Stress and Sexual Dysfunction Flashcards
What is the prevalence of sexual dysfunction?
-43% for women [30-40%]
-31% for men [20-30%]
-rates increase with age
How is sexual dysfunction defined and when can it occur?
-sexual dysfunction involves disturbances in sexual desire or psychophysiological changes during the sexual response cycle.
-the sexual response cycle includes: Desire; Arousal; Orgasm; Resolution
-dysfunction can occur in any stage, but most research focuses on the first three stages.
How are sexual dysfunctions classified (Masters & Johnson)?
-classification according to which part of the cycle is disrupted
-issue with desire –> Hypoactive Sexual Desire Disorder
-issue with arousal –> Sexual Arousal Disorder
What is Basson’s alternate sexual response cycle?
-willingness is key: must be open to intimacy (e.g., not right after a conflict)
-desire is triggered, not always spontaneous; needs specific stimulation
-psychological and physical arousal may not align (can feel one without the other)
-desire ↔ arousal: each can lead to the other
-orgasm is not the goal: intimacy and satisfaction don’t require orgasm
-spontaneous desire is still possible but less common
What are the female sexual disorders?
-Sexual Desire Disorders: Hypoactive Sexual Desire Disorder [lower libido]; Sexual Aversion Disorder
-Sexual Pain Disorders: Dyspareunia; Vaginismus
-Sexual Arousal Disorder
-Orgasmic Disorder
What are the male sexual disorders?
-Premature Ejaculation
-Prolonged Ejaculation
-Erectile Dysfunction
-Orgasmic Disorder
-Hypoactive Sexual Desire Disorder
What are some other sexual disorders?
-Sexual Dysfunction due to a general medical condition
-Substance Induced Sexual Dysfunction
-Sexual Dysfunction (NOS)
What are the classifications of sexual dysfunctions based on onset and context?
-Lifelong: present since sexual maturation
OR
-Acquired: develop after a period of normal sexual functioning
-Generalized: occur in all sexual situations
OR
-Situational: occur only in specific contexts or with specific partners
What are predisposing and precipitating factors in sexual dysfunction?
-predisposing factors: biological/constitutional vulnerabilities; early life experiences (e.g., poor parenting, insecure attachment, sexual/physical abuse)
-precipitating factors: events or conditions that trigger the onset of sexual dysfunction
What are maintaining and contextual factors in sexual dysfunction?
-maintaining factors: internal stress (stress within the relationship)
-contextual factors: external stress (from outside the relationship); acute stress (short-term); chronic stress (long-term, often uncontrollable)
How is the relationship between stress and sexual dysfunction bidirectional?
-increased stress can reduce sexual desire and arousal
-reduced sexual desire/arousal can increase stress → this creates a cycle that can maintain or worsen sexual dysfunction
[negative feedback loop of stress and sexual dysfunction]
How does performance anxiety relate to sexual dysfunction?
-performance anxiety is a common stress-related issue where individuals feel anxious about engaging in sexual activity.
-McCabe (2005) found that performance anxiety contributes to both the development and maintenance of various sexual dysfunctions in men and women.
What are the 2 kinds of female sexual desire disorders and their definitions?
-Hypoactive Sexual Desire Disorder (HSDD): low or absent sexual thoughts/desire or receptivity to sexual activity, causing distress
-Sexual Aversion Disorder: phobic aversion to and avoidance of sexual contact, causing distress
What are the 2 kinds of female sexual pain disorders and their definitions?
-Dyspareunia: genital pain during sexual intercourse
-Vaginismus: involuntary muscle spasms in the outer third of the vagina that block penetration, causing distress
What are Female Sexual Arousal Disorder and Orgasmic Disorder?
-Sexual Arousal Disorder: inability to achieve or maintain sexual excitement, causing distress (e.g., lack of lubrication or subjective arousal)
-Orgasmic Disorder: delay in or absence of orgasm after adequate stimulation and arousal, causing distress
What are the prevalence rates of female sexual dysfunctions?
-low sexual desire: 33.4%
-difficulty with lubrication: 20%
-pain during sex: 14.4%
-lack of orgasm: 24%
-early climax: ~10%
-most issues occur after the ages 18–59 and are influenced by stress, psychological, relational factors and by age.
What is Hypoactive Sexual Desire Disorder and how does it present in women?
-synonyms: sexual aversion, inhibited sexual desire, sexual apathy, sexual anorexia
-most frequent sexual problem among women
-involves persistent or recurrent lack of sexual desire
-in extreme cases: sex is experienced as repulsive, revolting, or distasteful; may trigger phobic or panic responses
How does work-related stress affect sexual desire in men and women?
-63% of working subjects reported decreased sexual desire during work stress
-women more affected than men (72.3% vs 55.5%)
-men: more erectile issues during stress (76% vs 22%)
-women: 63% wanted more foreplay (suggesting decreased arousal/lubrication)
-stress was the most frequently reported reason for reduced sexual desire in women (40%) across all age groups
What did Yoon et al. (2005) find about stress and female sexual behavior in rats?
-prolonged stress reduced female rats’ sexual receptivity
-stressed females were more aggressive and irritable toward males
-stress interfered with biological and physiological mechanisms of sexual behavior
-highlights how stress can suppress sexual interest and trigger avoidance behavior in females
What physical responses are affected by sexual arousal disorder?
-lacks or cannot maintain the physical signs of arousal
-no or reduced lubrication-swelling response
-affects blood vessel dilation, genital engorgement, and lubrication
-makes vaginal penetration more difficult or uncomfortable
How does stress impact sexual arousal in women?
-acute stress → lower genital and subjective arousal to erotic stimuli
-chronic stress → also reduces genital arousal
-control group with low stress showed the highest arousal/lubrication
-stress (both acute and chronic) reduces physiological sexual responsiveness
What psychological and relational stressors are most associated with female sexual dysfunction?
-marital difficulties: strongly linked to arousal, orgasm, and enjoyment issues
-anxiety and depression: significant impact on overall sexual function
-psychological stressors are key contributors to dysfunction in women
What are the most common male sexual dysfunctions and their prevalence?
-Premature Ejaculation (PE): most prevalent; affects ~30% of men globally
-Erectile Dysfunction (ED): affects ~40% of men [men with high anxiety and depression have high rates of ED]
-both conditions span across age groups and cultures
What are Erectile Dysfunction risk factors?
-psychological stress: anxiety; depression
-metabolic: diabetes; heart diseases; hypertension; GI disorders
-lifestyle: obesity; smoking
