Sexual Dysfunctions Flashcards
How prevalent is sexual dysfunction?
40-45% of women and
20-30% of men reported as having one or more sexual dysfunction
What what are the criteria sexual dysfunctions?
> A clinically significant disturbance in a person’s ability to respond sexually or experience sexual pleasure - there must be significant distress!
A minimum duration of 6 months - new criteria
Experienced on allmost all or all occasions of sexual activity (75-100%)
Consider cultural values and age
What are the specifiers/subtypes?
Nature of onset: > Lifelong or acquired Context: > generalized or situational Severity: > mild, moderate, severe, or extreme
What was the major change from DSM IV to DSM V
IV:
> Defined in terms of simple linear stages of sexual response - desire, arousal, orgasm.
V:
> Replaced the three stages of sexual response cycles by GENDER SPECIFIC DISORDERS
What female disorder was removed from IV to V
Sexual Aversion Disorder
What are the three female sexual dysfunctions in the DSM-V
> Female sexual interest/arousal disorder
Female orgasmic disorder
Genito-pelvic pain/penetration disorder
Sexual Desire Disorders
> Persistent disinterest in sexual activity
prevalence: 7-33%
increases with age
much higher in women - not necessarily lower libido in females, just more distress regarding the low libido levels
It is the most common female sexual dysfunction
Male sexual arousal disorders: Erectile Disorder (ED)
> Difficulty in obtaining or maintaining erection
Often spontaneously remits
Up to 50% of men will have ED at some stage
Will increase with age
Prevalence higher among smokers and substance abusers etc
Female sexual arousal disorder
> Desire to have sex but their body is not responding well enough - not lubricating; not enough blood to labial area; dryness and pain during sex
Prevalence rate uncertain due to overlap with other female disorders: 30-50%
less research in this area for females than men
Male orgasmic disorders
Delayed ejaculation:
> without person desiring the delay
> experienced on almost all or all occasions of partners sexual activity - can still ejaculate during masturbation
> least common male dysfunction
Premature ejaculation:
> Ejeculating with only minimal stimulation and before thy desires it
Female orgasmic disorder
> Marked delay, infrequency, or absence of orgasm, or markedly reduced intensity
WOMAN MUST BE CLINICALLY DISTRESSED ABOUT HER SYMPTOMS
lifelong vs acquired; can be situational
prevalence: 50%
Gential-pelvic pain/penetration disorder
Common comorbid symptoms:
> marked difficulty having intercourse/penetration
> vulvo-vaginal or pelvic pain during intercourse
> fear or anxiety about pain
> tensing of the pelvic floor during attempted pentration - body anticipates pain -> becomes anxious -> tightens muscles - VISCOUS CYCLE!
Dyspareunia: persistent or recurrent pain during intercourse
Vaginismus: tightening of vaginal muscles
What are the limitations of prevalence rates (3)
> Different samples - 20+ 40+ 70+ etc
Different measurements - self report vs clinical
Different definitions
Aetiology (3)
Psychological Factors: > culture and rearing > body issues > self-esteem > depression etc Physiological Factors: > ageing > illness > medication > substance use Relational-interpersonal Factors: > Attraction > Satisfaction w/non-sexual aspects
Psychogenic vs Organis Erectile Dysfunction
Psychogenic:
> Often sudden onset
> erection through masturbation
> younger patient
Organic:
> gradual course of deterioration
> no erections through masturbation
> older patients
