Sexual Disorders and Paraphilias

Question 1

What are high risk factors in human sexual behavior

Answer 1

Substance Use
Limited access to care
Poor health literacy (STI, Prevention)
Unassertive
Young

Question 2

What are high risk behaviors in human sexual behavior

Answer 2

Unprotected sex of any kind (oral, vaginal, butts hole)
Multiple Sex partners
High risk partners
Sex trade work
Self/partner use of IV drugs

Question 3

What are the 4 phases of the Sexual response cycle

Answer 3

Desire
Excitement
Orgasm
Resolution

Question 4

what are the three components of the Desire phase of the sexual response cycle

Answer 4

1. Sexual Drive
2. Motivation
3. Wish fulfillment

Question 5

What are the two physiological processes occurring during Excitement phase

Answer 5

1. Vasodilation/Constriction - shunts blood to genitals

2. Myotonia: muscle contractions throughout body

Question 6

If orgasm doesn’t occur, how long does resolution take

Answer 6

2-6 hrs.

Question 7

Compare males to females in refractory period

Answer 7

males average 3-10 minutes while females have no refractory period but usually need time for resolution

Question 8

What is the educational benefit of TIMING of the sexual cycle

Answer 8

teach patients about sexual cycle so they know what is normal for them and their partner.

Question 9

Male hypoactive sexual desire disorder

Answer 9

Persistently deficient sexual fantasies and desire for sexual activity taking into account age, context of life, for 6 mo.

Question 10

Allison has been stressed the past 6 months. She seems to have a reduced interest in sexual activity, no erotic thoughts, and when she does have sex there are no genital or non-genital sensations in 75% of her encounters. What does she have.

Answer 10

Female Sexual Interest/Arousal Disorder

Question 11

Dylan, in his age, began 6 months ago experiencing difficulty obtaining an erection, maintaining the erection, and its always a softy (decreased erectile rigidity) . What does he have

Answer 11

Erectile Dysfunction.

Question 12

What is female orgasmic disorder

Answer 12

persistent or recurrent delay in or absence of orgasm in 75-100% for 6 months

See girls in college, it wasnt me, it was you!

Question 13

What is delayed ejaculation

Answer 13

Marked delay in ejaculation and/or infrequency or absence of ejaculation for 6 months.

*must be fuckin nice back when I was a kid we are saying our ABCs backwards not to cum and now they got a whole group of people who say its a disorder must be FUCKIN nice

Question 14

What is premature ejeculation

Answer 14

persistent or recurrent ejaculation with partnered sexual activity within 1 minute of penetration for 6 mo in almost all occasions of sexual activity.

Question 15

What is genito-pelvic pain penetration disorder

Answer 15

Persistent or Recurrent difficulties with 1 or more of the following for 6 mo

1. Vaginl penetration
2. volvovaginal or pelvic pain during intercourse
3. Fear or anxiety about pain
4. tensing or tightening of pelvic floor muscles

Question 16

What is the general approach to treatment for sexual dysfunction

Answer 16

1. evaluate and treat underlying medical conditions
2. Consider medication side effects
3. Education if needed
4. Behavioral therapy if needed
5. Refer for counseling if relationship problems.

Question 17

What is a paraphilia

Answer 17

any intense or persistent sexual interest other than “vanilla” sex with a mature developed person for at least 6 mo.

Question 18

what disorder is highly comorbid in victimizing pharaphilias

Answer 18

antisocial personality disorder

Question 19

What is Sexual Masochism Disorder

Answer 19

derives pleasure from suffering (bondage, humiliation, med school)

Question 20

What is sexual sadism disorder

Answer 20

Arousal from the suffering of other people

-partner may or may not have consented

Question 21

What is fetishistic disorder

Answer 21

seual arousal from non-living objects or specfic focus on non-genital parts

panties or feet

Question 22

What is frotteuristic disorder

Answer 22

Touching or rubbing against non consenting people

males 15-25

Question 23

What is transvestic disorder

Answer 23

Sexually arousing fantasies, urges, behaviors, about cross dressing

Question 24

What is voyeuristic disorder

Answer 24

sexual arousal by watching and unsuspecting person who is naked, disrobing

must be 18+

Question 25

What is pedophilic disorder

Answer 25

Sexual fantasies, urges, or activity with prepubescent child (<13)

must be 16+ and 5 years older than child

Question 26

What is the recidivism rate for pedophiles and what are the risk factors for recidivism

Answer 26

100%

Risk factors

• male victims
• Stranger victims
• Prior Sex offenses
• lack of cohabitation history with adult partners