Sexual Dysfunctions (SD) Flashcards

Question 1

Q

What are the specifiers/subtypes of SD

Answer

A

- Nature of onset:

<ul>
<li>Lifelong vs. Acquired</li>
</ul>

- Context:

<ul>
<li>Generalised vs. Situational</li>
</ul>

- Severity:

<ul>
<li>Mild, moderate, severe - based the level of distress</li>
<li>Premature ejaculation is specified by time of ejaculation</li>
</ul>

Question 2

Q

Sexual DESIRE Disorders

Answer

A

- Persistent disinterest in sexual activity

- Distressed by this lack of interest

- Prevalence: 7-33%

<ul>
<li>Age differences: men in 40s (0.6%) vs. 70s (26%)</li>
<li>Gender: men (8%) vs. women (55%)</li>
</ul>

- Most commonfemalesexual dysfunction

Question 3

Q

Male Sexual AROUSAL Disorders

Answer

A

Erectile Disorder (ED)

• Difficulty in obtaining or maintaining erection or marked

decrease in erectile rigidity

• Often spontaneously remits

• Up to 50% of males will have erectile difficulties at some stage

• Prevalence increases with age

• Prevalence higher among:

<ul>
<li>Smokers, Diabetics, Hypertensives</li>
<li>Substance abusers</li>
</ul>

Question 4

Q

Female SEXUAL AROUSAL Disorder

Answer

A

<ul>
<li>Difficulty attaining or maintainign adequate lubrication until completion of the sexual act</li>
<li>Prevalence rates uncertain due to high overlap with the other female SD: 30-50%</li>
<li>Less research focused on females</li>
</ul>

Question 5

Q

Male ORGASMIC Disorderss

Answer

A

Delayed vs. Premature ejaculation

Question 6

Q

Delayed Ejaculation

Answer

A

<ul>
<li>
Maintains erection, but marked delay (or inability) to

~~~
achieve ejaculation, without the person desiring delay
</li>
<li>
Experienced on almost all or all occasions of partners sexual activity
</li>
<li>
Prevalence: 4%
</li>
<li>
Least common male sexual complaint
</li>
</ul>

~~~

Question 7

Q

Premature ejaculation

Answer

A

<ul>
<li>Ejaculation with only minimal stimulation (<1 min after vaginal penetration) and before the man wishes it</li>
<li>Prevalence: *%</li>
</ul>

Question 8

Q

Female ORGASMIC Disorder

Answer

A

<ul>
<li>Marked delay in, marked infrequency of, or absence of orgams</li>
<li>OR markedly reduced intensity of orgasmic sensations</li>
<li>Marked distressed</li>
<li>Lifelong vs. Acquired</li>
<li>Can be situational</li>
<li>Orgasm is a learned (not automatic) response
<ul>
<li>improves with experience</li>
</ul>
</li>
<li>Prevalence: ~51%</li>
</ul>

Question 9

Q

GENITO-PELVIC PAIN/

PENETRATION Disorder

Answer

A

<ul>
<li>Marked difficulty having intercourse/penetration</li>
<li>Mrked vulvo-vaginal or pelvic pain during intercourse or penetration attempts</li>
<li>Marked fear or anxiety about pain or vaginal penetration</li>
<li>Marked tensing of pelvic floor during attempted penetration</li>
</ul>

Question 10

Q

Cycle of Pain in Penetration Disorder

Answer

A

The body anticipates pain, fear/anxiety

>> The body automatically tightens vaginal muscles

>> Tightness makes sex painful, penetration may be impossible

>> pain reinforces/intensifies

>> Body reacts by 'bracing'

>> Avoidance of intimacy

>> Cycle repeats

Question 11

Q

Dyspareunia in Penetration Disorder

Answer

A

<ul>
<li>Persistent or recurrent pain during attempted or completevaginal entry and/or penile vaginal intercourse</li>
<li>Prevalence: 14-27%</li>
</ul>

Question 12

Q

Vaginismus in Penetration Disorder

Answer

A

<ul>
<li>Involuntary spasms of the muscles surrounding the entrance to the vagina, making penetration impossible and/or painful</li>
<li>Prevalence: 5-17%</li>
</ul>

Question 13

Q

What are the limitations of prevalence rates?

Answer

A

<ul>
<li>Different samples

~~~
<ul>
<li>Age groups: 18+, 40+, 70+</li>
<li>Clinical vs. non-clinical</li>
</ul>
</li>
<li>Different measurements
<ul>
<li>Self-report vs. Clinical interview</li>
</ul>
</li>
<li>Different definitions
<ul>
<li>Lack of specificity in definitions</li>
</ul>
</li>
</ul>

~~~

Question 14

Q

Psychogenic Erectile Dysfunction

Answer

A

<ul>
<li>Often sudden onset</li>
<li>Preservation of morning erections and nocturnal erections</li>
<li>Achieve erection with masturbation</li>
<li>May be partner-specific</li>
<li>Younger patient (<40)</li>
</ul>

Question 15

Q

Organic Erectile Dysfunction

Answer

A

<ul>
<li>Gradual deterioration</li>
<li>Decrease in morning erections and nocturnal/night erections</li>
<li>No erections with masturbation</li>
<li>No loss of libido</li>
<li>Presence of co-morbid conditions</li>
</ul>

Question 16

Q

Treatment of Sexual Dysfunction

Answer

A

<ul>
	<li>Medical treatments</li>
	<li>Behavioural therapy</li>
	<li>CBT</li>
	<li>Internet-based treatments</li>
</ul>

