Chapter 16 - Sexual Dysfunctions

Question 1

four main categories of sexual problems

Answer 1

intrapsychic, interpersonal/relational, cultural/psychological, organic
-fifth category, quality, can also be important

Question 2

intrapsychic factors

Answer 2

origins of sexual problems might begin in early childhood observation based on early family interactions; parental silence about sex can send a signal that sex is taboo; even more discomfort if sexual abuse/assault in childhood

Question 3

intrapsychic factors in adolescence and adulthood

Answer 3

low self esteem, fear of inadequacy, fear of pregnancy/STIs, can make is harder to anticipate and enjoy sexual experiences; performance anxiety may result from cultural expectations

Question 4

interpersonal/relational factors

Answer 4

conflict resolution is the key difficulty in communicating productively; other difficulties include nonconsensual monogamy, jealousy, and distrust; being disappointed in sex is also a major factor

Question 5

cultural/psychosocial factors

Answer 5

cultural mechanisms exist for teaching a given society’s sexual values (religious teachings, family teachings, school-based education, media)

Question 6

religious teachings (cultural factors)

Answer 6

religions promote certain sexual values and promote/restrict some behaviours; multicultural canada does not have uniform sexual values rooted in just one religion

Question 7

family-based teachings (cultural factors)

Answer 7

many children come to believe that sex is dirty/forbidden; parents avoid directly referencing genitals; parents often teach very little besides “where babies come from”

Question 8

school-based education (cultural factors)

Answer 8

formal sex education is provincially regulated in canada; overall in CAN is conveys reproductive biology and how to avoid STIs; no/very little discussion of sexual feelings/desire/pleasure

Question 9

media/misinformation (cultural factors)

Answer 9

many sources of misleading info are from pop media esp the internet (unrealistic body ideals and performance expectations)

Question 10

some pop media myths about sex

Answer 10

real sex = intercourse, sexual satisfaction = orgasm, bigger is better, men always want sex, etc

Question 11

organic factors

Answer 11

disease, disability, drugs can impact sexual function; cardiovascular disease can announce itself as erectile dysfunction and treatment can affect sexual arousal/lubrication

Question 12

role of hormones (organic factors)

Answer 12

hypothyroidism, anemia, diabetes can contribute to low desire; sometimes issues after childbirth such as low iron, elevated prolactin (vaginal dryness), interrupted sleep

Question 13

neurological disorders/CNS injuries (organic factors)

Answer 13

damage to CNS can affect sexual functioning and response; diabetes can reduce blood flow to genitals and eventually deteriorate nerve function

Question 14

drug related (organic factors)

Answer 14

many meds have an adverse impact on sexuality ; street drugs and alcohol can affect sexual functioning

Question 15

it is important to consider the ____ of sexual stimulation when diagnosing sexual disorders

Answer 15

quality/adequacy

Question 16

sexual disorder

Answer 16

a problem with sexual response that causes a person mental distress or interpersonal difficulty; occur on a continuum of mild to severe; symptoms must occur for min. 6mo

Question 17

male hypoactive sexual desire disorder

Answer 17

lack of interest in sexual activity
-no spontaneous thoughts/fantasies about sex, no interest in sexual activity, must cause distress or interpersonal difficulties

Question 18

erectile disorder

Answer 18

inability to have or maintain an erection; more common in older men; caused by heart and vascular issues, low T, spinal injury; treated by therapy and/or drugs

Question 19

premature ejaculation

Answer 19

male ejaculates too soon and feels he cannot control it; often psychogenic factors; could be malfunctioning ejaculatory reflexes or hypersensitivity; very few seek treatment

Question 20

delayed ejactulation

Answer 20

male cannot reach orgasm or orgasm is greatly delayed; can be psychogenic factors, drug use, spinal cord injury and more; treatment involves paying attention to how one actually feels during sex

Question 21

female orgasmic disorder

Answer 21

female cannot reach orgasm or experiences them less intensely; caused by inexperience/misinformation (primary) and antidepressants/antianxiety drugs (secondary); treated by psychoeducational counselling

Question 22

female sexual interest/arousal disorder

Answer 22

lack of/reduced sexual interest or arousal; often both psychological and physiological components (lack of subjective feeling of arousal, lack of vaginal lubrication); in addition to distress women must exhibit at least 3 of lack of interest/thoughts/desire or absent/reduced excitement/response to stimuli/physiological response

Question 23

genito-pelvic pain/penetration disorder

Answer 23

any one of four symptoms that typically occur together
-difficulty with penetration
-marked genital/pelvic pain during penetration
-fear of pain associated with penetration
-tension/tightening of pelvic floor muscles during penetration attempts

Question 24

dyspareunia

Answer 24

painful intercourse; decreases enjoyment and frequency of intercourse

Question 25

vaginismus

Answer 25

spastic contractions of the muscles in the outer third of the vagina; penetration may be painful or impossible

Question 26

causes and treatment for genito-pelvic pain disorders

Answer 26

more often physical problems (infection, PID, tumors, vag. dryness, etc); may need to learn relaxation or fear reduction techniques

Question 27

masters and johnson’s therapy

Answer 27

developed an intensive, brief, behaviour-oriented model for sex therapy
-eliminate obstacles to sexual functioning; spectatoring, sensate focus exercises, non-demand genital pleasuring; focus should be couples not individuals

Question 28

sex therapy in the new millennium

Answer 28

treatment still focuses on eliminating the sexual symptoms and getting more normative sexual functioning and getting to more normative sexual functioning (treat symptoms not problems)