Sexual Dysfunction Flashcards
What are the four phases of sexual response?
- Desire
- Excitement
- Orgasm
- Resolution
What is the prevalence of sexual dysfunction between men and women?
38% of women
29% of men
True or false: multiple types of sexual dysfunction rarely coexists
False
What are the top four issues with female sexual dysfunction?
- Lack of interest
- Lubrication problems
- Anorgasmia
- Pain
What are the top four issues with male sexual dysfunction?
- Premature ejaculation
- ED
- Lack of interest
- Anorgasmia
What are the three general qualities for all sexual (and all psych) dysfunctions?
- specific disorder dysfunction
- Disturbance causes distress
- Not d/t another diagnosis
What is the timeframe that must be had to diagnose sexual dysfunction?
6 months or longer
What are the three major categories of sexual dysfunction?
- sexual interest/arousal disorders
- Orgasm disorder
- Sexual pain disorder
What are the 6 criteria of female sexual arousal disorder? How many are needed to make a dx?
3 of:
- Sensations reduced
- Unresponsive to partner
- Pleasure reduced
- Erotic thoughts
- Response
- Interest reduced
(SUPER-I)
True or false: when women complain of lubrication issues, there is rarely an actual problem
True
What fraction of married women experience sexual disorders?
1/3
What is the definition of ED?
Marked difficulty in obtaining or maintaining an erection of sufficient rigidity during partnered sexual activity
What percent of the time is needed in order to diagnose ED?
More than 75% of the time
How can you prevent ED? (2)
- Continued sexual activity
- Reduce medical causes
What is the definition of orgasm disorders in females?
Persistent, or recurrent delay in, infrequency of, or absence of orgasm, or a markedly reduced intensity of orgasmic sensations
What percent of the time is needed to diagnose female orgasm disorder?
more than 75% of the time
What is the prevalence of female orgasm disorder?
30-40%
What is the treatment for female orgasm disorder? (3)
-Self-exploration
therapy
-Communication
What is the definition of premature ejactulation?
Persistent or recurrent pattern of ejaculation occurring during partnered sex within approximately 1 minute following vaginal penetration, and before the person wishes it
What is the prevalence of premature ejaculation (reported vs meet diagnostic criteria)?
20-30% report it
1-3% meet diagnosis
What is the treatment for premature orgasm disorder?
SSRIs and specific exercises
What are the mild, moderate, and severe criteria for premature ejaculation?
Mild: 30-60 secs
Moderate: 15-30 secs
Severe: less than 15 seconds
What percent of sexual contacts are needed to diagnose premature ejaculation disorder?
75-100%
What is the definition of inhibited orgasm for men?
Persistent or recurrent delay in, or absence of orgasm following a normal sexual excitement phase during sexual activity
What percent of sexual contacts are needed to diagnose inhibited orgasm?
More than 75% of the time
What are the meds that can cause inhibited orgasm?
- SSRIs
- HTN meds
What are the associated psych disorders with inhibited orgasm disorder?
- Closeness issues
- Guilt
- OCD
What are the 4 criteria for pain/penetration disorders?
- Vaginal pain during intercourse
- Marked vulvovaginal or pelvic pain during vaginal intecourse
- Marked fear or anxiety about pelvic pain
- Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration
Does the pain with pelvic/penetration disorder occur before, during, or after intercourse?
Any
What is a predictive factor for pelvic pain/ penetration disorder?
Difficulty with tampon insertion
What are the criteria for substance/medication induced sexual dysfunction?
- Sexual dysfunction is present
- s/sx began during or just after exposure to a substance
- The substance is capable or producing symptoms
What are the mild, moderate, and severe criteria for substance induced sexual dysfunction, in terms of percent of sexual episodes?
Mild: 25-50%
Moderate: 50-75%
Severe: more than 75%
What are some of the non-abused drugs that can cause sexual dysfunction? (4 listed)
- Li
- Anti-anything
What are the unspecified sexual dysfunctions? (5)
- Female premature orgasm
- postcoital HA
- Orgasmic anhedonia
- Masturbatory pain
- Excessive, sexual addictions
What is one of the biggest causes of sexual dysfunction?
