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Sexual Dysfunctions Flashcards

1
Q

Definition of Sexual Dysfunctions

A

disorders that make normal arousal and sexual response difficult or impossible

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2
Q

Dysfunctions should be differentiated from…

A

paraphilia in which arousal and response are dependent on unusual objects or behaviours, but physiological response is intact.

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3
Q

Types of Sexual Dysfunctions

A
  1. Sexual Desire Disorders
  2. Sexual Arousal Disorders
  3. Orgasmic Disorders
  4. Sexual Pain Disorders
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4
Q

Causes of Sexual Dysfunctions

A
  1. Organic
  2. Psychogenic
  3. Cultural/Interpersonal
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5
Q

Organic

A

physical trauma, illness, developmental differences, drug use, hormone changes.
+ Any possible organic cause should be investigated before other causes are explored.

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6
Q

Psychogenic

A

associated with low self esteem and confidence, conflict of personal values, history of abuse, anxiety and lack of sexual information.

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7
Q

Cultural/Interpersonal

A

problems arising from predominantly sexual repressive societal values and the feelings and desires of the individual or couple

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8
Q

Situational Dysfunctions

A

occur in given circumstances only, e.g.. with a specific partner or in a specific place.
+ They may be primary (present all of life) or secondary (occurring now or sometimes)

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9
Q

Early treatment methods focused on…

A

Freud’s psychoanalytic model

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10
Q

who introduced the behavioural approach?

A

Masters and Johnson

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11
Q

Kaplan used a combination model that she called?

A

psychosexual therapy

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12
Q

Most practitioners today use an…

A

eclectic approach that allows them to individualize their therapy and counselling to meet the needs of their clients.

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13
Q

Sex Counselling…

A

Changing Attitudes
Providing Information
Giving Permission
Reducing Anxiety

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14
Q

Sexual Desire Disorders

A
  • Low or Inhibited Sexual Desire

- Compulsive Sexual Behaviour

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15
Q

Low or Inhibited Sexual Desire

A
  • Lack of interest, does initiate, does not respond, but normal physiological function.
  • Most common complaint, difficult to resolve.
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16
Q

Low or Inhibited Sexual Desire

– Causes

A
  • hormonal deficiencies, illnessess
  • depression & anxiety
  • relationship dissatisfaction
  • history of assault or abuse
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17
Q

Low or Inhibited Sexual Desire

– Treatment

A
  • relationship counselling and sex education
  • therapy for psychological illnesses and abuse
  • behavioural exercises e.g. sensate focus
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18
Q

Compulsive Sexual Behaviour

A

constant sexual desire with pursuit of gratification, but an inability to have satisfying sexual interpersonal relationships.

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19
Q

Compulsive Sexual Behaviour

– Causes

A
  • organic, e.g. disease or injury to the brain

- strong need for love but inability to relate

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20
Q

Compulsive Sexual Behaviour

– Treatment

A
  • lifestyle counselling or therapy

- medications

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21
Q

Sexual Aversion

A
  • extreme negative reaction to sexual activity

- repulsed by genital (more often women)

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22
Q

Sexual Aversion – Causes

A
  • shame, fear & anxiety

- history of abuse or assault

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23
Q

Sexual Aversion – Treatment

A
  • medications

- psychological counselling

24
Q

Frequency of Sexual Activity & Choice of Behaviours

A

partners’ difference in timing, sex drive, and lifestyle demands, emotional needs and activity preferences.

