-Sexuality -Sexual response -Types of Sexual Orientation -Other types of sexual expression -Sexual Harassmnet -Disorder of sexual fuctioning Flashcards
It is a multidimensional phenomenon
that Includes feelings, attitudes, and
actions.
It has both biologic and cultural
components.
It encompasses and gives direction
to a person’s physical, emotional,
social, and intellectual responses
throughout life.
SEXUALITY
is the term used to denote a
person’s chromosomal sex: male (XY) or female
(XX).
Biologic gender
identity is the inner
sense a person has of being male or female,
which may be the same as or
different from biologic gender.
Gender identity or sexual
is the male or female
behavior a person exhibits, which,
again, may or may not be the same
as biologic gender or gender identity
Gender role
SEVERAL THEORIES EXIST
REGARDING THE DEVELOPMENT OF
GENDER IDENTITY ARISES FROM
PRIMARILY A BIOLOGIC OR A
PSYCHOSOCIAL FOCUS.
a The amount of testosterone secreted in
utero (a process termed sex typing) may
affect how gender develops.
b Role models portray their gender roles
may also influence how a child envisions
himself of herself.
c Gender role is also culturally
influenced
Four discrete Stages in Sexual Response are
- Excitement,
- Plateau,
- Orgasm,
- Resolution.
It occurs with physical and
psychological stimulation (i.e.sight,
sound, emotion, or thought)
Excitement
This leads to arterial dilation and
venous constriction in the genital area
leading to vasocongestion and
increasing muscular tension.
Excitement
In women, this vasocongestion causes
the clitoris to increase in size and
mucoid fluid to appear on vaginal walle
as lubrication
The vagina widenan diameter and
increases in length
The nipples become erect
Excitement
In men, penile erection occurs, as
well as scrotal thickening and
elevation of the testes.
In both sexes, there is an increase in
heart and respiratory
rates and blood
pressure.
Excitement
It is reached just before orgasm
Plateau Stage
Plateau Stage in woman
n woman, the clitoris is drawn forward
and retracts under the clitoral prepuce;
the lower part of the vagina becomes
extremely congested (formation of the
orgasmic platform), and there is
increased nipple elevation
Plateau Stage in men
In men, the vasocongestion leads to
distention of the penis, heart rate
increases to 100 to 175 bpm and RR to
approx.. 40 respirations per minute.
It occurs when stimulation proceeds
through the plateau stage to a point at
which the body suddenly discharge
accumulated sexual tension.
. Orgasm
It is a 30-minute period during which the
external and internal genital organs
return to an unaroused state.
Resolution
Types of Sexual Orientatio
Heterosexuality
Homosexuality
Bisexuality
Transsexuality or transgender person
is a person
who finds sexual fulfillment
with a member of opposite
gender
Heterosexuality
is a person who finds
sexual fulfillment with a member of his
or her own sex Many
homosexual men prefer
to use the term “gay”
“Lesbian” refers to a
homosexual woman.
Homosexuality
if they achieve sexual
satisfaction from both homosexual and
heterosexual relationships. Like men
who have sex with men, bisexual men
may be at greater risk for HIV and STIs
than are others.
Bisexuality
is
an Individual who, although of one
biologic gender feels as if he or she is of
the opposite gender. Such people may
have sex change operations so that they
appear cosmetically
Transsexuality or transgender person
Other Types of Sexual Expression
Sexual Abstinence (celibacy)
Masturbation
Erectile Stimulation
Fetishism
Transvestism
Voyeurism
Sadomasochism
Exhibitionism
Bestiality
Pedophiles
is separation from sexual activity). It is the
avowed state of certain religious orders.
Sexual Abstinence (celibacy)
is self-stimulation for
erotic pleasure
Masturbation
is
the use of visual materials
such as magazines or
photographs for sexual arousal
Erectile Stimulation
is sexual arousal resulting
from the use of certain objects or situations.
Leather, rubber, shoes, and feet are
frequently perceived to have erotic qualities
Fetishism
is an individual who
dresses in the clothes of the opposite sex.
Transvestites can be heterosexual,
homosexual, or bisexual.