Inter-relational conflicts
What are the common emotional problems that cause sexual dysfunction?
Depression/anxiety
What are the treatment options for sexual dysfunction? (many, but list 3)
- Sex/behavioral therapy
- Education/ exercises
- hypnotherapy
What are the pharmacotherapy options for sexual dysfunction?
- SSRIs
- Topical anesthetic
- ED drugs
What is the MOA of ED drugs? What are the three classic ones?
PDE5 inhibitors
- Sildenafil
- Vardenafil
- Tadalafil
What is the best way to treat sexual dysfunction?
Couple treat together
What are paraphilias?
A pattern of recurring sexual arousal mental imagery / behavior that involves unacceptable sexual practices
What is the is the difference between paraphilia and paraphilia disorder?
Disorder is the behavior that results from the paraphilia, whereas paraphilias are just the interests that are out of the norm
What is the major difference between diagnosing paraphilic disorders, relative to all other psych diagnoses?
Does not need to cause discomfort
True or false: most paraphilic disorders appear before age 18
True
True or false: most of the paraphilic disorders are in the homosexual population
False–heterosexual
Which gender usually have paraphilia?
Males
What are the co-occurring disorders of paraphilic disorders?
- Personality DO
- Substance use
What is the most common paraphilia?
Pedophilia
True or false: most paraphilic pts usually have only one paraphilia across their lifetime
False–3-5 types throughout life
Behaviors of paraphilic disorders peak at what age? What happens afterward?
15-25
Decline thereafter
True or false: many pts with paraphilic disorders have typical sex lives
True
What is the psychosocial theory of paraphilic disorder?
Failure to complete the normal developmental process
-Early experience that condition or socialize a child
What are the biological factors of paraphilic disorder?
hormone abnormalities
What are the diagnostic criteria for paraphilic disorder? (3)
- The presence of a pathognomonic fantasy and an intense urge to act out the fantasy or its behavior elaboration
- Unusual sexual material
- Orgams depends on mental elaboration
What is the timeframe needed to diagnose paraphilic disorders?
6 months
True or false: paraphilic diagnoses must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
True
What is exhibitionism?
The exposure of one’s genitals to an unsuspecting stranger
What are the two criteria that must be met to diagnose exhibitionism?
-Acted on
OR
-distressed by it
What is fetishism?
Involving the use of non-living objects
Does crossdressing count as fetishism?
No
What is frotteurism?
Touching and rubbing against a nonconsenting person
What is pedophilia?
Involving sexual activity with a prepubescent child or children (age 13 and younger)
True or false: male premature ejaculation disorder is less common in college+ educated males
False–more common
True or false: pelvic pain disorder is more common in college educated women
True
What sort of history should always be asked with pelvic pain / penetration disorder?
Rape or sexual abuse
What are the commonly abused substances that can cause sexual dysfunction? (6)
- Opioids
- Hallucinogens
- Cannabis
- EtOH
- Barbiturates
- Stimulants
What age must a pt be to be diagnosed with pedophilia?
either 16, OR 5 years older
When in development does pedophilia begin?
Adolescence
True or false: pedophilia tends to be chronic if the preference is girls
False–if boys
What is sexual masochism?
Involving the act of being humiliated, beaten, bounds, or otherwise made to suffer
What is sexual sadism?
Involving acts in which the psychological or physical suffering of the victim is sexually exciting to the person
What is voyeurism?
The act of observing an unsuspecting person who is naked, in the process of disrobing, or engaged in sexual activity
What is transvestic fetishism?
Cross dressing for sexual satisfaction
What are the four major negative prognostic signs for paraphilic disorders?
- earlier onset
- high frequency of acts
- No guilt or shame
- Substance abuse
Is one paraphilia a good or poor prognostic sign for paraphilic disorders?
Good
Is normal intelligence a good or poor prognostic sign for paraphilic disorders?
Good
Is substance a good or poor prognostic sign for paraphilic disorders?
Poor
Is a h/o normal intercourse in addition to paraphilia a good or poor prognostic sign for paraphilic disorders?
Good
What are the treatments for paraphilic disorders?
- Chemical castration
- Dynamic psychotherapy
