5508 Sexual disorders and parophilias Flashcards
(25 cards)
What are some types of sexual disorders?
- Delayed ejaculation
- Erectile disorder
- Female orgasmic disorder
- Female sexual interest/arousal disorder
- Genito-pelvic pain/penetration disorder
- Male hypoactive sexual desire disorder
- Premature ejaculation
- Substance/medication induced sexual disorder
Sexual disorders are characterized by clinically significant disturbances in sexual response or pleasure.
What must be considered before diagnosing sexual dysfunction?
- Inadequate sexual stimulation
- Partner factors
- Relationship factors
- Individual vulnerability factors
- Cultural or religious factors
- Medical factors
These factors can influence the presence and type of sexual disorder.
What is the definition of paraphilias?
Unusual expressions of sexuality considered aberrant or illegal, necessary for some to experience arousal and orgasm.
Paraphilia denotes any intense and persistent sexual interest other than typical sexual behaviors.
What is delayed ejaculation?
Marked delay or absence of ejaculation occurring at least 75-100% of the time for at least 6 months.
This condition occurs more frequently with partnered sex than masturbation.
What characterizes erectile disorder?
Difficulty obtaining or maintaining an erection, or decreased erectile rigidity, occurring 75-100% of the time for 6 months.
Impotence is no longer the term used for this condition.
What is female orgasmic disorder?
Marked delay, infrequency, or absence of orgasm occurring 75-100% of the time for at least 6 months.
It is more common among unmarried women.
What is male hypoactive sexual desire disorder?
Persistent deficient or absent sexual thoughts, fantasies, or desire for sexual activity for at least 6 months.
This disorder is most prevalent in younger and older age groups.
What is female sexual interest/arousal disorder?
Absent or reduced interest in sexual activity, thoughts, or initiation for 75-100% of the time for at least 6 months.
Evaluations should include hormonal levels and factors like aging and life stress.
What is genito-pelvic pain/penetration disorder?
Marked pain during vaginal intercourse, fear of pain, or tensing of pelvic floor muscles during attempted penetration.
Not diagnosed if severe relationship distress is present.
What are common causes of sexual disorders?
- General medical conditions
- Neurological disorders
- Medications (e.g., antidepressants)
- Substance use (e.g., alcohol, opioids)
These factors can contribute to various sexual dysfunctions.
What was the most common treatment for sexual disorders?
Psychotherapy was the most common treatment historically.
Modern treatment approaches also include behavioral therapies and pharmacotherapy.
What role does sildenafil play in treating erectile dysfunction?
Facilitates blood inflow to the penis for erection, effective only with sexual stimulation.
It lasts about 4 hours and can have side effects like headaches and flushing.
Other medications helpful for ED
Oral Phentolamine: reduces sympathetic tone and relaxes corporeal smooth muscle
Injectable alprostadil
Antidepressants can help with premature ejaculation
Trazodone for nocturnal erections
Wellbutrin can increase sex drive
Psychosocial tx for sex dysfunctions include
Dual sex therapy for couples
Sex therapy for premature ejac
Behavior therapy
Mindfulness training to help focus on the moment
What is voyeurism?
Recurrent and intense sexual arousal from observing an unsuspecting person who is naked or engaging in sexual activity.
Usually manifests in childhood.
What is masochism?
Pleasure derived from experiencing physical or emotional pain, often linked to childhood experiences. (autoerotic asphyxiation is a subtype)
Autoerotic asphyxiation is a subtype.
What is sadism?
Achieving sexual gratification by inflicting pain on another person.
Onset typically occurs before 18 years of age.
What is exhibitionism?
The act of exposing one’s intimate parts in public or semi-public contexts for sexual satisfaction. Almost 100% are men
Almost exclusively found in men.
What defines pedophilia?
Sexual attraction to prepubescent children, under the age of 14, and the pedophile must be at least 16 y/o and 5x the victim’s age
The pedophile must be at least 16 years old and 5 years older than the victim.
What is transvestic disorder?
Sexual arousal from cross-dressing, which can include fetishism or autogynephilia (aroused by thoughts/images of self as female).
Fetishism relates to materials, while autogynephilia involves self-perception as female.
What are the five types of psychiatric interventions for treating paraphilias?
- External control (ie prison)
- Reduction of sexual drives
- Treatment of comorbid conditions
- Cognitive behavioral therapy (disrupts patterns and modify behaviors)
- Dynamic psychotherapy
These interventions aim to modify behavior and address underlying issues.
What are the predictors for successful treatment of paraphilias?
- One paraphilia
- Absence of substance abuse
- Normal intelligence
- Absence of nonsexual antisocial traits
- Successful adult attachment
These factors can enhance the effectiveness of treatment.
What is the epidemiology of pedophilias
About 10-20% were molested by age 18
Mostly seen in males
50% occur before the age of 18 w/ peak age at 15-25 and gradually declines, rare in age >50
What are the four interrelated psychosexual factors in human sexuality?
- Sexual identity
- Gender identity
- Sexual orientation
- Sexual behavior
Each factor plays a role in an individual’s sexual experience and expression.