Transvestism
is obtaining sexual arousal
by looking at another person’s body. Almost
all children and adolescents pass through
a stage when ____ is appealing.
Voyeurism
involves inflicting pain
(sadism) or receiving pain (masochism) to
achieve sexual satisfaction.
Sadomasochism
inflicting pain
____ or receiving pain ____ to
inflicting pain
(sadism) or receiving pain (masochism) to
is revealing one’s
genitals in public.
Exhibitionism
is sexual relations with
animals.
Bestiality
are individuals who are
interested in sexual encounters with
children. Known pedophiles are
registered as sex offenders.
Pedophiles
The female orgasm has been a topic of
much controversy over the years,
beginning with Freud, who deducted that
there were two types of female orgasms:
clitoral orgasm and vaginal orgasm
Freud believed that clitoral orgasms
(originating from masturbation or other
noncoital acts)
sexual
immaturity.
And that only vaginal orgasms were the
authentic, mature form of sexual
behavior in women
Accordingly, he
considered women to be
___ if they could not
achieve orgasm through
intercourse.
neurotic
Masters (1998) showed that there is no
physiologic difference between an
orgasm achieved through
intercourse and
one achieved by direct stimulation of the
clitoris
presumably located on the inner portion
of the vaginal wall, halfway between the
pubic bone and the cervix, has been
promoted as an area of heightened erotic
sensitivity
G spot,
T or F Women also may be more
interested in initiating
sexual relations at this time,
Influence of Pregnancy on
Sexual Response
T
Influence of Pregnancy on Sexual Response
Pregnancy is another time in life when
there is _____ because of the blood supply
needed by a rapidly growing fetus.
vasocongestion of the lower
pelvis
many women
experience increased sexual interest
because
the new growth of blood vessels
during pregnancy lasts for some time and
continues to facilitate pelvic
vasocongestion.
is unwanted
and repeated sexual advances,
remarks, or behavior toward
another that is:
a) offensive to the recipient and
b) Interferes with job or school
performance.
Sexual harassment
It can involve actions as obvious as a job
superior demanding sexual favors or a
job superior sending sexist jokes by email to a person supervised.
Sexual harassment
Two types of sexual harassment
Quid pro quo (an equal exchange)
Hostile work environment
in which an employer asks for something in
return for sexual favors, such as a hiring
or promotion preference.
Quid pro quo (an equal exchange)`
in which an
employer creates an environment in
which an employee feels uncomfortable
and exploited (e.g., being addressed as
“honey,” asked to wear revealing
clothing, working where walls are
decorated with sexist posters).
Hostile work environment
Disorders involving sexual functioning can be:
.
a. (primary) lifelong
b. (Secondary) or acquired
They can have a psychogenic origin
(produced by psychic rather than organic
factors)
a biogenic origin (produced by biologic
processes), or both.
They occur in both men and women
Disorders of Sexual Functioning
Lessened interest in sexual relations is
normal in some circumstances, such as
after the death of a family member, a
divorce, or a stressful job change
Inhibited Sexual Desire:
The support of a caring sexual partner or
relief of the tension causing the stress
allows a return to sexual interest.
Inhibited Sexual Desire:
Decreased sexual desire can also be a
side effect of many medicines.
Inhibited Sexual Desire:
Chronic diseases, such as peptic ulcers or
chronic pulmonary disorders that cause
frequent pain or discomfort may interfere
with a man’s or a woman’s overall wellbeing and interest in sexual activity
Inhibited Sexual Desire:
Obese men and women may not feel as
much satisfaction from sexual relations
as others, because they have difficulty
achieving deep penetration because of
the bulk of their abdomens.
Inhibited Sexual Desire:
An individual with an STI such as genital
herpes may choose to forgo sexual
relations rather than inform a partner of
the disease.
Inhibited Sexual Desire:
Some women experience a decrease in
sexual desire during perimenopause.
Inhibited Sexual Desire:
The failure of a woman to achieve
orgasm can be a result of poor sexual
technique, concentrating too hard on achievement, or negative attitudes toward
sexual relationships.
