Sexual Disorders

Question 1

Describe the typical sexual response cycle.

Answer 1

desire
excitement 
plateau
orgasm
resolution (men have a refractory period as well)

Question 2

What are the typical sexual changes with aging?

Answer 2

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

Question 3

What are some illicit drug effects on sexual function?

Answer 3

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

Question 4

What are some medication classes that can cause sexual dysfunction?

Answer 4

antihypertensives
anticholinergics
antidepressants
antipsychotics

Question 5

Testosterone promotes libido in both men and women. Which hormone inhibits libido by blocking androgen receptors?

Answer 5

progesterone (keep in mind that it’s present in oral contraceptives, hormone replacement therapy and prostate cancer treatments)

Question 6

Dopamine enhances libido. Which neurotransmitter inhibits sexual function?

Answer 6

serotonin

Question 7

What are the two main disorders of desire?

Answer 7

hypoactive sexual desire disorder

sexual aversion disorder

Question 8

What is the prevalence of hypoactive sexual desire disorder?

Answer 8

up to 20% of the general population, more common in women

Question 9

What are the two disorders of arousal?

Answer 9

male erectile disorder

female sexual arousal disorder

Question 10

What are the features of male erectile disorder?

Answer 10

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

Question 11

What is the main feature of female sexual arousal disorder?

Answer 11

inability to maintain lubrication until completion (up to 33% of women)

Question 12

What are the two general orgasmic disorders?

Answer 12

male/female orgasmic disorder - inability to achieve an orgasm after a normal excitement phase (30% of women and 5% of men)

premature ejaculation

Question 13

What are the tow main sexual pain disorders?

Answer 13

dyspareunia and vaginismus

Question 14

Describe dyspareunia.

Answer 14

genital pain before, during or after sexual intercourse. much higher incidence in women.

Question 15

Describe vaginismus.

Answer 15

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

Question 16

What are the pharmacological treatments for erectile disorder?

Answer 16

phoosphodiesterase 5 inhibitos like sildenafil

alprostadil is injected into the corpora cavernosa or transurethrally to act locally

Question 17

What are the pharmacological options for premature ejaculation?

Answer 17

SSRIs and TCAs (basically using their sexual side effects for good use)

Question 18

What are the pharmacological treatments for hypoactive sexual desire disorder?

Answer 18

testosterone replacement for men (and maybe with low doses in women to improve libido)

estrogen replacement in women

Question 19

Which paraphilia is comprised of sexual pleasure from touching or rubbing against a nonconsenting person?

Answer 19

frotteurism

Question 20

What paraphilia is comprised of watching unsuspecting nude individuals in order to obtain sexual pleasure?

Answer 20

voyeurism

Question 21

What is the difference between sadism and masochism?

Answer 21

sadism is gaining pleasure form hurting or humiliating another

masochism is gaining pleasure from being humiliated or beaten

Question 22

What’s the term for sexual excitement from calling unsuspecting women and engaging in sexual conversations with them?

Answer 22

telephone scatologia

Question 23

What are the three most common types of paraphilias?

Answer 23

pedophilia, voyeurism, and exhibitionism

Question 24

What are the main psychotherapies involved in treatment of paraphilias?

Answer 24

insight-oriented is most common

aversive conditioning