Sexual Dysfunction Flashcards by Ahmed Alkhoufi

What are the four phases of sexual response?

Desire
Excitement
Orgasm
Resolution

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What is the prevalence of sexual dysfunction between men and women?

38% of women

29% of men

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True or false: multiple types of sexual dysfunction rarely coexists

False

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What are the top four issues with female sexual dysfunction?

Lack of interest
Lubrication problems
Anorgasmia
Pain

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What are the top four issues with male sexual dysfunction?

Premature ejaculation
ED
Lack of interest
Anorgasmia

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What are the three general qualities for all sexual (and all psych) dysfunctions?

specific disorder dysfunction
Disturbance causes distress
Not d/t another diagnosis

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What is the timeframe that must be had to diagnose sexual dysfunction?

6 months or longer

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What are the three major categories of sexual dysfunction?

sexual interest/arousal disorders
Orgasm disorder
Sexual pain disorder

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What are the 6 criteria of female sexual arousal disorder? How many are needed to make a dx?

3 of:

Sensations reduced
Unresponsive to partner
Pleasure reduced
Erotic thoughts
Response
Interest reduced

(SUPER-I)

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True or false: when women complain of lubrication issues, there is rarely an actual problem

True

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What fraction of married women experience sexual disorders?

1/3

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What is the definition of ED?

Marked difficulty in obtaining or maintaining an erection of sufficient rigidity during partnered sexual activity

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What percent of the time is needed in order to diagnose ED?

More than 75% of the time

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How can you prevent ED? (2)

Continued sexual activity

- Reduce medical causes

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What is the definition of orgasm disorders in females?

Persistent, or recurrent delay in, infrequency of, or absence of orgasm, or a markedly reduced intensity of orgasmic sensations

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What percent of the time is needed to diagnose female orgasm disorder?

more than 75% of the time

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What is the prevalence of female orgasm disorder?

30-40%

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What is the treatment for female orgasm disorder? (3)

-Self-exploration
therapy
-Communication

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What is the definition of premature ejactulation?

Persistent or recurrent pattern of ejaculation occurring during partnered sex within approximately 1 minute following vaginal penetration, and before the person wishes it

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What is the prevalence of premature ejaculation (reported vs meet diagnostic criteria)?

20-30% report it

1-3% meet diagnosis

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What is the treatment for premature orgasm disorder?

SSRIs and specific exercises

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What are the mild, moderate, and severe criteria for premature ejaculation?

Mild: 30-60 secs
Moderate: 15-30 secs
Severe: less than 15 seconds

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What percent of sexual contacts are needed to diagnose premature ejaculation disorder?

75-100%

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What is the definition of inhibited orgasm for men?

Persistent or recurrent delay in, or absence of orgasm following a normal sexual excitement phase during sexual activity

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What percent of sexual contacts are needed to diagnose inhibited orgasm?

More than 75% of the time

What are the meds that can cause inhibited orgasm?

- SSRIs | - HTN meds

What are the associated psych disorders with inhibited orgasm disorder?

- Closeness issues - Guilt - OCD

What are the 4 criteria for pain/penetration disorders?

1. Vaginal pain during intercourse 2. Marked vulvovaginal or pelvic pain during vaginal intecourse 3. Marked fear or anxiety about pelvic pain 4. Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration

Does the pain with pelvic/penetration disorder occur before, during, or after intercourse?

Any

What is a predictive factor for pelvic pain/ penetration disorder?

Difficulty with tampon insertion

What are the criteria for substance/medication induced sexual dysfunction?

- Sexual dysfunction is present - s/sx began during or just after exposure to a substance - The substance is capable or producing symptoms

What are the mild, moderate, and severe criteria for substance induced sexual dysfunction, in terms of percent of sexual episodes?

Mild: 25-50% Moderate: 50-75% Severe: more than 75%

What are some of the non-abused drugs that can cause sexual dysfunction? (4 listed)

- Li | - Anti-anything

What are the unspecified sexual dysfunctions? (5)

- Female premature orgasm - postcoital HA - Orgasmic anhedonia - Masturbatory pain - Excessive, sexual addictions

What is one of the biggest causes of sexual dysfunction?

