exam 3 - A Flashcards
Epidemiology - Sexual Disorders
Are these common problems? Which 3 disorders are mainly treated? Which of 1 of 3 sexual responses has increased in problems? How does age affect sexual function men vs. women?
yes
Treatment mainly for erectile disorder, orgasmic disorder and premature orgasm (in men)
Increase in sexual desire problems
age affects sexual function (in men - erectile dysfunction with age, in women - decrease in sexual desire, especially post menopausal)
Human Sexual Response Cycle - Masters & Johnson
normally follows a pattern of
excitement - genital tissues fill w/ blood causing erection or lubrication
plateau - increased swelling on genitals
orgasm - ejaculation or contractions of the uterus pelvic reaction (orgasm occurs here)
resolution - cannot have any further stimulation (for men - refractory period)
Human Sexual Response Cycle - Helen Singer Kaplan, why is there no resolution?
desire - interest in engaging sexually w/ others
excitement
orgasm
no resolution b/c its vague, different for everyone.
*disorders are based one 1 of the 3 things malfunctioning
Can you have resolution w/o orgasm?
Yes, resolution varies per couple, can be touching, full orgasm, etc.
Classification of Sexual Dysfunctions (x5) Psychogenic!! (not biological)
> 6 months of distress/interpersonal difficulty
no distress = no diagnosis
people w/ paraphilias who don’t experience distress or don’t cause harm to others aren’t diagnosed
can’t be explained by another disorder - ex. substance abuse especially tobacco & alcohol
not associated with another medical condition - ex. cancer, heart disease, parkinsons
Time distinction:
lifelong dysfunction vs. acquired sexual dysfunction
Contextual distinction:
generalized sexual dysfunction vs. situational sexual dysfunction
lifelong dysfunction - never had orgasms, continue to not have
acquired sexual dysfunction - had orgasms, and now cannot
generalized sexual dysfunction - cannot become erect w/ all partners
situational sexual dysfunction - cannot become erect w/ multiple partners once
Sexual arousal and desire/phase disorders (common):
male hypoactive
female sexual interest/arousal
erectile disorder
male hypoactive - man is uninterested in sex (problem, when they indv. complains about it, bad b/c it sets a standard of how much sex men should have)
female sexual interest/arousal - interested = arousal (unlike men), inability to become interested even when engaged
erectile disorder - cannot achieve erection when should, or last long/hard enough
Orgasmic phase disorders:
Delayed ejaculation
female orgasmic disorder (anorgasmia/frigidity)
premature orgasm (premature ejaculation)
Delayed ejaculation - takes longer than it should
female orgasmic disorder - cannot achieve orgasm even w/ sufficient stimulation
premature orgasm - <1 min
hypersexuality - more common in men or women? is it difficult to receive treatment?
excessive sexual desire or behavior
more common in men
ex. may go bankrupt from cost of paying prostitutes, phone sex, etc..
Yes, b/c it’s not in DSM-5, therefore not covered by insurance.
Genito-pelvic pain/penetration disorder x4 (more comment in men or women?)
more common in women - very common
persistent/recurrent difficulties w/ one of the following:
- vaginal penetration during sex
- marked vulvovaginal and pelvic pain during sex (dyspareunia)
- fear about #2 b/c of anticipation or during
- marked tensing/tightening of pelvic floor muscles during attempted vaginal penetration (vaginismus)
Etiology of Sexual Disorders - Biological Factors (x6) Role of hormones men vs. women erectile dysfunction drugs (x3) medication (x1) neurological disorders in men vs. women
men - testosterone
women - all 3 (testosterone, estrogen, progesterone) ex. b/c menopause
erectile dysfunction - vascular dysfunction (blood vessels are clogged w/ junk, therefore cannot achieve erection)
tobacco, alcohol (change your desires, affect CNS and peripheral), marijuana (not enough studies)
SSRIs - kills sexual interested, especially in women
men - injury to spine or pelvis
women - interfere w/ vaginal swelling and lubrication
strong medical exam should be conducted first to eliminate biological factors
Etiology of Sexual Disorders - Social Factors (x4)
culture - telling people what NOT to do w/ their sexuality (ex. being naked in public)
childhood socialization - preparing children or education them on sexuality, or is it “hush hush”
women report fewer orgasmic problems in recent times due to liberation
women w/ orgasmic disorder are less likely to talk about sex b/c they hold negative attitudes about masturbation and feel guilt.
Etiology of Sexual Disorders - Psychological (x4)
- performance anxiety - men > women, feel like they have to be amazing bed
- relationship factors - shitty relationship = shitty sex
- assertiveness problems, lack of social skills and discomfort w/ sex - unable to communicate preferences, and limits/boundaries
- previous harmful experiences - sexual assault, rape, sexual abuse
Treatment Sexual Disorders - PLISSIT Model
Permission - opening up to someone, how you make people comfortable to talk about their sexual problems
Limited Information - reassurance that it’s common, sometimes a small dose is effective, info on the problem
Specific Suggestions - to function better - assignments
Intensive Therapy - comorbid w/ depression, drug use, or relationship problems then referral to psychiatrist
Treatment Sexual Disorders - what is sensate focus? should you schedule time for sex? What other two types of treatment? What is the treatment for genito-pelvic/penetration disorder? What are the biomedical treatments for erectile dysfunction?
sensate focus - desensitization - holding hands > cuddling > hugging > kissing
yes
cognitive restructuring (sex ed) + communication training (need to be able to talk to your partner about sex)
psychosocial approaches (relaxation, changes to sexual approaches, interventions targeting body image and relational problems) + medical interventions (pain medication)
mechanical devices, injections on NT, pde5 inhibitors (ex. viagra, cialis, levitra)
