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PSYC3018 > Lecture 23: Sexual dysfunction > Flashcards

Lecture 23: Sexual dysfunction Flashcards

1
Q

what is sexuality

A
  • important and legitimate aspect of well being
  • no normal or average
  • we’re all sexual beings with or without partner
  • intimacy
  • loving relationship
  • sexual activity
  • physical appearance, body image
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2
Q

what is sexual health

A

physical, emotional, well-being relating to sexuality

- not merely absence of disease, dysfunction

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3
Q

what is sexual dysfunction

A

when you can’t participate in sexual relationship he or she would wish

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4
Q

prevalence of sexual dysfunction: at least 1 sexual dysfunction–>women

A

40-50%

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5
Q

prevalence of sexual dysfunction: at least 1 sexual dysfunction–>men

A

20-30%

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6
Q

prevalence rates (limitations)

A
  • diff samples– age groups, clinical vs. non-clinical
  • diff measurements– self-report vs. clinical interview
  • instead of asking: are you sexually active? yes or no
    ask: how satisfied are you with your sexual life?
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7
Q

kaplan’s triphasic (3-stage) models of sexual response

A
  • desire
  • excitement
  • orgasm
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8
Q

basson’s non-linear model of F sexual response

A

circular, rather than linear model
emotional intimacy–> sexual stimuli–> sexual arousal–> arousal and sexual desire–> emotional + physical satisfaction–> goes back to emotional intimacy
= considers how emotional intimacy, sexual stimuli, relationship satisfaction–> affect F sexual response

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9
Q

how to detect sexual dysfunction (DMS-5)

A
  • clinically sig disturbance in person’s ability to respond sexually or to experience pleasure
  • min duration of 6 months
  • symptoms must cause sig distress
  • experienced almost all or all occasions of sexual activity
  • important to consider cultural values + age
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10
Q

what are sexual dysfunction: subtypes

A
  1. nature of onset
  2. context
  3. severity
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11
Q
  1. nature of onset
A

lifelong or acquired

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12
Q
  1. context
A

generalised or situational

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13
Q
  1. severity
A

mild, moderate, severe– based on level of distress

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14
Q

DSM-5 classification of sexual dysfunction

A
  • moving away from kaplan’s model

- replaced with gender specific dysfunctions

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15
Q

stage of sex response: desire (male)

A

male hypoactive sexual desire disorder

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16
Q

stage of sex response: arousal (male)

A

erectile disorder

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17
Q

stage of sex response: orgasm (male)

A
  • delayed ejaculation

- premature ejaculation

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18
Q

stage of sex response: desire (female)

A

female sexual interest / arousal disorder

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19
Q

stage of sex response: arousal (female)

A

female sexual interest / arousal disorder

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20
Q

stage of sex response: orgasm (female)

A

F orgasmic disorder

21
Q

stage of sex response: pain (female)

A

genito- pelvic / pain penetration disorder

22
Q

what are sexual desire disorders

A
  • don’t think about it, not excited about doing it= frustrated about this= why am I not feeling this?
  • gender differences: M= 8% F= 55%
  • age differences
23
Q

what is the most common F sexual dysfunction

A

sexual desire disorders

24
Q

male hypoactive sexual desire disorder

A
  • not interested in sex, little sexual activity + fantasising
  • physical response–> normal
25
Q

F sexual interest / arousal disorder

A
  • not interested in sex

- arousal: hard to attain or maintain wet till end of sex– painful

26
Q

M sexual arousal disorders

A
  • erectile disorder (ED)
    • hard to get or maintain erection, or decrease in erectile rigidity
  • v age related
27
Q

causes of sexual dysfunction

A
  • biological / physical factors
  • psychosocial stuff
  • personal stuff
  • env. stuff
28
Q
  • biological / physical factors
A
  • aging
  • illness
  • substance abuse
  • medications (ex. antidepressants)
29
Q
  • psychosocial stuff
A
  • cultural, religious beliefs
  • body image
  • self acceptance
  • depression, anxiety
  • life stressors
  • past experience (trauma, abuse)
30
Q
  • personal stuff
A
  • attraction to partner
  • excessive goal orientation
  • relationship problems
  • can you compensate for each other?- libido differences
31
Q
  • env. stuff
A
  • lack of privacy
  • don’t have time
  • physical discomfort
32
Q

medical trt for erectile dysfunction

A
  • pharmacotherapy / oral medication
  • penile injections
  • vacuum device
  • penile prosthesis
33
Q
  • pharmacotherapy / oral medication
A
  • time to take effect + duration of effect= diff
  • rly effective
  • dose modification might be necessary
    = increased satisfaction
34
Q
  • penile injections
A
  • injection of smooth muscle relaxing drugs into erection chambers
  • erection= 30-45 mins
35
Q
  • vacuum device
A

erection= 30 mins

  • effective, but high drop out
  • numbness, pain
36
Q
  • penile prosthesis
A

last resort trt

37
Q

important to…?

A

promote sexual intimacy

  • doesn’t have to be just sex
  • oral sex, sex toys, holding hands, kissing, cuddling
  • emotional connection
38
Q

psychogenic erectile dysfunction

A
  • often sudden onset
  • situational
  • continued morning erections
  • erection with masturbation
  • spouse relationship: might be partner specific
  • younger patient (<40)
  • abnormal sex development
39
Q

organic erectile dysfunction

A
  • gradual onset / deterioration
  • decrease in morning erections
  • no erection w/ masturbations
  • chronic medical illness
  • pelvis trauma / surgery
  • recreational drugs
  • reduced size of penis
40
Q

M orgasmic disorders

A
  • delayed ejaculation

- premature (early) ejaculation

41
Q
  • delayed ejaculation
A
  • maintains erection, but delayed to ejaculate w/o person wanting delay
  • experience it almost all the time
  • prevalence: about 4&– not so common
42
Q
  • premature (early) ejaculation
A
  • ejaculate with only little stimulation (less than 1 min of penetration)– before guy wishes it
  • prevalence; about 8%
43
Q

F orgasmic disorder

A
  • marked delay, infrequency, no orgasm, OR not much intensity of orgasmic sensations
  • but if orgasm achieved with clitorial stimulation but not penetration–> doesn’t meet criteria
  • needs to be distressed about this
  • can be situational
  • orgasm learnt response (not automatic)– improves with experience
  • prevalence; 5%
44
Q

DSM-5 genito pelvic pain / penetration disorder

A

persistent or recurrent difficulties in any 1 of following:

  • vaginal penetration during sex
  • pelvic pain
  • fear or anxiety about pain (actual + thinking about it) or after penetration
  • tensing, tightening of pelvic floor muscles
  • important to take detailed history
45
Q

medical trt for D sexual dysfunction

A

pharmacological

  • hormonal therapy: vaginal or systemic oestrogen + androgen
  • oral medication for low sexual desire in premenopausal women– but serious side effects: low blood pressure, dizziness– not good to mix with alcohol
46
Q

non-pharmocological interventions for F sexual dysfunction

A
  • vag lubricants
  • vag moisturisers
  • vag dilators
47
Q

what are barriers to trt uptake

A
  • embarrassment
  • patients unaware of available resources
  • lack of engagement
  • always ask if its desired– what if theres abuse in relationship
48
Q

trt most effective if…

A
  • multi-modal, involving partner
  • be more comfortable talking about sex
  • intimacy= always possible

PSYC3018 (27 decks)

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