Sexual aversion disorder

Question 1

Definition

Answer 1

A persistent or recurrent extreme aversion to and avoidance of or almost all genital sexual contact with a sexual partner which cause distress or interpersonal difficulty.

Question 2

Characteristics of SAD

Answer 2

• lack of desire
• fear
• revulsion
• disgust

All when the person engages in genital contact with a partner.

Question 3

What forms are there?

Answer 3

Specific part of intercourse

Sight of genitals

Smell of bodily secretions

Hugging

Kissing

Question 4

Subclassifications

Answer 4

Lifelong

Acquired e.g. after a traumatic experience

Situational (with a specific partner or in a specific set of circumstances)

Generalised (occurring with any partner in all situations)

Question 5

Psychological causes

Answer 5

The most common is interpersonal problems and traumatic experiences.

Question 6

Interpersonal causes

Answer 6

Tend to cause situation specific sexual aversion disorder therefore sx only occur in a specific set of conditions. Underlying tension or discontent with the relationship is often the cause.

Question 7

Traumatic causes

Answer 7

Tend to cause generalised sexual aversion disorder. E.g. rape, incest, molestation. The patient associates intercourse with a painful experience or memory. It can also be caused by religious/cultural teachings that associate sexual activity with excessive feelings of guilt

Question 8

Sx

Answer 8

Lack of interest

Mild disgust

Panic attacks – dizziness, SOB, intense fear, rapid heartbeat

People tend to avoid situations that means they can avoid sexual intercourse e.g. extra time at work, going to bed at different times, make themselves less sexually attractive

Question 9

Diagnostic criteria

Answer 9

1. Actively avoiding nearly all genital contact with partner
2. Strong negative feelings about contact or possible contact
3. Cause serious difficulties and unhappiness for the patient and/or their partner
4. No physical cause

Also need to do a physical exam in both partners to rule out a physical cause

Question 10

Differentials

Answer 10

Hypoactive sexual disorder BUT in hypoactive there is no sexual fantasies but in sexual aversion the patient tends to have normal sexual fantasies and they tend to enjoy kissing and cuddling until there is some genital contact in sexual aversion disorder.

Female sexual arousal disorder - a woman’s recurrent inability to achieve or maintain an adequate lubrication-swelling response during sexual activity which can manifest itself as a problem of interest or desire.

Question 11

Treatment

Answer 11

Couples psychotherapy

Medication to treat the physical sx e.g. BB for panic attacks