Sexuality/Disfunction

Question 1

age at which gender identity may start to be expressed

Answer 1

ages 3-4

Question 2

age at which sexuality may be expressed

Answer 2

unlikely before puberty

Question 3

unable to identify w/ assigned birth gender

Answer 3

gender identity disorder

Dx w/ persistent, strong cross gender identity

Question 4

focus of early reproductive years

Answer 4

sexuality explored and reproduction/prevention a priority

Question 5

focus of later years

Answer 5

decline in frequency and satisfaction with intercourse (esp. after menopause)

Question 6

female sexual issues after menopause

Answer 6

• decreased estrogen production
• vaginal atrophy
• dyspareunia

Question 7

homosexual rates

Answer 7

men: 6-20%
women: 3-18%

Question 8

bisexual rates

Answer 8

men: 1-7%
women: 1-2%

Question 9

strong belief starting in childhood that person is born with wrong body gender

Answer 9

transgender/transsexual

Question 10

initiation of female sexual response

Answer 10

willingness -> sensation of desire

Question 11

4 phases of female sexual response**

Answer 11

1. excitement
2. plateau
3. orgasmic
4. resolution

Question 12

phase w/ physical and psychological stimulation (flush, engorgement, HR and BP increase)

Answer 12

excitement phase

Question 13

phase w/ continued engorgement w/ tenting of uterus, clitoral retraction, Bartholin secretion, and muscle tension increase

Answer 13

plateau phase

Question 14

phase w/ release, synchronized contractions (5-12), loss of involuntary muscle tone

Answer 14

orgasmic phase

Question 15

phase w/ return to normal size and position, loss of sex flush, vitals return to normal

Answer 15

resolution phase

Question 16

failure of one or more phases in sexual response cycle

Answer 16

sexual dysfunction

Question 17

3 categories of sexual dysfunction

Answer 17

1. primary: psychogenic, lasts longer
2. secondary: disease/medication
3. situational

Question 18

sexual dysfunction treatment strategies

Answer 18

• evaluate medical conditions
• screen/tx depression, discontent, drug abuse, anxiety, OCD
• reduce/change medications
• address menopause, hormonal changes

Question 19

persistent/recurrent absence of sexual fantasies or desire

Answer 19

hypoactive sexual desire disorder

Question 20

persistent/recurrent version to and avoidance of genital contact

Answer 20

sexual aversion disorder

Question 21

lack of lubrication and vasocongestion, lack of sexual excitement and pleasure - estrogen responsible

Answer 21

sexual arousal disorder

Question 22

delay or absence of orgasm following normal excitement phase

Answer 22

female orgasmic disorder

Question 23

persistent involuntary spasm of muscles of outer third of vagina interfering w/ intercourse

Answer 23

vaginismus

Question 24

genital pain assoc. w/ intercourse

Answer 24

dyspareunia

Question 25

causes of intromission pain

Answer 25

- vestibulitis - vaginismus - fissures - vulvar lesion

Question 26

causes of mid-vaginal pain w/ intercourse

Answer 26

- lack of lubrication - surgical scars - urethral diverticulosis

Question 27

causes of thrust pain w/ intercourse

Answer 27

- endometriosis - interstitial cystitis - pelvic adhesions - neoplasms

Question 28

non-intercourse stimulation causing pain

Answer 28

noncoital sexual pain disorder

Question 29

management of sexual dysfunction

Answer 29

- hormone therapy (estrogen or testosterone) - Sildenafil (Viagra) - clitoral vacuum device (EROS-CTD) - mindfulness and cognitive behavioral therapy lack of desire most difficult to tx, orgasmic more responsive