WEEK 8

Question 1

Phases

Answer 1

Desire phase:
- sexual urges occur in response to sexual cues or fantasies

Arousal stage:
- a subjective sense of sexual pleasure and physiological signs of sexual arousal

Plateau phase:
- brief period occurs before orgasm

Orgasm phase:

• Males: ejaculation
• Females: contractions of the walls of the lower third of the vagina

Question 2

Male hypoactive sexual desire disorder
- Criteria

(sexual desire/ arousal disorders)

Answer 2

• A. persistently or recurrently deficient or absent sexual/ erotic thoughts. Judgement of deficiency made by clinician who takes into account other features
• B. Criteria A symptoms persisted for a min. of 6 mths.
• C. Criteria A symptoms causes clinically significant distress
• D. dysfunction is not better explained by a non sexual mental disorder or a consequence of sever relationship distress or other stressors or medication

Question 3

Erectile Disorder (Male)
- Criteria 

(sexual desire/ arousal disorders)

Answer 3

• A. At least one of the following three on almost or all sexual activity (75-100%)
  
  1. marked difficulty in obtaining an erection during sexual activity
  2. marked difficulty in maintaining an erection until completion of sexual activity
  3. Marked decrease in erectile rigidity

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

Question 4

Female Sexual Interest/ Arousal Disorder

sexual desire/ arousal disorders

Answer 4

A. lack of or sig. reduced sexual interaction/ arousal as manifested by at least 3 of the following:

1. absent/ reduced interest
2. absent/ reduced thoughts
3. no/ reduced attempts to initiate and typically unreceptive to partners attempts
4. absent/ reduced sexual excitement/ pleasure (75-100)
5. absent/ reduced sexual interest in response to any internal or external sexual erotic cues
6. absent/ reduced genital sensations (75-100)

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

Question 5

(sexual desire/ arousal disorders)

Answer 5

• Male hypoactive sexual desire disorder
• Erectile Disorder (Male)
• Female Sexual Interest/ Arousal Disorder

Question 6

Orgasm Disorders

Answer 6

Male:

• delayed ejaculation
• premature ejaculation

Female:
- Female orgasmic disorder

Question 7

Delayed Ejaculation

Answer 7

A. Either of the following symptoms must be experienced on almost all or all occasions (75 – 100%) of partnered sexual activity and without the individual desiring delay:

1. Marked delay in ejaculation.
2. Marked infrequency or absence of ejaculation.

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

8% of males reported having delayed/ absent orgasms–> diagnosis is rare

Question 8

Premature Ejaculation

Answer 8

A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 minute following vaginal penetration and before the individual wishes.
NOTE can be applied to non-vaginal sexual activities however specific duration criteria have not bee established for these activities

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

Occurs in 21% of men, declines with age (more common in inexperienced males)

Question 9

Female orgasmic disorder

Answer 9

A. Presence of either of the following symptoms and experienced on almost all or all (75 – 100%) occasions of sexual activity (in identified situational contexts or, if generalised, in all contexts):

1. Marked delay in, marked infrequency of, or absence of orgasm.
2. Markedly reduced intensity of orgasmic sensations.

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

Question 10

Sexual Pain Disorders

Genito-pelvic Pain/Penetration Disorder

Answer 10

A. Persistent or recurrent difficulties with one (or more) of the following:

1. Vaginal penetration during intercourse.
2. Marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts.
3. Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration.
4. Marked tensing or tightening of pelvic floor muscles during attempted vaginal penetration.

B. Criteria A persisted for a min. of 6 mths.
C. cause clinically significant distress
D. Not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other sig. stressors or medication

Occurs in 7 % of females

Question 11

Assessing sexual behaviour:

Interviews

Answer 11

• Clinicians must demonstrate comfort/put the patient at ease
• Use the vernacular of the patient
• Cover nonsexual relationship issues and physical and psychological health
• Inclusion of partners in interview