Inter-relational conflicts

What are the common emotional problems that cause sexual dysfunction?

Depression/anxiety

What are the treatment options for sexual dysfunction? (many, but list 3)

- Sex/behavioral therapy - Education/ exercises - hypnotherapy

What are the pharmacotherapy options for sexual dysfunction?

- SSRIs - Topical anesthetic - ED drugs

What is the MOA of ED drugs? What are the three classic ones?

PDE5 inhibitors - Sildenafil - Vardenafil - Tadalafil

What is the best way to treat sexual dysfunction?

Couple treat together

What are paraphilias?

A pattern of recurring sexual arousal mental imagery / behavior that involves unacceptable sexual practices

What is the is the difference between paraphilia and paraphilia disorder?

Disorder is the behavior that results from the paraphilia, whereas paraphilias are just the interests that are out of the norm

What is the major difference between diagnosing paraphilic disorders, relative to all other psych diagnoses?

Does not need to cause discomfort

True or false: most paraphilic disorders appear before age 18

True

True or false: most of the paraphilic disorders are in the homosexual population

False--heterosexual

Which gender usually have paraphilia?

Males

What are the co-occurring disorders of paraphilic disorders?

- Personality DO | - Substance use

What is the most common paraphilia?

Pedophilia

True or false: most paraphilic pts usually have only one paraphilia across their lifetime

False--3-5 types throughout life

Behaviors of paraphilic disorders peak at what age? What happens afterward?

15-25 | Decline thereafter

True or false: many pts with paraphilic disorders have typical sex lives

True

What is the psychosocial theory of paraphilic disorder?

Failure to complete the normal developmental process -Early experience that condition or socialize a child

What are the biological factors of paraphilic disorder?

hormone abnormalities

What are the diagnostic criteria for paraphilic disorder? (3)

- The presence of a pathognomonic fantasy and an intense urge to act out the fantasy or its behavior elaboration - Unusual sexual material - Orgams depends on mental elaboration

What is the timeframe needed to diagnose paraphilic disorders?

6 months

True or false: paraphilic diagnoses must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

True

What is exhibitionism?

The exposure of one's genitals to an unsuspecting stranger

What are the two criteria that must be met to diagnose exhibitionism?

-Acted on OR -distressed by it

What is fetishism?

Involving the use of non-living objects

Does crossdressing count as fetishism?

What is frotteurism?

Touching and rubbing against a nonconsenting person

What is pedophilia?

Involving sexual activity with a prepubescent child or children (age 13 and younger)

True or false: male premature ejaculation disorder is less common in college+ educated males

False--more common

True or false: pelvic pain disorder is more common in college educated women

True

What sort of history should always be asked with pelvic pain / penetration disorder?

Rape or sexual abuse

What are the commonly abused substances that can cause sexual dysfunction? (6)

- Opioids - Hallucinogens - Cannabis - EtOH - Barbiturates - Stimulants

What age must a pt be to be diagnosed with pedophilia?

either 16, OR 5 years older

When in development does pedophilia begin?

Adolescence

True or false: pedophilia tends to be chronic if the preference is girls

False--if boys

What is sexual masochism?

Involving the act of being humiliated, beaten, bounds, or otherwise made to suffer

What is sexual sadism?

Involving acts in which the psychological or physical suffering of the victim is sexually exciting to the person

What is voyeurism?

The act of observing an unsuspecting person who is naked, in the process of disrobing, or engaged in sexual activity

What is transvestic fetishism?

Cross dressing for sexual satisfaction

What are the four major negative prognostic signs for paraphilic disorders?

- earlier onset - high frequency of acts - No guilt or shame - Substance abuse

Is one paraphilia a good or poor prognostic sign for paraphilic disorders?

Good

Is normal intelligence a good or poor prognostic sign for paraphilic disorders?

Good

Is substance a good or poor prognostic sign for paraphilic disorders?

Poor

Is a h/o normal intercourse in addition to paraphilia a good or poor prognostic sign for paraphilic disorders?

Good

What are the treatments for paraphilic disorders?

- Chemical castration | - Dynamic psychotherapy