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Sexual dysfunction 9-10Q Flashcards

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1
Q

What is a sexual dysfunction?

A

disorders that make normal arousal and sexual response difficult or impossible

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2
Q

What is the difference between dysfunctions and paraphilias?

A

Paraphilias: arousal/response dependent on unusual things but physiological response intact

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3
Q

What are the 4 types of sexual dysfunctions?

A
  1. sexual desire disorders
  2. sexual arousal disorders
  3. orgasmic disorders
  4. sexual pain disorders
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4
Q

What is the prevalence of sexual dysfunction in females? males?

A

females 43%

males 31%

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5
Q

What is the prevalence of hypoactive sexual disorder in females? males?

A

females 30%

males 15%

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6
Q

Sexual arousal disorders (ED in men and sexual desire disorder in women) are how prevalent?

A

10-20%

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7
Q

What % of women does orgasmic disorder affect?

A

10-15%

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8
Q

What is the most common complaint of men?

A

premature ejaculation

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9
Q

What is the prevalence of premature ejaculation?

A

~30%

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10
Q

What is the prevalence of sexual pain disorders in women? men?

A

women 10-15%

men 5%

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11
Q

What are the basic causes of sexual dysfunction?

A

organic, psychogenic and cultural/interpersonal

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12
Q

What is a situation dysfunction?

A

a dysfunction that only occurs in given circumstances

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13
Q

What is a primary dysfunction?

A

present for all of life

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14
Q

what is a secondary dysfunction?

A

occurs now or sometimes

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15
Q

What are the 4 main strategies of sex counseling?

A
  1. changing attitudes
  2. providing info
  3. giving permission
  4. reducing anxiety
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16
Q

What did the early methods to treat sexual dysfunction focus on?

A

FREUD’s psychoanalytic model

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17
Q

What approach did KAPLAN and JOHNSON introduce?

A

behavioural approach

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18
Q

What was the combo method used by KAPLAN?

A

psychosexual therapy

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19
Q

What are the 2 sexual desire disorders that affect both genders?

A

low or inhibited sexual desire

compulsive sexual behaviour

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20
Q

What is low or inhibited sexual desire disorder?

A

lack of interest, doesn’t initiate, doesn’t respond but normal physiological function

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21
Q

What are the causes of low or inhibited sexual desire disorder?

A
  • hormonal deficiencies or illness
  • depression or anxiety
  • relationship dissatisfaction
  • history of assault or abuse
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22
Q

What are the tx methods for low or inhibited sexual desire disorder?

A
  • relationship counseling and sex ed
  • therapy for psychological illness or abuse
  • behavioural exercises (sensate flow)
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23
Q

What is compulsive sexual behaviour?

A

constant sexual desire with pursuit of gratification, but an inability to have satisfying interpersonal relationships

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24
Q

What causes compulsive sexual behaviour?

A
  • organic (disease or brain injury)

