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Sexology > Week 8 > Flashcards

Week 8 Flashcards

1
Q

What are five sexual complaints women report?

A

Dyspareunia
Vaginismus
Orgasmic problems
Reduced sexual desire
Arousal problems

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2
Q

What is needed for a genito-pelvic pain / penetration disorder (GPPPD) diagnoses?

A

At least one of the following:
- difficulty with penetration
- vaginal or pelvic pain during (attempted) penetration
- anxiety about anticipation of pain / during penetration
- tensing of the pelvic floor during (attempted) penetration
and all the obvious DSM-5 criteria (significant distress, etc.)

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3
Q

What causes pain in dyspareunia?

A

Tampon, penis, finger, cycling, tight clothes, inserting/during/after penetration

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4
Q

What describes the pain in dyspareunia?

A

Burning

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5
Q

What is provoked vulvodynia (PVD)?

A

Specific type of dyspareunia, largest part of people with dyspareunia.
- Somatic cause excluded
- Localized; provoked; burning sensation; superficial (not deep); intermittent (not continuous)

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6
Q

What does the circle of pain look like?

A

Pain –> catastrophic thoughts –> pain-related fear –> decreased arousal + increased muscle tension –> decreased lubrication + increased tension pelvic floor –> mechanical friction –> vulvar skin irritated –> pain

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7
Q

What does the circle of pain result in?

A

Lowered sexual desire

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8
Q

What does assessment in dyspareunia look like?

A
  • Physical research first
  • Pain (intensity, onset, duration, location, what hurts)
  • Cognitive-behavioral factors
  • Partner and relationship factors
  • Impact on sexual functioning
  • Pelvic floor complaints (bladder and bowel routine)
  • Earlier treatment
  • Request for help
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9
Q

What is an important first step in CBT therapy for someone with dyspareunia?

A

Stopping painful behaviors first

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10
Q

What options are available for treating dyspareunia?

A

CBT, surgery, pelvic floor physiotherapy

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11
Q

What are the main goals in treating dyspareunia?

A

Reducing pain and improving sexual functioning

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12
Q

What are six important factors to focus on in treating dyspareunia?

A
  1. Pelvic floor relaxation
  2. Fear of pain
  3. Partner relationship
  4. Stopping the vicious circle of pain
  5. Self-efficacy
  6. Sexual desire and arousal
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13
Q

What are six treatments for dyspareunia?

A
  1. Vulvar skin creme
  2. Mindfulness and relaxation exercises
  3. Gradual exposure
  4. Psycho education
  5. Prohibition pain / intercourse
  6. Searching for sexual stimuli
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14
Q

What is vaginismus?

A

Not being able to put anything in the vagina, despite the wish to do so. Somatic cause is excluded.

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15
Q

What is the prevalence of vaginismus?

A

1 - 6 %

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16
Q

What social factors can induce or cause vaginismus (indirectly)? How?

A

Conservative religions. Women experience pressure or stress because of the strict rules for sex before marriage.

17
Q

Vaginismus is a dysfunction of the pelvic floor. True or false?

A

False, but the pelvic floor is involved.

18
Q

What moderates vaginismus?

A

History of sexual abuse

19
Q

What does the circle of fear for vaginismus look like?

A

Penetration attempt –> catastrophic thoughts –> fear –> increased tension pelvic floor –> penetration impossible –> penetration attempt

20
Q

What is an important consequence of fear in the circle of fear for vaginismus?

A

Avoidance

21
Q

What are five forms of treatment for vaginismus?

A
  1. Gradual exposure
  2. Bibliotherapy (selfhelpbook with calls)
  3. Relaxation / mindfulness exercises
  4. Searching for sexual stimuli
  5. Psycho education
22
Q

What kind of treatment has the best results for vaginismus? What is this related to in the circle of fear?

A

Penetration exposure. This is related to stopping with avoiding fearful behavior.

23
Q

What is one thing exposure therapy does not help with?

A

Increasing positive beliefs

Sexology (8 decks)

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