Sexual Disorders Flashcards
Describe the typical sexual response cycle.
desire excitement plateau orgasm resolution (men have a refractory period as well)
What are the typical sexual changes with aging?
the desire for sex does not change with age, but men usually require more stimulation and more time to achieve orgasm. the intensity of ejaculation usually decreases and the length of the refractory period increases
woman often experience vaginal dryness and thinning due to decreased levels of estrogen
What are some illicit drug effects on sexual function?
alcohol and marijuana enhance sexual desire by decreasing inhibition, but long-term alcohol will decrease sexual desire
cocaine and amphetamines enhance libido by stimulating dopamine receptors
narcotics inhibit libido
What are some medication classes that can cause sexual dysfunction?
antihypertensives
anticholinergics
antidepressants
antipsychotics
Testosterone promotes libido in both men and women. Which hormone inhibits libido by blocking androgen receptors?
progesterone (keep in mind that it’s present in oral contraceptives, hormone replacement therapy and prostate cancer treatments)
Dopamine enhances libido. Which neurotransmitter inhibits sexual function?
serotonin
What are the two main disorders of desire?
hypoactive sexual desire disorder
sexual aversion disorder
What is the prevalence of hypoactive sexual desire disorder?
up to 20% of the general population, more common in women
What are the two disorders of arousal?
male erectile disorder
female sexual arousal disorder
What are the features of male erectile disorder?
inability to attain an erection - can be primary (never had an erection) or secondary
note - if a guy has erections in the morning, during masturbation, or with other sexual partners, it’s probably a psychological cause rather than a physical one
What is the main feature of female sexual arousal disorder?
inability to maintain lubrication until completion (up to 33% of women)
What are the two general orgasmic disorders?
male/female orgasmic disorder - inability to achieve an orgasm after a normal excitement phase (30% of women and 5% of men)
premature ejaculation
What are the tow main sexual pain disorders?
dyspareunia and vaginismus
Describe dyspareunia.
genital pain before, during or after sexual intercourse. much higher incidence in women.
Describe vaginismus.
involuntary muscle contraction of the outer third of the vagina during penetration
incidence is increased in higher socioeconomic groups and in women of strict religious upbringing
What are the pharmacological treatments for erectile disorder?
phoosphodiesterase 5 inhibitos like sildenafil
alprostadil is injected into the corpora cavernosa or transurethrally to act locally
What are the pharmacological options for premature ejaculation?
SSRIs and TCAs (basically using their sexual side effects for good use)
What are the pharmacological treatments for hypoactive sexual desire disorder?
testosterone replacement for men (and maybe with low doses in women to improve libido)
estrogen replacement in women
Which paraphilia is comprised of sexual pleasure from touching or rubbing against a nonconsenting person?
frotteurism
What paraphilia is comprised of watching unsuspecting nude individuals in order to obtain sexual pleasure?
voyeurism
What is the difference between sadism and masochism?
sadism is gaining pleasure form hurting or humiliating another
masochism is gaining pleasure from being humiliated or beaten
What’s the term for sexual excitement from calling unsuspecting women and engaging in sexual conversations with them?
telephone scatologia
What are the three most common types of paraphilias?
pedophilia, voyeurism, and exhibitionism
What are the main psychotherapies involved in treatment of paraphilias?
insight-oriented is most common
aversive conditioning
