+sildenafil(S)=taken for low sexual excitation; testosterone(T)+buspirone(B; anti-anxiety drug)=taken for high sexual inhibition
drug treatments
Helpful for women—_______: treatment of sexual desire problems; changes levels of neurotransmitters in the brain and increases dopamine; inject 45 minutes before sex
- central action
- approved by FDA June 2019
Bremelanotide
treatment for erectile disorders; inject into corpora cavernosa and dilates the blood vessels in the penis; use when Viagra doesn’t work; restores man’s confidence in erection ability and reduces performance anxiety
Intracavernosal Injection
Alprostadil
used instead of needle for intracavernosal injection(cream/place inside urethra)
treatment for erectile disorders; tube with rubber band is placed over the penis, suction is applied to produce erection, which is maintained by the constricting rubber band one the tube is removed.
Suction Devices
- Implanting a penile prothesis; sac of water is implanted in the lower abdomen, connected to 2 inflatable tubes running through the corpora cavernosa with a pump in the scrotum—man can inflate his penis to a full erection
o Damages penis so normal erection is never possible again
The inflatable penis
Semirigid, silicone-like rod is implanted into the penis; less costly than inflatable and lower rate of complications
penile implant
for hypoactive sexual desire (HSDD)
o Testosterone + sildenafil
o Dutch clinical trials in the US published in 2018
o Not yet FDA approved
Lybrido
for HSDD in women taking antidepressants (SSRIs)
o Testosterone + buspirone (short-term serotonin suppression, anti-anxiety
Lybridos
treated with masturbation and sensate focus exercises
Primary orgasmic disorder in women
therapy in sex ed, sexual skills training, communication skills training, body image
Aquired orgasmic dysfunction
treated with progressive vaginal dilators (with Botox injections), relaxation, physical therapy, and Kegel exercises
Viginismus
treated with drugs (antidepressents) combined with CBT
Premature ejaculation
treated with Masters and Johnson therapy and CBT
Hypoactive sexual desire disorder in women
- Some problems can be fixed with psychotherapies instead of drugs
- Szasz says that sex therapy is classifying people who have problems in living and calling them “sick”
o Sex therapists create a lot of illnesses by creating different unnecessary categories
o Thinks these disorders are not scientific
Critiques of theories, causes, effects, and treatment
- Communicate with your partner
- Don’t be a spectator (focus on giving and receiving sexual pleasures)
- Don’t set up goals of sexual performance (you will fail)
- Be choosey about the situations in which you have sex
- “Failures” will occur
good sexual mental health
When choosing a sex therapist, it is important that the person is _____ or ______
licensed; certified
You CANNOT get an STI from oral sex.
False
Birth control protects against pregnancy and STIs
False
Once you’ve had an STI, you CANNOT get it again.
False
Anal sex has a higher risk of spreading STIs than many other types of sexual activity.
True
You CANNOT get an STI if your partner is a virgin.
False
Only promiscuous or “trashy” people get STIs.
False
You CANNOT have two STIs at once.
False
You can get an STI from a toilet seat.
False
Women are more likely to get tested for STIs.
True
Lesbians CANNOT get STIs.
False
If my partner has an STI, I’ll know/see it.
False
How is it spread? Blood, semen, or other body fluids from a person with the virus - even in very small amounts - enters the body of a non-infected person.
How long does it last? Mild illness (a few weeks) but Lifelong or chronic condition.
How serious is it? 15-20% develop chronic liver disease including cirrhosis, liver failure, or liver cancer.