Question 17

Q

Medical treatments for MALE sexual dysfunction

(Erectile Dysfunction)

Answer

A

<ul>
	<li>Sildenafil (Viagra), Levita and Cialis
	<ul>
		<li>Highly effective (70-90%)</li>
		<li>Dose modification may be necessary over time</li>
		<li>Lead toincreased satisfaction in both men &amp; women</li>
	</ul>
	</li>
	<li>Penile Injections
	<ul>
		<li>Injections of smooth muscle relaxing drugs into erection chambers</li>
	</ul>
	</li>
	<li>Vacuum devices
	<ul>
		<li>Erection limited to 30mins</li>
		<li>Results: 80-90% but high drop out rate</li>
		<li>Complications: coolness, numbness, pain with ejaculation</li>
	</ul>
	</li>
	<li>Penile prothesis (inflatable)
	<ul>
		<li>'Last-resort' treatment</li>
		<li>Out-patient surgery</li>
		<li>Minimal complications (<5%), high satisfaction rate</li>
	</ul>
	</li>
</ul>

Question 18

Q

Medical treatments for FEMALE sexual dysfunctions

Answer

A

Pharmacological interventions:
Hormonal therapy: vaginal or systemic oestrogen and androgen
Sildenafil (Viagra): limited effectiveness, promo sign to address medication side effects

Limitations:
Heavy focus on objective measures
Not enough focus on subjective experience and relationship issues

Question 19

Q

Non-pharmacological treatments for FEMALE sexual dysfunction

Answer

A

Kegel exercises and vaginal weights
Strengthen the muscle of the pelvic floor

Vaginal lubricants:
Minimise dryness and/or pain during sexual activity

Vaginal moisturisers:
Non-hormonal products
Improve overall vaginal health by restoring lubrication and the natural pH level to the vagina and vulva

Vaginal dilator:
Plastic/rubber tube used to stretch the vagina
To treat vaginismus and dyspareumia

Eros ctd: Female vacuum therapy
FDA-approved to treat female sexual arousal disorder
Requires prescription
Creates gentle suction over the clitoris to cause engagement
Improves vaginal blood flow and lubrication
Improve respond in sensation, lubrication, orgasm, and satisfaction

Question 20

Q

What are the barriers to treatment uptake and retention in SD?

Answer

A

Patients unaware of availability sources
Lack of referral
Embarrassment (patients and/or GP providers)
Lack of engagement (either or both partners)
Minimal attention to partners (not included or assessed)

Question 21

Q

What are some of the limitations in treatment research for SD?

Answer

A

Inadequate research methodology
Limited treatment focus: commonly do not work form a bio-psycho-social perspective
Paucity of studies

Question 22

Q

Pharmacological interventionsfor FEMALE sexual dysfunction

Answer

A

•Hormonal therapy: vaginal or systemic oestrogen &

androgen

• Sildenafil (Viagra): limited effectiveness, promising to

address medication side-effects

•Limitations: Heavy focus on objective measures

rather than subjective experience and

relationship issues

Question 23

Q

NON-PHARMACOLOGICAL INTERVENTIONS

for FEMALE sexual dysfunction

Answer

A

- Kegel exercises and vaginal weights

<ul>
<li>aimed at strengthening the muscle of the</li>
</ul>

- Vaginal lubricants

<ul>
<li>usually a liquid/gel that is applied around the clitoris,labia and inside the vaginal entrance to minimise drynessand/or pain during sexual activity</li>
</ul>

- Vaginal moisturisers

<ul>
<li>non-hormonal products</li>
<li>improve overall vaginal health by restoring lubricationand the natural pH level to the vagina and vulva</li>
</ul>

- Vaginal dilators

<ul>
	<li>
	<p>Plastic/rubber tube used to stretch the vagina</p>
	</li>
	<li>
	<p>To treat vaginismus &amp; dyspareunia</p>
	</li>
</ul>

-Eros ctd: Female vacuum therapy

<ul>
<li>
FDA-approved to treat female sexual arousal

~~~
disorder
</li>
<li>
Requires prescription
</li>
<li>
Creates gentle suction over the clitoris to causeengorgement
</li>
<li>
Improves vaginal blood flow and lubrication
</li>
</ul>

~~~

Question 24

Q

SENSATE FOCUS exercises

Answer

A

• Non-goal-oriented physical intimacy

<ul>
<li>Takes the pressure off of“performance” and achieving orgasm</li>
</ul>

• Focus on sensation of touching yourpartner

• Exploring sensual touching beyond thegenitals

• Discovering whether aspects of intimacybring up any feelings of discomfort

Question 25

Q

INTERNET-based TREATMENTS for sexual dysfunction

Answer

A

• Personalised, interactive ONLINEPSYCHO-EDUCATIONAL RESOURCE

• For cancer patients and partners

• 6 self-led online modules

• Tailored according to:

<ul>
	<li>Type of user (patient &amp;/or partner)</li>
	<li>Gender of user</li>
	<li>Sexual orientation</li>
</ul>

• RCT stage

Question 26

Q

What are some of the barriers to treatment uptake and retention in SD?

Answer

A

• Patients are unaware of available resources

• Lack of referral

• Embarrassment (patients and/or GP providers)

• Lack of engagement (either or both partners)

• Minimal attention to partners (not included or assessed)

Question 27

Q

What are some limitations to treatment research for SD?

Answer

A

• Inadequate research methodology

• Limited treatment focus: commonly do not workfrom a bio-psycho-social perspective

• Paucity of studies

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Sexual Dysfunctions (SD) Flashcards

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