Sexual Disorders and Paraphilias Flashcards
What is abnormal sexuality?
not a human sex partner
stimulates other than primary sex organs
compulsive and injurious to self or others
Describe high risk factors
substance use
limited access to care
poor health literacy about STI, STI sx and prevention
unassertive
poor communication skills
young age
Describe high-risk behaviors
unprotected genital, mouth-genital, anal sex
multiple sex partners
high-risk partner
sex trade work
self or partner use of IV drugs
Describe undesired outcomes from high-risk factors–> behaviors–> outcomes
STI
unwanted pregnancy
relationship complications
poverty
Describe sexual response cycle
Desire
Excitement
Orgasm
Resolution
Describe desire of sexual response
sexual drive
-biological, genital sensations and thoughts about sex
motivation
-psychological, willingness to offer body for sex
wish fulfillment
-social, hoping or expectation for sex, can be culturally influenced
Describe excitement stage of sexual response
AROUSAL:
lasts several minutes to hours
erection, vaginal lubrication, hardening of nipples
increased respiration, tachy up to 180 bpm, rise in BP
What are the 2 basic physiological processes that occur during the excitement stage of sexual response?
vasodilation/constriction
-engorgement of blood vessels of genitals d/t dilation of blood vessels
mytonia
-muscle contractions in genitals and throughout body
Describe orgasm stage of sexual response
peak of sexual pleasure
release of tension and rhythmic contraction of perinatal muscles and pelvic reproductive organs
3-25 seconds
Describe resolution of sexual response
disgorgement of blood from genitalia
body returns to resting state
if orgasm occurred–> rapid resolution with general sense of well-being
if orgasm did not occur–> can take up to 2-6 hours for resolution
What sexual response stage is erectile disorder associated with?
excitement/arousal
What sexual response stage is delayed or premature ejaculation associated with?
orgasm
What is the difference between male and female hypoactive sexual disorders?
male: with decreased desire
female: with decreased desire, excitement or arousal
Define male hypoactive sexual desire disorder
absent or deficient sexual fantasies and desire for 6 MONTHS
Define female sexual interest/arousal disorder
lack or significantly reduced interest/arousal (at least 3) for 6 MONTHS
interest in sexual activity sexual/erotic thoughts initiation or unresponsive pleasure arousal response sensations during activity
Define erectile disorder
at least one in 75-100% of sexual encounters for 6 months:
difficulty obtaining erection
” maintaining erection until completion
marked decreased in erectile rigidity
Name some RF for ED
HTN or tmt DM smoking CAD peripheral vascular DO blood lipid abn priapism tmt alcoholism antidepressant meds lack of sexual knowledge poor technique interpersonal problems
Describe female orgasmic disorder
delay in or absence of orgasm (75-100% of encounters) for 6 months
Describe delayed ejaculation
all occasions for 6 months:
marked delay in ejaculation, infrequency or absence
Describe premature ejaculation
within 1 minute for 6 months, all encounters
Describe genito-pelvic pain penetration disorder
persistent with 1+ for 6 months:
vaginal penetration
vulvovaginal or pelvic pain
fear or anxiety about pain
tensing or tightening of pelvic floor muscles during attempted penetration
Define paraphilia
sexual interest in things other than genital stimulation or sex with genetically normal, physically mature people
at least 6 months
Describe non-victimizing paraphilias
not likely to present for treatment
described as alternative sexual lifestyle
no severe co-morbid psychopathologies (no other psych issues)
Examples of non-victimizing or legal paraphilias
fetishism
sexual masochism
transvestic fetishism
mild sexual sadism
Examples of victimizing and illegal paraphilias
voyeurism
exhibitionism
pedophilia
sexual sadism
Describe victimizing paraphilias
unlikely to seek treatment
tend to rationalize as defense mechanism
antisocial personality disorder frequent with this paraphilia
Define sexual masochism disorder
sexual pleasure from suffering (humiliation, beaten, bound)
real acts, not simulations
Define sexual sadism disorder
arousal from suffering of another person (physical or psychological)
may or may not have consented (possible victimizing)
Describe Frotteuristic disorder
victimizing
touching or rubbing against non-consenting person in crowded area
male, 15-25
Does transvestic disorder correlate with gender identity?
NO
when guy wants to wear women’s underwear or dress up–> derives sexual pleasure but doesn’t want to become that gender
Define voyeuristic disorder
arousal by watching unsuspecting person naked, disrobe, engage in sexual activity
must be 18+ to diagnose
Describe pedophilic disorder
sexual fantasies, urges, activity with child under 13 (prepubescent)
must be 16+ and over 5 years older than child to diagnose
exclusive–> only arousal from kids
non-exclusive–> usually heterosexual and married
