Sexual Dysfunction

Question 1

How prevalent are sexual dysfunction disorders in men and women?

Answer 1

40-50% women

20-30% men

Question 2

What are the four aetiological factors for SDS? Name some examples in each

Answer 2

1. Biological or Physical - ageing, illness, disability, medications
2. Psychosocial - cultural/religious beliefs, self-acceptance/body image, life stress, past experiences, performance anxiety
3. Interpersonal - attraction to partner, change in roles (wife to carer), relationship quality
4. Environmental - lack of privacy, time, physical discomfort

Question 3

What are some of the differences between psychogenic vs organic disorder

Answer 3

organic - gradual onset/sudden deterioration, occurs always, decrease in morning erection, no erections with masturbation, sometimes with chronic medical illness, trauma, surgery, disease, drug use.

psychogenic - sudden onset, situational (partner specific or depression), preserved morning erections, erection with masturbation, may be partner specific, usually younger patient, potentially other psych problems.

Question 4

The DSM defines sexual dysfunction as a clinically significant disturbance in a person’s ability to ______ sexually, or to experience sexual ______. Minimum duration of ________ and in ____/____ sexual activity. This rules out any _________ stress factors. The dysfunction will also cause the person significant ______.

Answer 4

respond
pleasure
6 months
most/all
situational
distress

Question 5

List all the disorders for sexual dysfunction

Answer 5

Male

• sexual desire
• sexual arousal
• pre-mature/delayed ejaculation

Female

• sexual desire and arousal disorder
• orgasmic disorder
• genito-pelvic pain

Question 6

sexual desire disorder _____ in prevalence in women with age. However, on average it affects ____% of women and ____% of men. Sexual desire/arousal disorder in women (now combined) is prevalent too, around _______%

Answer 6

increases, 55%, 8%, 30-50%

Question 7

What is the most prevalent sexual dysfunction disorder in women?

Answer 7

sexual interest/arousal disorder - 55%
Note this does not mean they have a lower libido. It means there are women who are distressed by it and which persists on most occasions for 6 months.

Female orgasmic disorder ~51% - very prevalent!

Question 8

In male sexual desire disorder, they have ____ interest in sex, limited ____ _____ or _______. However, the _______ response may be normal.

Answer 8

little, sexual activity, fantasising, physical

Question 9

In females, sexual interest/desire and sexual arousal disorders were combined in the DSM-5 because…?

Answer 9

There was significant overlap between symptoms

Question 10

Male sexual arousal disorder is known as ______ _______. It involves difficulty in _______or _______ an erection, or a decrease in erectile _______

Answer 10

erectile disorder
obtaining or maintaining
rigidity

Question 11

Erectile disorder increases with _____, and also with other lifestyle factors such _____ and _______. It is also known that, around some point in their life, ____ of men will experience ED.

Answer 11

age
smoking
obesity
half

Question 12

There are two male orgasmic disorders, ______ ejaculation and _______ ejaculation. The former is much less common, with only ___% of men reporting it. However, it can be quite distressing as the man wishes to _____ but cannot. The latter is much more common, occurring in ____% of men

Answer 12

delayed
premature
4%
orgasm
8%

Question 13

Female orgasmic disorder is the ______, reduced ______ and/or _____ of orgasmic sensations. It is very prevalent, however, orgasm is a ______ response in women.

Answer 13

absence, frequency, intensity

learned

Question 14

Genito-pelvic pain involves _______ - persistent or recurrent pain during attempted or complete vaginal entry. The prevalence is around ______%. It also involves ______ - where the muscles in the vagina involuntarily contract whenever vaginal penetration is attempted. This makes intercourse _____ or ______. It’s prevalence is ______%. These were ______ disorders in the DSM-IV and are now combined

Answer 14

dyspareunia
14-27%
vaginismus
painful, impossible
5-17%
separete

Question 15

Describe the cycle of pain in genito-pelvic pain/penetration disorder

Answer 15

muscles tighten with entry –> makes sex painful –> continues to intensify –> body reacts by bracing –> avoidance of intimacy —> however, when intercourse does occur, the body anticipates pain and tightens, further exacerbating the issue

Question 16

Name four ways psychological therapy can be used for sexual dysfunction.

Answer 16

1. psycho-education
2. communication-skills training - communication is so important!!!
3. CBT
4. Sensate Focus exercises

Question 17

Sensate Focus exercises involve a graded series of mutual _____ _______ exercises. The goal here is _____ and _______, not _________. This takes the pressure off ________.

Answer 17

body touching
intimacy
sensuality
penetration
performace

Question 18

Any effective treatment for sexual dysfunctions must be ___________.

Answer 18

multi-modal

Question 19

Name some medical treatments available to males

Answer 19

Mainly for erectile dysfunction

• Viagra - highly effective
• penile injections - gives you erection for 30-40mins
• vacuum devices
• penile prosthesis - last reort

Question 20

Despite the focus on restoring the erection with the medical methods, what else should be considered?

Answer 20

Important to promote sexual intimacy, despite functional challenges. Possible to have a sex life without erection-dependent sex.

Question 21

Name some medical treatments available to females for desire/arousal disorder

Answer 21

pharmacological interventions - hormonal therapy or a drug similar to viagra (limited effectiveness). New intervention called vacuum therapy now…creates gentle sucking of the clitoris

Question 22

Name some medical treatments available to females for genito-pelvic pain/penetration disorder

Answer 22

1. kegel exercises and vaginal weights - strengthens muscles of pelvic floor
2. vaginal lubricants
3. vaginal moisturisers
4. vaginal dilators - rubber tube to stretch vagina