Hepatitis B
_ in _ (__%)sexually active adolescent girls have an STD (affects teens and young adults more)
1;4;20
chlamydia, gonorrhea, syphilis
STIs caused by bacteria
AIDS, HPV, hepatitis B
STIs caused by viruses
STIs caused by bacteria _____ be cured by antibiotics, but STIs caused by viruses _____ be cured but can be treated to reduce symptoms
can; cannot
an infection transmitted through sexual contact with an infected individual
STIs/STDs
Often NO signs or symptomsUNAWARE of infection, and don’t receive treatmentLONG-TERM damagemay have PASSED infection to others
why STIs are a significant health concern
_____% of US adults have an STI at any given time
1/5 (20%)
___ million new infections every year in the US
20
__% of all new STIs occur among young adults between the ages of 15 and 24—commonly HPV, trichomoniasis, and chlamydia for these cases
50
most frequently reported STI in the US with 1.8 million new cases each year
- Spread by vaginal, anal, or oral sex with someone who actively has it
o If partner is male, you can still get if they don’t ejaculate because bacteria may be present in pre-ejaculator fluid
o Infected pregnant women can pass it to their baby during pregnancy/childbirth
Symptoms:
- Female bodied symptoms: 75% asymptomatic, unusual vaginal discharge, burning with urination
- Male-bodied symptoms: 50% asymptomatic, clear discharge from the penis, mild discomfort with urination
Treatment:
- treatable with antibiotics (azithromycin or doxycycline) but does not respond to penicillin
- Without treatment: urethral damage, infection of the epididymis, Reiter’s syndrome, for women: pelvic inflammatory disease that can impact future fertility, baby with eye infection of pneumonia
- Prevention: condoms, regular testing, communication with partners about testing; possible development of a vaccine that prevents infection
Chlamydia
1/8 people 14-49 have–women have higher rates
- Often HSV-1 is lips/mouth, HSV-2 is genitals
- disease of the genital organs caused by the ___ simplex virus (HSV); 2 strains—HSV-1 and HSV-2 (can be caused by either one); transmitted by sexual intercourse and oral-genital sex
- Symptoms: many asymptomatic
- Spread by vaginal, oral, or anal sex or skin-to-skin contact with someone who has it
- Symptoms (“having an outbreak”): one or more blisters on or around the genitals, rectum, or mouth; blisters break and leave painful sores that take 3 weeks to heal but virus lives in the body causing unpredictible periods of sores
- No cure–trying drugs that treat symptoms and vaccinations that prevent; antiviral drugs (acyclovir, valacyclovir) shorten outbreaks and reduce rates of transmission
- For oral: can be treated with medication Valtrex—reduces duration of outbreak
o If taken before the time of infection, can be somewhat preventative and/or reduce possibility of recurrence
- Long-Term Consequences: increased risk of becoming infected with HIV due to open blisters, possible transfer from mother to infant in childbirth
o Some get meningitis, narrowing of the urethra due to scarring
- Psychological Aspects: Coping: there are those who are asymptomatic and unaware living their best lives, and those who experience pain, feel stigmatized, and abstain from sex to avoid affecting others. Makes it worse that outbreaks are unpredictable, and they are always somewhat infectious.
Genital Herpes (HSV-1 and HSV-2)
(“the great imitator”) caused by Treponema pallidum; estimated 35,063 new cases in 2018 in the US
- Less cases but effects are more serious if left untreated—can damage the nervous system or result in death
- Spread by direct contact with a ____ sore (chancre) during vaginal, anal, or oral sex
- More susceptible to HIV
- has 4 stages (chancre in primary)
- Can lead to Congenital ____: fetus is infected when the bacteria crosses the placental barrier; may lead to early death or severe illness; mothers most infectious with primary or secondary-stage but can infect 8 years after initial infection
- Diagnosis: physical exam of genitals and entire body surface; women—pelvic exam, rectal exam if anal intercourse; fluid taken from a chancre and tested for Treponema pallidum; blood tests—VDRL
- Treatment: penicillin not in large doses (unless in later stages) and for those allergic–tetracycline or doxycycline (not for pregnant women)
Syphilis
oldest of sexual diseases; cases raised after penicillin because of the pill (less condom use)
- Spread through vaginal, anal, or oral sex with someone who has the infection.
o Infected pregnant woman can pass it to her baby during childbirth
- Symptoms: men–abnormal penile discharge, burning sensation when urinating, rectal discharge, itching or bleeding, pain/swollen in testicles; women: often asymptomatic, abnormal vaginal discharge, pelvic pain, irregular/painful menstruation, burning while peeing
- nongenital gonorrhea infection: mouth and throat—sore throat; rectal—discharge from the rectum and itching or asymptomatic; eyes—common in infants, swollen and painful with pus, blindness
- Can lead to: sterility/infertility, disseminated infection (rash, fever, arthritis), painful infection tubes attached testicles, pelvic inflammatory disease (PID), long-term abdominal/pelvic pain, ectopic pregnancy scar tissue form in fallopian tubes
- Diagnosis: urine test, throat and rectum swabs; pelvic examination for women may show PID
- Treatment: used to use penicillin but common strains were resistant so started to use antibiotic Cipro, common strains were resistant again so now using an injection of ceftriaxone
Gonorrhea
most common STI in the US with 13 million new cases each year
- Pre-vaccine era: 43% of males 14-59 were infected
- Increases the risk of certain cancers such as cervical cancer and cause genital warts