25
Frequency of Sexual Activity & Choice of Behaviours | -- Treatment
- identify and treat underlying causes | - relationship counselling
26
Dyspareunia
- painful intercourse (most often women) | - see notes on male/female issues
27
Substance/Medication — Induced Sexual Dysfunction
symptoms develop during or soon after intoxication or withdrawal or after exposure to substance/medication
28
Female Sexual Dysfunctions | -- Interest & Arousal Disorders
inadequate excitement and vaginal lubrication
29
Female Sexual Dysfunctions - - Interest & Arousal Disorders - - Causes
-diabetes - reduced estrogen levels - neurological disorders e.g. SCI - anxiety - stress - narcotics, alcohol, medications - negative experiences such as abuse - most often psychological causes related to specific situations
30
Female Sexual Dysfunctions - - Interest & Arousal Disorders - - Treatment
- medical intervention for physical causes - sexual counselling to reduce - performance anxiety relationship counselling
31
Female Sexual Dysfunctions | -- Orgasmic Disorders
(anorgasmic or pre-orgasmic) | - difficulty or inability to achieve orgasm
32
Female Sexual Dysfunctions - - Orgasmic Disorders - - Causes
- guilt or anxiety - insufficient clitoral stimulation - often situational, e.g. Orgasmic in masturbation but not intercourse
33
Female Sexual Dysfunctions - - Orgasmic Disorders - - Treatment
- counselling and education to counteract negative attitude toward sex - self exploration and massage - couple education on female sexual response - education and counselling on alternative sexual activities and use of devices such as vibrators
34
Female Sexual Dysfunctions | -- Dyspareunia
pain intercourse or penetration of the vagina
35
Female Sexual Dysfunctions - - Dyspareunia - - Causes
- most often inadequate vaginal lubrication - vaginal infection of STD’s - P.I.D., endometriosis, other diseases
36
Female Sexual Dysfunctions - - Dyspareunia - - Treatment
- medical intervention for physical causes - use of artificial lubricants - counselling for psychological causes e. g. Low Self Esteem, anxiety - education on sexual techniques e. g. Increased Foreplay
37
Female Sexual Dysfunctions | -- Vulvodynia
- is a condition characterized by vulvar pain, such as chronic burning, sensation, irruption, and soreness. - Although it can lead to painful intercourse not seen as a true sexual dysfunction
38
Female Sexual Dysfunctions | -- Vaginismus
involuntary contractions of the pelvic muscles surrounding the outer third of the vaginal barrel
39
Female Sexual Dysfunctions - - Vaginismus - - Causes
fear of vaginal penetration often related to history of assault or abuse
40
Female Sexual Dysfunctions - - Vaginismus - - Treatment
- use of graduated plastic vaginal dilators - couples sexual activities with women in control - intercourse with women on top - counselling regarding prior abuse
41
Male Sexual Dysfunctions
Sexual dysfunction can be related to: desire, arousal, penetration, erection maintenance, orgasm & ejaculation
42
Male Sexual Dysfunctions | -- Erectile Dysfunction (impotence) (ED)
inability to achieve or maintain an erection of sufficient firmness to have intercourse
43
Male Sexual Dysfunctions - - Erectile Dysfunction - - Causes
- diabetes (1/2 of all) - stress and fatigue - low testosterone - vascular problems - general illness - anxiety about performance - use of abuse of narcotics, alcohol, and medications
44
Male Sexual Dysfunctions - - Erectile Dysfunction - - Treatment
- 50% psychological — therapy aimed at decreasing anxiety so sexual response can occur normally. Treatment could include sensate focus etc. - medical intervention for physical causes - Vacuum Pump - Penile Injections - Penile Prostheses — Malleable - Penile Prosthesis — Inflatable
45
Male Sexual Dysfunctions - - Erectile Dysfunction - - Treatment - - Penile Injections
- gold standard of therapies for ED | - mixture(s) of: papaverine, PGE1, phentolamine, foreskolin
46
Male Sexual Dysfunctions - - Erectile Dysfunction - - Treatment - - Penile Prosthesis (Inflatable)
3 piece: most natural appearing erection & excelling flaccidity for optimal concealment 2 piece: easier implantation & larger scrotal pump Complications: infection, erosion, deformities, mechanical malfunction
47
Male Sexual Dysfunctions | -- Premature Ejaculation (Rapid Ejaculation) (RE)
is an inability to delay ejaculation as long as he wishes
48
Male Sexual Dysfunctions - - Premature Ejaculation (Rapid Ejaculation) (RE) - - Causes
Most have psychological causes: - Masturbating in secret, learned for immediate gratification - 1st sexual experience in less than ideal situations etc… - anxiety
49
Male Sexual Dysfunctions - - Premature Ejaculation (Rapid Ejaculation) (RE) - - Treatment
- Goal of therapy is to train the man to focus his sensations. This focusing teaches him to anticipate orgasm and to gain control over the timing of his ejaculation. - Two Primary methods: 1. stop & go technique 2. squeeze techniques
50
Male Sexual Dysfunctions | -- Ejaculatory Incompetence
inability to ejaculate after penetration despite firm erection and sufficient arousal
51
Male Sexual Dysfunctions - - Ejaculatory Incompetence - - Causes
Primarily psychological, anxiety related with penetration and ejaculation
52
Male Sexual Dysfunctions - - Ejaculatory Incompetence - - Treatment
Focus on the psychological causes for the inhibition along with the use of sensate focus exercise, also can use behaviour approach
53
Male Sexual Dysfunctions | -- Dyspareunia - Genito-Pelvic Pain / Penetration Disorders
recurrent or persistent genital pain occurring either before, during or after intercourse (not very common)
54
Male Sexual Dysfunctions - - Dyspareunia - Genito-Pelvic Pain / Penetration Disorders - - Causes
- Usually associated with an organic condition, such as herpes, prostatitis, or Peyronie’s Disease (curvature of penis caused by sclerotic plaques on the penis) - Peyronie’s Disease: acquired disorder of the tunica albuginea Fibrous plaque, pain & penile curvature -- Treatment: Orally can take Vitamin E & Cochicine, Ultrasound, Surgery
55
Male Sexual Dysfunctions - - Dyspareunia - Genito-Pelvic Pain / Penetration Disorders - - Treatment
Medical intervention to address underlying organic causes

HECOL 211 (16 decks)

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