Sexual function, dysfunction and deviance Flashcards
Four phased model of sexual response
○ Excitement, Plateau, Orgasm, and Resolution
substance stimuli is called
aphrodisiac
Excitement is Characterized by two physiological processes
○ Vasocongestion: Increase in blood flow to body tissues, especially genital
tissue
chest and torso (Women more common)
○ Myotonia: Voluntary/involuntary tensing/contracting of muscles throughout the body, genital
region
_____: Increase in blood flow to body tissues, especially genital
tissue
Vasocongestion
_____: Voluntary/involuntary tensing/contracting of muscles throughout the body, genital
region
Myotonia
Plateau
● Sexual tension continues to increase
● Vasocongestion and myotonia become more pronounced
● Considered an extension of the excitement phase
● Prolonging this phase is known as “edging” and may enhance the pleasure of a
subsequent orgasm
Resolution
● Occurs once all stimulation stops
● Resolution can occur after any of the prior phases
● Genitals return to their non-aroused state
● Heart rate and breathing slow
● This phase can take minutes to hours
● Behaviors during this phase vary
○ Relaxation and sleep
○ Cuddling or physical intimacy
T/F Problems in one sexual stage do not necessarily translate to problems
in other stages
T
_____ is a disturbance in one or more phases of the sexual response cycle
Sexual Dysfunction
● A survey of middle-aged adults found ___ % of men and ____% of women in
the general population reported some degree of sexual dysfunction
31; 43
Prolonging this phase is known as “edging” and may enhance the pleasure of a
subsequent orgasm
plateau
Considered an extension of the excitement phase
plateau
Five areas to address with patients who present with sexual problems:
- Explicit symptoms or questions the patient is having
- Onset and course of symptoms
- Patient’s perception of the cause and maintenance of the problem
- Medical evaluation, including medical history, past treatment, and
outcome - Current expectations and goals for treatment
Medical Conditions & Treatments that affect sexual performance
● Arthritis, bone/joint disease
● Diabetes mellitus
● Endocrine problems
● Injury to autonomic nervous system by surgery or radiation
● Liver or renal failure
● Vascular Disease
● Mood disorders
etc.
Non-prescription medicines that have side effects of sexual issues
Some over-the-counter antihistamines and decongestants can cause
erectile dysfunction or problems with ejaculation.
Sexual side effects of antidepressants
● Tricyclic antidepressants, including amitriptyline (Elavil), doxepin
(Sinequan), imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor)
● Monoamine oxidase inhibitors (MAOIs), including phenelzine (Nardil)
and tranylcypromine (Parnate)
● Antipsychotic medications, including thioridazine (Mellaril), thiothixene
(Navane), and haloperidol (Haldol)
● Anti-mania medications such as lithium carbonate (Eskalith, Lithobid)
● Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine
(Prozac), sertraline (Zoloft), and paroxetine (Paxil).
The following medications may cause erectile dysfunction:
● Anti-hypertensive medications (used to treat high blood pressure)
○ Diuretics, including spironolactone (Aldactone) and the thiazides (Diuril, Naturetin, and others)
○ Centrally acting agents, including methyldopa (Aldomet) and reserpine (Serpasil, Raudixin)
○ a-Adrenergic blockers, including prazosin (Minipress) and terazosin (Hytrin)
○ b-adrenergic (beta) blockers, including propranolol (Inderal) and metoprolol (Lopressor)
The following medications may decrease sexual desire:
● Hormones
○ Leuprolide (Lupron)
○ Goserelin (Zoladex)
_____: behavior that significantly differs from cultural norms for a person’s birth sex
Gender-nonconforming Behaviors
It is often part of normal childhood development for a child to experiment with behaviors outside the norm.
Gender-nonconforming Behaviors
Gender Dysphoria
If the perceived mismatch between birth sex and the internal sense of gender identity causes significant distress or functional impairment, a clinical diagnosis of gender dysphoria may be appropriate
Gender Dysphoria in children
Marked incongruence between a child’s gender assigned at birth and
their experienced and/or expressed gender. Symptoms can include the following:
Gender dysphoria in adults
Marked incongruence between a person’s assigned gender/secondary sexual
characteristics, and their experienced and/or expressed gender. Symptoms can include the following
Paraphilias
Any intense and persistent sexual interest, attraction, or behavior that is outside the
phenotypic or culturally normal range of sex interest
Paraphilias - Voyeuristic Disorder
Clinical Presentation/Diagnosis: Sexual arousal or satisfaction from
observing an unsuspecting victim naked or engaging in sexual activity (peeping tom)
Paraphilias - Exibitionistic Disorder
Clinical Presentation/Diagnosis: Sexual arousal from displaying their genitals to an
unsuspecting victim.
Paraphilias - Frotteuristic Disorder
Clinical Presentation/Diagnosis: Sexual arousal from touching or rubbing against a nonconsenting person.
○ Legal Ramifications: Depends on the extent of touching, but often results in sexual
assault.
Paraphilias - Sexual Masochism Disorder
Clinical Presentation/Diagnosis: Sexual arousal from the act of being beaten,
humiliated, bound, or generally made to suffer.
○ Can include bondage, beating/whipping, electrical shock, cutting, object insertion
into orifices, urinated or defecated on, hypoxyphilia and asphyxiophilia (Arousal
caused by oxygen deficiency)
Paraphilias - Sexual Sadism Disorder
Clinical Presentation/Diagnosis: Sexual arousal from the physical or psychological
suffering of a non-consenting person. Disorder occurs when the perpetrator has
acted on this urge on another.
Paraphilias - Pedophilic Disorder
Clinical Presentation/Diagnosis: Sexual arousing fantasies, urges, or behaviors
involving sexulal activity with a prepubescent child (usually under age 13)
○ Perpetrator must be at least 16 and at least 5 years older than the child.
○ Symptoms usually include extensive use of child pornography
○ Legal Ramifications: Acting on this is often considered rape.
Paraphilias - Fetishistic Disorder
Clinical Presentation/Diagnosis: Sexual arousal from non-sexual inanimate
objects or nongenital body parts that causes clinically significant distress or
impairment.
○ Objects can include underwear, shoes, or other clothing. Body parts can include feet,
toes, and hair.
○ Activities can include holding, tasting, rubbing, inserting, or smelling objects, often
during sexual activity.