- strong need for love but inability to relate

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25
what are the tx methods for compulsive sexual behaviour?
- lifestyle counseling or therapy | - meds
26
What is sexual aversion?
- extreme negative reaction to sexual activity | - repulsed by genitals (more often women)
27
Who can be affected by sexual aversion?
both genders
28
what are the causes of sexual aversion?
- shame, fear and anxiety | - hx of abuse or assault
29
What are the tx methods for sexual aversion?
- meds | - psychological counseling
30
Fill in the blanks: sometimes couples struggle with ______ of sexual activity and choice of ______, this is caused by _______ in timing, sex drive, lifestyle demands, emotional needs and activity preferences. Tx for this includes: ID and treat _______ causes and ________ counseling
sometimes couples struggle with frequency of sexual activity and choice of behaviours, this is caused by differences in timing, sex drive, lifestyle demands, emotional needs and activity preferences. Tx for this includes: ID and treat underlying causes and relationship counseling
31
What is dyspareuria? (general)
painful intercourse
32
Who does dyspareuria affect? (general)
both genders
33
Who is most commonly affected by dyspareuria? (general)
women
34
When does substance induced sexual dysfunction occur?
during or soon after intoxication or withdrawal
35
What are the 3 female sexual dysfunctions?
1. interest/arousal disorder 2. orgasmic disorder 3. genito-pelvic pain/penetration disorders
36
What is interest/arousal disorder?
inadequate excitement and vaginal lubrication
37
What causes interest/arousal disorder?
- diabetes - decreased estrogen levels - neurological disorders - anxiety or stress - narcs, alcohol, meds - negative experiences
38
What is the most common cause of interest/arousal disorder?
psychological related to specific situations
39
What are the tx methods for interest/arousal disorder?
- med intervention for physical causes - sex counseling to decrease performance anxiety - relationship counseling
40
What are the 2 types of orgasmic disorders?
anorgasmic | preorgasmic
41
What is orgasmic disorder?
difficulty or inability to achieve orgasm
42
what are the causes of orgasmic disorder?
- guilt or anxiety - insufficient clit stimulation - often situational
43
What are the tx methods for orgasmic disorder?
- counseling and education to counteract negative attitudes towards sex - self exploration and massage - couple education on female sexual response - education and couseling on alternative sexual activities and use of devices
44
What is dyspareuria? (F)
painful intercourse/vaginal penetrations
45
What are the causes of dyspareuria? (F)
- most often: inadequate vaginal lubrication - vaginal infection - PID, endometriosis, other diseases
46
What are the tx methods for dyspareuria? (F)
- medical intervention for physical causes - lube - try different positions - counseling for psychological causes (low self esteem, anxiety) - education on sexual techniques - foreplay
47
What is vulvodynia?
Not a sexual dysfunction!! | vulvar pain- such as chronic burning, irritation and soreness
48
What are the 2 genito-peliv/penetration disoders?
1. dyspareuria | 2. vaginismus
49
What is vaginismus?
involuntary contractions of the pevlic muscles surrounding outer 3rd vaginal barrel
50
What are the causes of vaginismus?
- fear of vaginal penetration often related to assault or abuse
51
What are the tx methods for vaginismus?
- use of graduated plastic vaginal spreaders - couples have sex with women in control - intercourse with women on top - counseling
52
What are the 5 things that male SD can be related to?
1. desire 2. arousal 3. penetration 4. erection maintenance 5. orgasm and ejaculation
53
What is erectile dysfunction?
inability to achieve or maintain an erection of sufficient firmness for intercourse
54
What are the possible causes of erectile dysfunction?
- diabetes (50%) - stress and/or fatigue - decreased testosterone - vascular problems - general illness - narcs, alcohol or meds - anxiety about performance
55
Can you ejaculate without being hard?
yes
56
What are the tx methods for erectile dysfunction?
- 50% psychological: tx aimed at decreased anxiety - vacuum pump - penile injection - penile prosthesis - meds
57
What is a penile injection?
gold standard for erectile dysfunction
58
What is in a penile injection?
mixtures of papaverine, PGE1, phentolamine, foreskolin
59
What are the 2 types of penile prosthesis?
malleable and inflatable
60
How long have inflatable prosthesises been used?.
since 1973
61
explain the 2 types of inflatable prosthesises
3 piece: most natural appearing, excellent flaccidity as well 2 piece: easier to implant, larger scrotal pump
62
What are the complications of penile prosthesis?
- infection - erosion - deformities - mechanical malfunction - pt dissatisfaction
63
What is premature ejaculation (rapid ejaculation)?
inability to delay ejaculation as he wishes
64
What are the causes of premature ejaculation (rapid ejaculation)?
- most have psychological causes - masturbating in secret, learned immediate gratification - 1rst sexual experience in less than ideal situations - anxiety
65
What is the tx for premature ejaculation (rapid ejaculation)?
focused on training the man to focus sensations, anticipate and control orgasm 2 methods: 1. stop and go 2. squeeze technique also some antidepressants may be prescribed
66
What is ejaculatory incompetence?
inability to ejaculate after penetration despite firm erection and sufficient arousal
67
What are the causes of ejaculatory incompetence?
primarily psychological, anxiety
68
What is the tx for ejaculatory incompetence?
focus on psych causes for the inhibition along with use of sensate focus exercises
69
What is dyspareuria? (M)
recurrent or persistent pain occurring either before, during or after intercourse
70
What causes dyspareuria? (M)
herpes, prostatitis or peyronie's disorder
71
What is the tx for dyspareuria? (M)
tx the cause
72
What is peyronie's disorder?
curvature of penis caused by sclerotic plaques on penis | - acquired from disorder of tunia albuginea
73
How do you tx peyronie's disorder?
- oral vit E and cochicine - ultrasound - surgery

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