Sexual Dysfunction Flashcards
Vaginismus
- Involuntary spasm of the musculature of the outer 3rd of the vagina that interferes with penetration, which causes distress
Noncoital sexual pain disorder
- genital pain induced by noncoital sexual stimulation
Women’s Health Challenges of aging
- Menopause
- Incontinence
- Surgery: hysterectomy, mastectomy, reconstruction
Factors that ease women’s talking to providers about sexual concerns
- Provider seems concerned
- provider seems comfortable
- Provider seems caring and understanding
- Professional demeanor
- Has seen provider before and knows patient
Medical conditions associated with sexual dysfunction
- Medical: thyroid Dz, hyperprolactinemia, depression, adrenal insufficiency
- Meds: Antidepressants, corticosteroids, oral estrogen therapies
Arousal/Orgasm Disorder Treatments
- Vacuum Therapy: Increases blood flow to clitoris
- Electrical stimulation
Vaginal Dryness/Pain Treatment
- Estrogen therapy
- Water-based lubricant
Low Sexual Desire Tx
- Combination estrogen-testosterone therapy
Indications to refer to sex therapist or OB-GYN
- Long-standing dysfunction
- Multiple sexual dysfunctions
- Comorbid psychologic disorders
- Marital problems
- Sexual abuse
- Lack of response
Determinants of Healthy Sexual Function
- Psychological well-being
- Partner relationship
- Developmental experiences
- Physical health
- Medications
- Lifestyle factors (life demands, stress, family, substance abuse)
Masters and Johnson Theory of Sexual Response (1966)
- 4 Phases
1) Excitement (rapid in men)
2) Plateau
3) Orgasmic
4) Resolution - In men, includes refractory period in which erection may not be achieved; refractory period increases in time with age; NO refractory period in women
Kaplan’s Theory of Sexual Response (1979)
- Desire
- Arousal
- Orgasm
Что нибудь
Anything
Z & E Theory of Sexual response (1980)
- Desire
- Arousal
- Physiological readiness
- Orgasmic
- Satisfaction
DSM-IV Theory on Sexual Response
- Appetite (Desire)
- Excitement
- Orgasmic
- Resolution
Medical Model of Sexual Function
- Based on ideal script of regular and mutually desired relations involving erection, vaginal lubrication, and mutual orgasm
- Assumption is that sexual Fx is coital experience
Cultural Model of Sexual Function
- Physical equipment for all human activities exists in everyone
- Activities may never be desired
- May need culture based learning to shape appropriate rules and goals
- Sexual performance that fulfills high expectations requires training, practice, and patience
Female Sexual Dysfunction
- Comorbidity of arousal and desire disorders
- Disorders may vary from one culture to another
- Women complain more often about contextual problems than about functional problems
Reasons for Female Sexual Intercourse
- Procreation
- Physical pleasure
- Emotional intimacy
- Provide a service (often disguised and difficult to admit)
Factors Related to Sexual Problems
- Sociocultural, political, economic
- Partner and relationship
- Psychological
- Medical/physical
Categories of Female Sexual Disorders
- Sexual Desire Disorders: Hypoactive sexual desire disorder; Sexual aversion disorder
- Female Sexual Arousal Disorder
- Female sexual orgasm disorder
- Sexual Pain Disorders: Dyspareunia, Vaginismus, Noncoital sexual pain disorders
Hypoactive Sexual Desire Disorder
- Sexual desire disorder
- Absence of sexual fantasies, thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress
Sexual Aversion Disorder
- Sexual desire disorder
- Phobic aversion to and avoidance of sexual contact sexual contact with a sexual partner, which causes personal distress
Female Sexual Arousal Disorder
- Inability to attain or maintain sufficient sexual excitement, causing personal distress
- May be expressed as lack of subjective excitement, genital lubricant/swelling, or other somatic response
Female Orgasmic Disorder
- Delay in or absence of attaining orgasm following sufficient sexual stimulation and arousal, which causes personal distress
