Topic 5: Sexual Function Flashcards
What is the sexual function of the septal region?
Pleasurable response and orgasm
What is the sexual function of the hypothalamus?
Neuroendocrine and autonomic aspects of sexual drive and sexual orientation
What is the sexual function of the Ansa lenticularis and pallidus?
Sexual drive (libido) and hypersexuality
What is the sexual function of the frontal lobes?
Motor components of sexual behavior, control of sexual response (disinhibition)
What is the sexual function of the parietal lobes (paracentral lobule)?
Genital sensation
What is the sexual function of the temporal lobes (amygdala)?
Sexual orientation, sexual disorders (eg. Paraphilias) and sexual drive (hypo and hypersexuality, impotence)
What is the human sexual response cycle?
- desire: sex drive or sexual need
- arousal/excitement: arousal is preparing for sexual activity by physical changes (increased HR, increased muscle tension etc)
- plateau: sexual activity is occurring and the physical changes become more intense
- orgasm/climax: feelings of sexual tension are released
- resolution: quiet phase, body returns to normal state
Brain injury can directly and indirectly affect important aspects associated with sexuality and sexual function. Name examples.
Direct: - change in sexual desire - disruption of genital response from disease - pain Indirect: - reduction of self-image (eg. By incontinence) - depressed mood - impaired mobility - reduced energy
What is the biopsychosocial model of sexuality?
Sexuality is influenced by neuropsychological and psychological effects, medical and physical issues and relationship changes
What are the key brain regions involved in sexuality?
Subcortical:
- septal region -> pleasurable response and orgasm
- hypothalamus -> neuro endocrine and autonomic aspects of sexual drive and sexual orientation
- ansa lenticular is and pallidus -> sexual drive / libido / hypersexuality
Cortical:
- frontal lobes: motor components of sexual behavior and control of sexual response
- parietal lobes: genital sensation
- temporal lobes: amygdala: sexual orientation, sexual disorders and sexual drive.
Ictal sexual manifestations typically originate from the …
Right hemisphere
This is in line with findings proposing right hemisphere dominance in the mediation of sexual function
In Parkinson’s disease, hypersexuality is observed following treatment with ….
Antiparkinsonian medications and deep brain stimulation
What is the conceptual model for sexual dysfunction in MS
- primary sexual dysfunction: physiological impairments directly due to demyelinating lesions in the spinal cord and brain
- secondary sexual dysfunction: non-sexual physical changes which affect the sexual response indirectly
- tertiary sexual dysfunction: psychological, social and cultural issues that may affect sexual functioning
Name examples for primary sexual dysfunction in MS
Physiological impairments directly due to demyelinating lesions in the spinal cord and brain
- decreased libido
- numbness or sensory paresthesias in the genitals
- loss of vaginal lubrication / erectile dysfunction
- problems with arousal and orgasm
Name examples of secondary sexual dysfunction in MS
Non-sexual physical changes which affect the sexual response indirectly.
MS symptoms that do not directly include nervous system pathways related to the genital system, such as:
- fatigue
- weakness
- difficulty with mobility
- bladder and bowel dysfunction
- side effects from the medications