Sexual Disorders and Paraphilias (Schmidt) Flashcards
high-risk factors for sexual health (5)
- substance use
- limited access to care
- poor health literacy
- unassertive
- poor communication skills
high-risk sexual behaviors (5)
- unprotected
- multiple sex partners
- high-risk partners
- sex trade work
- self or partner use of IV drugs
4 phases of sexual response
1) desire
2) excitement
3) orgasm
4) resolution
components of desire (3)
1) sexual drive
2) motivation
3) wish fulfillment
components of excitement (2)
- arousal (erection/vaginal lubrication/nipples harden)
1) vasodilation/constriction
2) myotonia
describe orgasm
- peak of sexual pleasure
- release of sexual tension and rhythmic contraction of the perinatal muscles
describe resolution
- disgorgement of blood from the genitalia
- body returns to its resting state
Classification: female impaired desire
female sexual interest/arousal disorder
classification: male impaired desire
male hypoactive sexual desire disorder
classification: female impaired excitement
female sexual interest/arousal disorder
classification: male impaired excitement
erectile disorder
classification: female impaired orgasm
female orgasmic disorder
classification: male impaired orgasm
delayed ejaculation/premature ejaculation
classification: female sexual pain
Genito-pelvic pain/penetration disorder
male hypoactive sexual desire disorder
- persistently deficient (or absent) sexual fantasies and desire, for 6 months
- take into account age and the context of the person’s life
female sexual interest/arousal disorder criteria
lack of sexual interest/arousal with AT LEAST 3 of the following, for 6 months:
- reduced interest in sexual activity
- reduced sexual thoughts/fantasies
- reduced initiation of sexual initiation, unreceptive to partner’s attempts to initiate
- absent of reduced sexual pleasure
- absent or reduced sexual interest/arousal inreponse
- absent or reduced genital sensations
criteria for erectile disorder
at least one of the three following symptoms must be experienced on almost all or all occasions of sexual activity, for 6 months (75-100% sexual encounters)
1) difficulty obtaining an erection
2) difficult maintaining an erection until completion of sexual activity
3) marked decrease in erectile rigidity
criteria female organism disorder
persistent or recurrent delay in, or absence of, orgasm or reduced intensity (75%-100%) following a normal sexual excitement phase, for 6 months
criteria delayed ejaculation
either of the following symptoms must be experienced on almost all or all occasions, for 6 months
- marked delay in ejaculation
- marked infrequency or absence of ejaculation
criteria premature ejaculation
persistent or recurrent ejaculation with partnered sexual activity within approximately 1 minute following penetration and before the patient prefers it, for 6 MONTHS, for almost all or all occasions of sexual activity
criteria Genito-pelvic pain penetration disorder
persistent or recurrent difficulties with 1 or more of the following, for 6 months:
- vaginal penetration during intercourse
- marked vulvovaginal or pelvic pain during penetration on intercourse
- marked fear or anxiety about pain as a result of vaginal penetration
- marked tensing or tightening of the pelvic floor muscles
general approach to treatment sexual disorders (5)
1) evaluate/Tx underlying medical conditions
2) consider medication side effects
3) education
4) behavior therapy
5) refer for counseling
describe sensate focus
behavioral therapy: no intercourse allowed for a period of time, then systematically re-introduce sexual stimulation
paraphilia definition
any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners, for at least 6 months
