Sexual Dysfunctions Flashcards
What is the definition of a Sexual Dysfunction?
Anything that makes normal arousal and sexual response to be difficult or impossible. Dysfunctions should be not confused with paraphilias (arousal and response are dependent on unusual objects or behaviours. Their physiological response is intact)
Describe the 4 types of sexual dysfunctions
- Sexual Desire - not feeling or wanting to have sex
- Sexual arousal
- Orgasmic - difficult to have an orgasm or orgasm happens too quickly
- Sexual pain - keep in mind pain is not a normal aspect of sex
Describe organic cause of a sexual disorder
Examples incl. Physical trauma, illness, developmental differences, drug use, hormone changes. (these causes should be explored before any of the other causes are explored). ie. ask about any drugs/medicine patient is using
Describe psychogenic cause of a sexual disorder
More of a cause to do with the mind. Examples incl. associations with low self esteem and confidence, anxiety and stress, history of assault or abuse, disagreement of personal values
Describe Cultural/Interpersonal as a cause of sexual disorders
Examples incl. relationship issues, marital problems or differences in values and beliefs, and could also be mis match of behaviors and desires. This usually stems from a lack of sexual experience or information
Describe the process of how you would determine the cause of the disorder
- Has the problem always existed? or is it something that was acquired? Is it a sudden onset or has it been more gradual?
- Is the problem generalized (happens no matter what the situation) or situational? (ex. troubles with erections happen only when having sex, but when alone erections happen)
- When the problem has been life long immediately it becomes a generalized issue
- all three causes can be mixed into creating the disorder
- when assessing the problem keep these points in mind:
1. there is a correlation that men who show erectile dysfunction at 40 will have heart disease at 50 years old
2. blood pressure medications are well known for erectile dysfunction
3. if the person is taking cholesterol medications - this is an indication that circulatory issues may exist
What are some treatment strategies?
Early treatment dealt with Freud’s psychoanalytic model
While masters and Johnson looked at it from a behavioural approach (by bringing each individual partner to talk about things such as self esteem issues, etc. when their partner is not there)
Kaplan - psychosexual therapy
While most physicians today use more of an all encompassing approach allowing them to look at attitudes, and individualize therapy and counselling
What are some aspects of sex counselling?
The main goal is to provide information and correct the misinformation some people have, by doing this you change attitudes, and reduce anxiety.
Low or Inhibited Sexual Desire (For both Men and Women)
5 dysfunctions for both men and women
Description of disorder: Individual does not feel like having sex, no urge or motivation and they will not initiate towards sexual activity. However, they still show normal physiological function.
Causes:
- Hormone deficiencies (testosterone)
- depression and anxiety
- relationship dissatisfaction
- history of assault or abuse
Treatment:
- relationship counselling and sex education
- therapy for psychological illnesses and abuse
- behavioural exercies (sensate focus) –> allows for the individual to explore their partners body, the giver will touch parts of the body not involving the genitals and then add the genitals but not to orgasm then eventually the purpose of touching is to orgasm. ( good for MS or spinal cord injury individuals, since they have lost sensation in several places - therefore you find other places where sensation exists)
Compulsive Sexual Behaviour
for both men and women
Description of disorder: constant sexual desire, but they cannot have satisfying sexual interpersonal relationships
Cause: Organic (ex. a disease or injury to the brain), having a strong need for love but inability to relate
Treatment: Lifestyle counselling (however, it doesnt really work, therapy medications work a lot better)
Sexual Aversion (For both men and women)
Description: extreme negative reaction to sexual activity. repulsed by genitals, more often women. When sex is initiated they become anxious, or have a panic attack.
Cause: shame, fear and anxiety, history of abuse or assault.
Treatment: medications (ex. anxiety medications), counselling (dealing with assault and abuse issues)
Frequency of sexual activity and choice of behaviors (both men and women)
Description: a couples sex desires are not matching up, there are differences in timing, sex drive, and lifestyle demands, emotional needs and activity preferences.
Treatment: identify and treat causes, relationship counselling
Dyspareunia (both men and women)
Description: painful intercourse
Substance/Medication - Induced sexual dysfunction (both men and women)
symptoms develop during or soon after intoxication or withdrawal, or after exposure to substance/medication
Interest/arousal (female dysfunction)
Description: Inadequate excitement and vaginal lubrication
Cause:
- Diabetes (very common - half of all women with diabetes will have some sort of sexual dysfunction)
- Reduced levels of estrogen
- circulatory problems
- anxiety or stress
- alcohol, medications
- negative associations with sex (abuse)
Treatment:
- physical causes –> medication
- sex counselling to reduce anxiety
- relationship counselling
