Treatment for Sexual Dysfunctions Flashcards
What comprises non-medical treatment?
Psychotherapy and pelvic floor physiotherapy
What comprises medical treatment?
Pharmacological options
Mechanical options
Surgical options
What is sex therapy?
Talk therapy that addresses sexual concerns
What is the difference between sex therapy and sex surrogacy?
Sex surrogacy is hands on and sex therapy is NOT!
What is the PLISSIT model?
A scientific model of which sex therapy and other forms of therapy are based on.
Determines the different levels of intervention for a client
What does the PLISSIT model stand for?
P -> Permission
LI -> Limited information
SS -> Specific suggestion
IT -> Intensive therapy
What does the PLISSIT model mean by “permission”
Reassurance
Permission to engage or not
Permission to feel comfortable
What does the PLISSIT model mean by “limited information”
Provide client with information about specific concern
Sex education
Dispel myths
What does the PLISSIT model mean by “specific suggestions”
Homework exercises
Behavioural exercises
Based on client goals
What are common client goals?
Reduce anxiety
Enhance communication
Enhance arousal
What kind of homework/behavioural exercises can be specifically suggested?
Sensate focus Body exploration Communication skills Pelvic floor exercises Stop-start technique Squeeze technique
What is sensate focus?
- > One of the most useful activities for enhancing sexual enjoyment
- > Cornerstone of sex therapy
- > Can reduce anxiety caused by goal orientation
- > Focusing on sensation rather than performance
- > Expands sexual repertoire by starting at baseline again
- > Basic step for treating all sexual issues
- > Helps couples explore what they like and don’t like through verbal feedback
What are the different stages of sensate focus?
- Non-genital
- Genital sensate focus
- Penetration without movement
- Penetration with movement
What are some suggestions for premature (early) ejaculation (PE)?
- > Ejaculate more frequently
- > Change positions
- > Communicate
- > Alternatives to penetrative activities
What are some suggestions for erectile dysfunction?
- > Talk about performance anxiety
- > Dispel myths (such that sex = intercourse, and that a male is always ready and wants to have sex)
- > Sensate focus
When is intensive therapy suggested?
- When the issue cannot be addressed by other exercises
2. Cases of trauma or psychological comorbidities
What sexual dysfunctions can pelvic floor physiotherapy address?
Most commonly GPPPD (vulvodynia and vaginismus)
Evidence is coming out for PE and ED
It can help most people who don’t really understand what is happening in the core in their body
What are the goals of pelvic floor physiotherapy for GPPPD?
- > Increase awareness of pelvic floor muscles
- > Improve muscle relaxation
- > Increase elasticity at vaginal opening
- > Desensitize painful areas
- > Decrease fear of penetration
What are some pelvic floor physiotherapy techniques for GPPPD?
Manual (massaging, stretching, treats restrictions)
Vaginal dilation exercises (desensitizes and stretches vaginal opening, improve control, reduce fear)
Biofeedback (improves control of muscles)
What are the oral medications used to treat ED?
Viagra, Cialis, Levitra (PDE-5 inhibitors)
What is the first line treatment for ED?
Oral medication
What are the 4 important components of an erection?
- Blood flow
- Neuronal communication
- Sex hormones
- Brain