Inhibited Sexual Desire:
Treatment Inhibited Sexual Desire:
Administration of androgen
-relieving the underlying cause
(testosterone)
may be helpful at that time, because it can
improve interest in sexual activity
Administration of androgen
It may
include instruction and counseling for the
couple about sexual feelings and needs.
relieving the underlying cause
formerly referred
to as impotence, is the inability of a man
to produce or maintain
an erection long enough
for vaginal penetration
or partner satisfaction
(Wessells et al., 2007).
Erectile Dysfunction:
Most causes of ED are:
Physical
Side effect of certain drugs.
such as aging, atherosclerosis, or
diabetes, which limit blood supply
Physical
Examples of
drugs prescribed today for ED are: sildenafil
(Viagra), tadalafil (Cialis), and vardenafil
(Levitra), which are taken up to once a day to
stimulate penile erection (Karch, 2009).
Side effect of certain drugs.
Sildenafil Citrate (Viagra)
Classification:
A phosphodiesterase
(PDE) inhibitor Prescribed as therapy for
erectile dysfunction:
Sildenafil Citrate (Viagra)
action
Causes smooth muscle
relaxation and inflow of blood to the
corpus cavernosum of the penis,
achieving erection (Karch, 2009)
Dosage: 50 mg PO prn 1 hour before
sexual activity, up to one dose per day
side effects of viagra
headache, facial flushing, and upset
stomach.
Less commonly, ventricular arrhythmia,
bluish vision, blurred vision, impairment
of blue/green discrimination, or
sensitivity to light may briefly occur.
Advise patients not to take this drug
within 4 hours of taking an alpha-blocker
agent
Nursing Implications VIAGRA
Assess patient for pre-existing cardiovascular
risk.
1. Caution patient that dose should be
limited to one time per day; use is
contradicted if the patient is taking
nitrates or an alpha-blocker.
2. Erection lasting more than 4 hours
(priapism) can occur. Caution patient to
alert health care provider if this occurs to
avoid penile tissue damage.
3. Caution patients that this drug does not
protect against sexually transmitted
infections or pregnancy, so the user must
continue to use safer sex practices.
4. In rare instances, men taking PDES
inhibitors have reported a sudden
decrease or loss of vision.
Caution patient that if he experiences
sudden decrease or loss of vision to stop
taking the medication and call a doctor
right away
Alternative Treatment
- A surgical implant to aid erection by the use of
vacuum pressure is a possible alternative
(Hossein, 2007). - Testosterone injections may be helpful in
some men. - In all instances, frank discussion about the
cause of the problem and currently available
therapies is helpful. - Various herbal products such as fennel extracts
are available for women that may improve
sexual libido. - Vibration or vacuum devices are also
available to increase clitoral
enlargement and sexual arousal in
women
is ejaculation before penile-vaginal
contac
Premature Ejaculation
The term also is often used to mean
ejaculation before the sexual partner’s
satisfaction has been achieved.
Premature Ejaculation
can be
unsatisfactory and frustrating for both
partners.
Premature Ejaculation
occurs in men
when semen leave the body (ejaculate)
sooner than wanted during sex
Premature Ejaculation
is a common
sexual complaint
As many as 1 out of 3 people say they
have it at some time.
Premature ejaculation isn’t cause for
concem if it doesn’t happen often flut you
might be diagnosed with ____if you
Always or nearly always ejaculate within
1 to 3 minutes of penetration
Are not able to delay ejaculation during
sex all or nearly all the
Premature Ejaculation
Premature ejaculation can be classified
as:
Lifelong and Acquired
ejaculation occurs
all or nearly all the time beginning with
the first sexual encounter
Lifelong premature
ejaculation
develops after having previous sexual
experiences without problems with
ejaculation.
Acquired premature
Psychological causes Premature ejaculation
Psychological factors that might play a
role include:
Early sexual experiences
Sexual abuse
Poor body image
Depression
Worrying about premature ejaculation
Guilty feelings that can cause you to rush
through sex
Other factors that can play a role
include:
Erectile dysfunction.
Anxiety.
Relationship problems.
Other reasons suggested are doubt
about masculinity and fear of
impregnating a partner, which
prevent the man from sustaining an
erection.
