Sexual dysfunction

Question 1

Key facts/problems with sampling

Answer 1

• Almost half of women experience at least 1 sexual dysfunction
• Common across all ages

Different samples:
- Need to identify age group
- Clinical vs non-clinical

Different measurements:
- self report vs clinical interview
- What are we measuring? are they the right questions?
“Are you sexually active” vs “how satisfied are you with your sex life?”

Question 2

Kaplan’s triphasic (3-stage) model of sexual response

Answer 2

• Based on work of Masters and Johnson
• Assumes individuals progress through a series of stages
• Widely used
• Desire > excitement > orgasm

Limitations:
- Too simplistic, linear and focuses on genital responses
- Assumes sexual desire is spontaenous, automatic drive
- Idea that desire and arousal are seperate entities
- Idea that psychological, relational, and contextual aspects are secondary to the physiological aspects of sexual response

Question 3

Basson’s (2000) model of FEMALE sexual response

Answer 3

Reconceptualisation of FEMALE sexual problems/dyfunction
- A circular rather than a linear model
- recognises the complexity and importance of intimacy and psychosocial aspects of wellbeing.

Important also to consider the biopsychosocial aspects of the causes, maintenance and treatment of sexual dysfunction

Question 4

DSM-5 sexual dysfunction disorders

Specifiers/subtypes

Answer 4

Nature of onset: lifelong or acquired
Context: generalized or situational
Severity: mild, moderat or severe (based on distress)

Types
Male Hypoactive Sexual desire disorder
- Persistent lack of sexual desire, fantasies taking into account age and sociocultural context

Erectile disorder: Psychogenic/organic
- Marked difficulty in achieving and maintaining erection during sexual activity
- Approximately in 75-100% occasions

Delayed ejaculation:
- Marked delay, infrequency or absence of ejaculation

Premature ejaculation:
- Persistent or recurrent ejaculation within 1 minute of insertion and before individual wishes it

Female sexual interest/Arousal disorder
At least 3:
- reduced or absent sexual desire
- reduced or absent sexual/erotic thoughts/fantasies
- Reduce intitation, unreceptive to sex
- Absent sexual excitement/pleasure
- Absent sexual interest/arousal
- Absent or reduced gential/non-genital sensations

Female orgasmic disorder:
- Marked delay in, infrequency of, or absence of orgasm
- Markedly reduced intensity of orgasm
If it is the resulf of inadequate sexual stimulation, diagnosis is not applicable.
Many women reach orgasm via clitoral stimulation, while fewer via vaginal penetration

Question 5

Female orgasm - issue

Answer 5

High level of variation in orgasm occurrence and experience particularly among women

91.3% of men reached orgasm during most recent sexual experience compared to 64.4% of women

Question 6

Genito-Pelvic pain/penetration disorder

Answer 6

• Vaginal pain during intercourse
• Fear or anxiety when anticipating penetration
• Often due to tightening or tensing of pelvic floor muscles
• Inadequate sexual stimuli?

Cycle of pain: Body comes to associate sex with pain > body tightens vaginal muscles>tightening makes sex painful, penetration may not be possible > pain reinforces further tightening > body reacts by bracing to protect from pain > avoidance of intimacy/lack of desire may develop

Main issue: most people do not seek help