Sexual Dysfunction

Question 0

What problems can be experienced during sexual desire?

Answer 0

Lack of loss of sexual desire

Question 1

What are the stages of the sexual response cycle?

Answer 1

Sexual desire
Sexual arousal
Orgasm

Question 2

What problems can be experienced during sexual arousal?

Answer 2

Erectile disorder in men

Sexual arousal disorder in women (constantly aroused)

Question 3

What problems can be experienced with orgasms?

Answer 3

Rapid (premature) ejaculation
Orgasmic dysfunction in women
Inhibited orgasm in men

Question 4

What are some other problems?

Answer 4

Sexual aversion
Lack of sexual enjoyment
Dyspareunia (painful sex)
Vaginismus (spasm upon penetration)

Question 5

What factors can lead to sexual problems?

Answer 5

Problems often present in both partners
More than one problem can exist in an individual
Problems may be lifelong or acquired, generalised or situational, physical and/or psychological

Question 6

How common is sexual dysfunction?

Answer 6

40% of women
22% of men
Receive a diagnosis

Question 7

How can somebody present with a sexual dysfunction?

Answer 7

Overtly eg repeated negatives for pain or discharge
Covertly eg never being happy with contraception
-often reluctance to raise sexual problems

Question 8

What points should be considered when discussing sexual issues?

Answer 8

Empathy
Reassurance
Embarrassment
Stigma
Open and specific questions
Don't make assumptions 
Terminology
Religious/cultural issues
Interview their partner

Question 9

How is a structured clinical interview about sexual dysfunction done?
ie how is it done, what is asked?

Answer 9

Get a detailed description of the problem - time and onset
Find out about relationship with partner
Relevant past relationships 
Medical history and drug use
Family and psychosexual history
Significant life events
Sexuality
Cultural aspects
Coping mechanisms and support networks

Question 10

What (non-physical) treatment is there?

Answer 10

Educative counselling of the individual/couple
Modification of attitudes/beliefs
Facilitation of communication assertiveness
Specific directions for sexual behaviour

Question 11

What physical treatments are there for males?

Answer 11

Oral therapy eg Viagra, testosterone, SSRIs
Local therapy eg EMLA cream
Self injection therapy
Mechanic therapy eg pumps, rings
Surgery eg penile implant

Question 12

What physical therapy is there for women?

Answer 12

Testosterone
Oestrogen
Zestra gel
Lubricants
Clitoral therapy device

Question 13

What approaches are most likely to be successful?

Answer 13

Integrated approach of physical and psychological treatments

Question 14

What are some precipitating factors that lead to sexual problems?

Answer 14

Physical
Psychological
Life events
Partner’s problems

Question 15

Predisposing factors to sexual problems?

Answer 15

False beliefs and concepts
Unrealistic expectations
Poor communication skills
Physical vulnerability 
Early sexual trauma

Question 16

Perpetuating factors (self)?

Answer 16

Loss of confidence
Spectatoring
Guilt and shame
Anger and frustration

Question 17

Perpetuating factors? (Partner)

Answer 17

Breakdown in communication
Pressure to perform
Criticism and hostility
Guilt and self blame

Question 18

What is the cycle that all the risk factors feed into?

Answer 18

Failure, fear of failure, failure…