- More than 40 different types– some low risk (genital warts) and some high (cervical/penil/anal cancer)
- Majority are asymptomatic and go away by themselves withing 2 years
- Diagnosis: DNA test to detect cervical cancers, inspecting the warts (though some are harder to see); no test for high-risk types on the penis/anus yet
- Treatment: chemicals to apply on the warts (podophyllin, bichloroacetic acid), freeze the warts off with cryotherapy, drugs like Podofilox—many cases go away on their own
- Vaccine: 3 shots over a 6 month period and is available to all, protects against 4 types including 16 and 18 (cervical cancer types) and 2 types that cause genital warts. Best to get before sexual activity takes place (approved for women up to 26)–protects against all forms of HPV
HPV (human papillomavirus)
stage with chancre:
men: on penis or scrotum
women: on cervix (unaware she is affected), vaginal walls, or vulva
mouth or rectum: lips, longue, tonsils, around the anus, cuts
Primary stage syphilis
cauliflower-like warts appearing on the genitals, usually around the urethral opening of penis, shaft of penis, scrotum, vulva, walls of vagina, cervix, or anus
Genital warts
3.7 million new cases in 2018 in US
- Spread by parasite passed during vaginal sex but can live on toilet seats
- Symptoms: 70% asymptomatic, abnormal vaginal/penile discharge (white, yellow or green color with foul odor), irritation of urethra, burning urinating and ejaculation, genitals itching, sore, red, burning
- Lower genital tract (vulva, vagina, penis, urethra)
- Long-term consequences: PID, problems with birth, susceptibility/high risk of getting to HIV
- Treatable: metronidazole taken orally
Trichomoniasis
Almost all cases of cervical cancer are linked to
HPV
White American’s common cancer-causing types:
16 and 18
African American’s common cancer-causing types:
33, 35, 45, 58
4-valent vaccine only prevents ___ and ___, but new 9-valent prevents Black’s and Whites
16 and 18
major early symptom of syphilis; a round, ulcerlike lesion with a hard, raised edge resembling a crater; painless; appears at the point where the bacteria entered the body; if untreated, goes away by itself meaning disease has gone underground and will move on to the next stage
- appears usually within 2-6 weeks after exposure but possibly up to 3 months
chancre
stage 4 weeks after chancre heals, body rash that does not itch or hurt forms, hair loss, mucous patches usually in the mouth, vagina, or anus; - Condylomata lata (“fleshy warts”) in anogenital region; disease can still be cured; symptoms disappear, leading to next stage after a few weeks
Secondary-stage syphilis
serious infection of woman’s reproductive organs
- Often from untreated STDs like chlamydia and gonorrhea
- Symptoms: long-term pain in lower abdomen, pain and bleeding during sex, burning while peeing, vaginal discharge with bad odor, bleeding between period, fever, unable to undo damage, fallopian tube scar tissue, ectopic pregnancy infertility
o May have mild or no symptoms
- You are more likely to get PID if you: Have an STD and do not get treated, Have more than one sex partner, Have a sex partner who has sex partners other than you, Have had PID before, Are sexually active and are age 25 or younger, Douche, Use an intrauterine device (IUD) for birth control
Pelvic Inflammatory Disease (PID)
vaginal infection with similar discharge; discharge has a foul odor
Bacterial Vaginosis
½ of people enter stage 10-30 years after infection begins; cardiovascular late ____ (hear and major blood vessels attacked; can lead to death), late benign___, and neuro____ (brain and spinal cord attacked; lead to insanity and paralysis–fatal); gumma: soft gummy tumor
Late syphilis
inflammation of the prostate gland
o Causes: E coli or gonorrhea or chlamydia
o Symptoms: fever, chills, pain around anus and rectum, frequent urination, painful ejaculation
o Can also be chronic and have no symptoms or only lower-back pain
o Treatment: antibiotics
Prostatis
occurs during late stage/at any time
Symptoms: difficulty coordinating muscle movements, paralysis, numbness, blindness, dementia (mental disorder), damage to internal organs, can result in death
Occurs sooner in those who have HIV (can occur in the primary stage)
Neurosyphilis Syphilis
form of vaginitis caused by the yeast fungus _____
o Causes: long-term use of birth control pills, menstruation, diabetes or a prediabetic condition, pregnancy, and long-term use of antibiotics; can be aggravated by intercourse, though not sexually transmitted
o Symptom: thick, white, curd-like vaginal discharge on vaginal lips and walls—causes itching
o Treatment: drugs miconazole or clotrimazole or fluconazole
o If women has while pregnant, can pass it to the child: Thrush (yeast in the baby’s digestive system)
Candida (yeast infection)
stage that may last for years; Treponema pallidum effects the tissues of the body, blood vessels, central nervous system, and bones; no symptoms or infectious in stage; ½ of people stay in stage permanently
Latent syphilis
- Monogamous relationship with an uninfected person, abstain from sex, use condoms
- Washing genitals before intercourse, inspect partner’s genitals, urinating before and after intercourse
- Don’t assume person is uninfected—could be asymptomatic
- It is the person’s ethical responsibility to get diagnosed and treated and tell partners if they have a disease
How to protect yourself
common in women
o Common infections of the sex organs, not sexually transmitted
o Prevent: wash the vulva carefully and dry it, do not use feminine hygiene deodorant sprays, wear cotton underpants, don’t wear pants tight in the crotch, wipe the anus from front to back, do not go from anal to vaginal intercourse
Vaginitis (vaginal inflammation or irritation)
