Sexual Health Flashcards
Sexual Identity:
Gender Identity:
Sexual Orientation:
Sexual Behavior:
Sexual Identity: biological sexual characteristics
Gender Identity: a person’s sense of “maleness” or “femaleness.”
Sexual Orientation: homosexual, heterosexual, bisexual.
Sexual Behavior: The Physiological Responses
• Sexual behavior that is destructive to a person(s), cannot be directed toward a partner, is inappropriately associated with guilt and anxiety, or is compulsive.
Abnormal sexuality:
Sexual function depends on two complex and delicate neurologic pathways:
(1) a connection between the brain and the genitals; and
(2) a reflex loop between the genitals and spinal cord. Both involve the central nervous system (CNS), peripheral nervous system (PNS), and autonomic nervous system (ANS).
Involves difficulty with 1 or more aspect of the sexual response cycle
Result from biological, psychological or interpersonal causes
• May be due to combination of causes
Must cause significant distress to the individual
Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stress
: dysfunction has always been present
vs
: occur after interval when function has been normal: More common than primary sexual dysfunction
Primary (lifelong) sexual dysfunction
Secondary (acquired) sexual dysfunction
General medical conditions
• Diabetes: erectile dysfunction
- Pelvic adhesions: dyspareunia
- Medication side effects • SSRIs: delayed orgasm
- Substance abuse
- Alcohol: erectile dysfunction
• Hormonal or neurotransmitter alterations
Biological Causes of Sexual Dysfunction
Examples of Physiolgocial causes of sexual dysfunciton
Relationship problems, Stress, Depression, Anxiety, Guilt, Performance anxiety
Erectile dysnf: have morning wood and can masturbate
Disorders of Sexual Desire
• Hypoactive
- Reduced or absent fantasies of desires
- Up to 20% of population, more common in women
• Sexual Aversion: Aversion to ALL sexual contact
1+ symptoms occurring >75% of the time
Difficulty in obtaining erection during sexual activity
Difficult maintaining erection until completion of sexual activity
Marked decreased in erectile rigidity
Erectile Disorder (Arousal disorder)
Absent/reduced interest in sexual activity, sexual/erotic thoughts or fantasies, no/reduced initiation of sexual activity, unreceptive to partner’s attempts to initiate, absent/reduced interest to any internal/external sexual cues
Up to 33% of females
Female Sexual Arousal Disorder
Anorgasmia/Female Orgasmic Disorder
• Either symptom present ______
Marked delay in, marked infrequency of, or absence of orgasm
Markedly reduced intensity of orgasmic sensations
- 5% of married women > 35y/o never achieved orgasm • Overall prevalence from all causes: 30%
- Likelihood to have orgasm increases with age
>75% of sexual activity
• Either symptoms present >75% of partnered sexual activity
- Marked delay in ejaculation
- Marked infrequency of absence of ejaculation
Delayed (retarded) Ejaculation
• Persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before individual wishes it
Premature (Early) Ejaculation
Recurrent or persistent involuntary contraction of the perineal muscles surrounding the outer third of the vagina that prevents penile insertion
In some cases, even the anticipation of vaginal insertion may result in muscle spasm
Vaginismus
Genital pain that is associated with sexual intercourse
Most commonly experienced during coitus, it may also occur before or after intercourse
Dyspareunia
Can occur in both males and females, more common in females
• In females: the pain may be described as superficial during intromission or as deep during
penile thrusting
• Chronic pelvic pain common complaint in women with history of sexual assault
• Dyspareunia
• Used to treat sexual desire, arousal and orgasmic disorders
Sensory-focused exercises
• Used to treat premature ejaculation
Squeeze technique
Relaxation, hypnosis, systematic desensitization
•
Aids with reducing anxiety associated with sexual performance • May be helpful with vaginismus
Dilators can help with
Dilators
• Useful to treat vaginismus
SSRIs: delay orgasm, therefore treat
premature ejaculation
Opioid antagonists and vasodilators can be used to treat
erectile
disorders
PDE5 inhibitors (sildenafil) can be used to treat
erectile dysfunction
Intracorporeal injection of vasodilators, implantation of prosthetic devices used to treat
erectile dysfunction
Sense of self as being male or female
Differential exposure to prenatal sex hormones
May or may not agree with physiologic sex or gender role (ie. GID)
Gender identity
Expression of one’s gender identity in society
Societal pressure to conform to sexual norms
May or may not agree with gender identity or physiologic sex
Gender Role
Persistent and unchanging preference for people of the same sex or opposite sex for love and sexual expression
Differential exposure to prenatal sex hormones Genetic influences
True bisexuality is uncommon; most people have a sexual preference
Sexual Orientation
- A condition in which a person has been assigned one gender, usually on the basis of their sex at birth, but identifies as belonging to another gender and feels significant discomfort or is unable to deal with the situation.
- There must be evidence of a strong and persistent cross-gender identification.
- This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
- There must also be evidence of persistent discomfort about one’s assigned sex or a sense of inappropriateness in the gender role of that sex.
Gender Identity Disorder [Gender Dysphoria]
conditions for most sexual reassignment surgeries
- Standard is for the patient to live a cross-gendered lifestyle for 3-12 months.
- For some this “test” may change their minds due to difficulties relating to friends, family, co-workers, etc.
- Patients that undergo SRS must also undergo hormonal treatment
• Affects 70-85% of postpartum women
- Considered NORMAL!
- Relatively mild emotional disturbance
- Mood lability, tearfulness, anxiety, insomnia • Onset peaks 3-5 days post-delivery
- Typically resolves within 2 weeks
- Transient with little intervention required
• “Maternity blues” or “Baby blues”
Most common complication of childbirth • Incidence: = 10-12%
Highest rates in adolescent mothers
Onset typically within 2-12 weeks
• Some consider PPD risk up to 1 year
• However, vast majority will have had symptoms during pregnancy
If previous episode of PPD, 25% chance of relapse with subsequent pregnancies
Postpartum Depression
Risk for post partum depression
- History of depression
- Stressful life events
- Conflictual relationship with baby’s father • Short inter-pregnancy interval
- Low birth weight infant
- Frequent infant health problems
Risk to infant in mom with post partum depression
Infant Risks
Decreased IQ
Slowed language development
Delayed motor development
Delayed cognitive development – object permanence
Less emotional expressiveness
Decreased concentration
Impaired attachment
Increased psychiatric disorders in children
Maternal risk in post partum depression
- Difficulty breastfeeding
- Missed pediatric outpatient appointments & increased emergency room visits
- Marital and relationship difficulties
Sexual dysfunction is defined as d
ifficulty with 1 or more aspect of the sexual response cycle; the dysfunction must be distressing to patient in order to be diagnostic.
____sexual dysfunction is more common than primary sexual dysfunction.
Secondary
In order to diagnose GID, there must be evidence of
persistent discomfort about one’s assigned sex or a sense of inappropriateness in the gender role of that sex.
