Sexual DO and Paraphilia

Question 1

What are the risk factors in human sexual behavior? (6)

Answer 1

Substance use
Limited access to care
Poor health literacy (about STI's, the symptoms and prevention)
Unassertive personalities
Poor communication skills 
Young age

Question 2

What are the phases of the sexual response cycle? (4)

Answer 2

1. Desire
2. Excitement/physiologic arousal
3. Orgasm
4. Resolution

Question 3

What is the physiologic process during the excitement phase of the sexual response cycle? (2)

Answer 3

1. Vasodilation/Constriction - blood engorgement of genitals

2. Mytonia - muscle contractions throughout body

Question 4

What is the difference in the resolution phase between biologic males and females?

Answer 4

Males have a refractory period that can vary in time.

Females do NOT have a refractory period

Question 5

For how long do males have to be have absent/deficient sexual desires or fantasies to be dx with male hypoactive sexual desire DO?

Answer 5

6 mo

Question 6

A female presents with her partner who complains she lacks sexual interest in being intimate and is unresponsive to her partners attempts to initiate sexual activity. The patient herself states she is not interested in sexual activity. This has been going on for the last 6 mo. Diagnosis?

Answer 6

Female sexual interest/arousal DO

Question 7

3 male pts were seen separately with the same diagnosis. One has difficulty obtaining an erection for the last 6 mo. One has difficulty maintaining an erection for the last 7 mo. One has noticed marked decrease in erectile rigidity for the last 8 mo. What is the common diagnosis between all of them?

Answer 7

Erectile dysfunction (ED)

*Min. of 6 mo of symptoms

Question 8

Persistent/recurrent delay or absence of an orgasm for 6 mo in females. Dx?

Answer 8

Female orgasmic DO

Question 9

What is delayed ejaculation?

Answer 9

Delay or infrequent/absent ejaculations in males for the last 6 mo.

Question 10

What is premature ejaculation?

Answer 10

Ejaculation ~1 min after sexual activity and before patient prefers. Occurs for at least 6 mo

Question 11

What is genito-pelvic pain penetration DO?

Answer 11

Persistent/Recurrent difficulties for the last 6 mo. with:

• Vag. penetration
• Vulvovag/pelvic pain during penetration
• Fear or anxiety about pain as a result of vag pen.
• Marked tensing/tightening of pelvic floor during attempt to pen.

Question 12

General approach to treatment of sexual DOs? (5)

Answer 12

1. Tx underlying conditions
2. Consider med’s side effects
3. Educate
4. Behavior therapy
5. Counseling for relationship problems

Question 13

Name the paraphilia: Deriving pleasure from ones own humiliation, pain or being bound.

Answer 13

Sexual masochism DO

m = me - acts to ones self

Question 14

Name the paraphilia: Sexual arousal from physical/psychological suffering of a partner

Answer 14

Sexual sadism DO

Question 15

Name the paraphilia: Person is sexually aroused from surprising strangers with flashing their genitals

Answer 15

Exhibitionism

Question 16

Name the paraphilia: A person who thinks feet, knees, pillows or lamps are sexually arousing

Answer 16

Fetishistic DO

Question 17

Name the paraphilia: Person who is sexually aroused by touching/rubbing up against non-consenting people on their commute to work on the metro.

Answer 17

Frotteuristic DO

Question 18

Name the paraphilia: Man who derives sexual pleasure from fantasizing & wearing his wife’s lingerie

Answer 18

Transvestic DO

Question 19

Name the paraphilia: 18+ yo who is sexually aroused from peeping through a neighbors window when they are home and unsuspecting

Answer 19

Voyeuristic DO

“peeping Tom”

Question 20

Name the paraphilia: Sexual fantasies/urges/activity with prepubescent kids

Answer 20

Pedophilic DO