Sexual Dysfunctions Flashcards
Sexual dysfunction
significant disturbance in the ability to respond sexually or to experience sexual pleasure
-use clinical judgment to determine if due to inadequate sexual stimulation (in which case, no dx is made)
Subtypes of sexual dysfunction dx
Lifelong
Acquired
Generalized
Situational
Delayed ejaculation
Either of following on most occasions of sexual activity w/ partner (75-100%), & no desired delay:
-marked delay in ejaculation
and/or
-marked infrequency or absence of ejaculation
Min time for delayed ejaculation sx to have persisted
at least 6 months
Specifiers of delayed ejaculation
lifelong/acquired
or generalized/situational
least common male sexual complaint
delayed ejaculation
Erectile disorder
At least 1 of following on most occasions of sexual activity (75-100%)
-marked difficulty obtaining erection during sex
and/or
-marked difficulty maintaining an erection until completion of sexual activity
and/or
-marked decrease in erectile rigidity
7 factors to consider w sexual dysfunctions
- partner factors
- relationship factors
- individual vulnerability factors
- psychiatric comorbidity
- stressors
- cultural/religious factors
- medical factors relevant to prognosis, course, or tx
% of men under 50 to complain of erectile disorder
around 2%
% of men 60+ to complain of erectile disorder
40-50%
Female orgasmic disorder
Either of following on most occasions of sexual activity (75-100%):
-marked delay in, marked infrequency of, or absence of orgasm
and/or
-marked reduced intensity of orgasmic sensations
additional specifier for female orgasmic disorder
never experienced an orgasm under any situation
% of women to never orgasm across lifetime
10%
Female sexual interest/arousal dx
Lack of, or sig reduced, sexual interest/arousal, manifested by 3+:
- absent/reduced interest in sexual activity
- absent/reduced sexual/erotic thoughts
- absent/reduced sexual excitement/pleasure during sexual activity in 75-100% sexual encounters
- absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues
- absent/reduced genital or congenital sensations during sexual activity in 75%-100% sexual encounters
Genito-Pelvic Pain/Penetration Disorder
persistent difficulties with 1+ : -vag penetration during intercourse
- vulvovaginal or pelvic pain during vag intercourse or penetration attempts
- fear/anxiety about pain from vag penetration
- tensing or tightening of pelvic floor muscles during attempted vag penetration
% of women who report pain during intercourse in North America
15%
Lifelong sexual dx
problem present from 1st sexual experiences
acquired sexual dx
disorders that develop after a period of sexual function w/in typical norms
generalized sexual dx
sexual difficulties that are not limited to certain types of stimulation, situations, or partners
situational sexual dx
sexual difficulties that only occur w/ certain types of stimulation, situations, or partners
other factors to be considered during assessment of sexual dysfunctions
- partner factors
- relationship factors
- individual vulnerability factors
- psychiatric comorbidity
- stressors
- cultural or religious factors
- medical factors relevant to prognosis, course, or tx
Severity specifier for delayed ejaculation based on ___
distress over sxs
Male Hypoactive Sexual Desire Disorder
Persistent deficiency of sexual/erotic thoughts or fantasies and desire for sexual activity
Clinical judgment accounting for age and general and sociocultural contexts of individual’s life
Minimum sx duration of around 6 months
Sxs cause clinically significant distress
Premature (early) ejaculation
Persistent pattern of ejaculation w/in -1 min after vaginal penetration and before the individual desires
*Specific duration criteria have not been established for nonvaginal sexual activities, but can still be dx
min 6 mos
on most occasions of sexual activity
sxs cause clinically sig distress