Treatment Premature ejaculation
: Sexual counseling for both
partners to reduce stress, as well as
serotonergic antidepressants such as
Mirtazapine, may be helpful in
alleviating the problem.
is excessive and unrelenting
sexual arousal in the absence of desire
is spontaneous, persistent, unwanted and
uncontrollable genital arousal in the
absence of sexual stimulation or sexual
desire, and is typically not relieved by
orgasm.
It may be triggered by medications or
psychological factors.
When assessing someone with the
disorder, be certain to ask if the person is
taking any herbal remedies such as
Ginkgo biloba because some of these can
have arousal effects.
Persistent Sexual Arousal Syndrome
Because the reproductive system has a
sensitive nerve supply, when pain
occurs in response to sexual activities, it
can be acute and severe and impair a
person’s ability to enjoy this segment of
their life.
Pain Disorders
is involuntary contraction
of the muscles at the outlet of the vagina
when coitus is attempted that prohibits
penile penetration.
Vaginismus
Vaginismus Treatment:
sexual or psychological
counseling to reduce this response may
be necessary.
Dyspareunia
is pain during coitus. -
This can occur because of endometriosis
abnormal placement of endometrial
tissue.
Dyspareunia SYMPTOMS
If you have painful intercourse, you
might feel: -Pain only at sexual entry
(penetration)
Pain with every penetration, Including
putting in a tampon Throbbing pain,
lasting hours after intercourse
Deep pain during thrusting
Burning pain or aching pain
Dyspareunia CAUSES
Physical causes of painful intercourse
differ, depending on whether the pain
occurs at entry or with deep thrusting.
Emotional factors might be associated
with many types of painful intercourse.
Pain during penetration might be
associated with a range of factors,
including:
Entry pain
Pain during penetration might be
associated with a range of factors,
including:
Not enough lubrication. This is often the
result of not enough foreplay.
Certain medications are known to affect
sexual desire or arousal, which can
decrease lubrication and make sex
painful.
Injury, trauma or irritation.
Inflammation, infection or skin disorder.
Vaginismus.
A problem present at birth. Not having a
fully formed vagina (vaginal agenesis) or
the development of a membrane that
blocks the vaginal opening (imperforate
hymen) could cause dyspareunia.
Deep pain Causes include
Certain illnesses and conditions. The
list includes endometriosis, pelvic
inflammatory disease, uterine prolapse,
retroverted uterus, uterine fibroids,
cystitis, irritable bowel syndrome, pelvic
floor dysfunction, adenomyosis,
hemorrhoids and ovarian cysts.
Surgeries or medical treatments.
Scarring from pelvic surgery, including
hysterectomy, can cause painful
intercourse. Medical treatments for
cancer, such as radiation and
chemotherapy, can cause changers that
make sex painful.
Emotional factors Deep pain DYSPAREUNIA
Psychological issues. Anxiety,
depression, concerns about your physical
appearance, fear of intimacy or
relationship problems can contribute to a
low level of arousal and a resulting
discomfort or pain.
Stress History of Sexual abuse. It can be
difficult to tell
whether emotional
factors are associated
with dyspareunia.
Initial pain can lead to fear or recurring
pain, making it difficult to relax, which
can lead to more pain. You might start
avoiding sex if you associate it with the
pain.
(inflammation of the
vestibule), vaginal infection, or
hormonal changes such as those that
occur with menopause and cause vaginal
drying. A psychological component may
be present.
Vestibulitis
is a type of vulvodynia, or pain around
the vulva—the sex organs outside a
woman
’s body.
-The pain is in your vestibule, the part
of your vulva around the opening of your
vagina.
Vulvar vestibulitis, also known as VVS,
VVS can be aggravated by
acid foods in the
diet, by low levels of estrogen
hormone, and by any infections that
happen to occur while it is there. At the
same time, it seems that many treatments
bring about at least some relief in some
women.
TREATMENT FOR VVS OR DEEP PAIN
Treatment. is aimed at the underlying
cause. Encouraging open
communication between sexual partners
can be instrumental in resolving the
problem.
