Chapter 14---Human Sexuality

sex is about ____

10% of the relationship, but when there are problems, sex becomes of the focus of the couple’s relationship

self-awareness

individuals know their own bodies, needs, and preferences

communication

the respective partners feel comfortable talking about sex with each other

positive role models

individuals have watched loving adults display physical affection

sexual competence includes:

• self-awareness

• communication

• absence of past trauma that has not been addressed

• positive role models

• consent

• therapy as needed

sexual problems are_____

not infrequent, with one Australian study reporting that 48% of men and 68% of women reporting at least on difficulty

sexual function includes:

• sexual desire

• arousal

• lubrication

• orgasm

• satisfaction

• pain

sexual dysfunctions

a heterogeneous group of disorders that are typically characterized by a clinically significant disturbance in a person’s ability to respond sexually or experience sexual pleasure

***an individual may have several at dysfunctions at once

the term sexual dysfunction is not appropriate if_____

the problem is caused by inadequate simulation

sexual problems have been medicalized in an attempt to_____

identify medical sources for their causes and treatment, however, it lacks a focus on emotional and psychological factors that impact sexual feelings and behavior

a couple may have various sexual issues, yet_____

still be happy with each other and their sexual relationship

lifelong/primary dysfunction

a person has ALWAYS experienced this

acquired/secondary dysfunction

CURRENTLY experiencing this, but has not always experienced

situational dysfunction

only SOMETIMES———occurs only with certain types of stimulation, situations, or partners

generalized dysfunction

not limited to certainypes of stimulation

sexual dysfunctions affects the ____

EPOR cycle, or the Excitement, Plateau, Orgasm, and Resolution phases

you cannot have situational and ____

generalized, but you can have acquired and situational or generalized and acquired

men will not go to the doctor until_____

their medical condition negatively impacts their sex life

Cardiovascular, diabetes, arthritis, prostate and breast cancer are_____

among the most common causes of erectile and general sexual dysfunction

COVID-19 has been linked to____

erectile dysfunction due to its damage to blood vessels/flow

psychiatric disorders are also_____

associated with sexual dysfunctions because of its hormonal and neuronal connections

neurological conditions that affect sexual performance include____

parkinsons, MS, and alzheimer’s

vaginal atrophy

as you age, all of your tissue loses their thickness—that atrophy can create issue for women

more organic factors that affect your ability to have sex include:

Age, weight, alcohol, drugs, prescription medicine

children who learn that sex is a taboo subject may_____

come to regard sex as somehow wrong or shameful

traditional gender role socialization is an _____

example of a sociocultural factor of sexual dysfunction

performance anxiety

the excessive concern over adequate sexual performance

higher levels of stress are associated_____

with lower levels of sexual arousal

fear of an STI can affect____

sexual desire and arousal

relationship, marriage, and sex therapists always focus on the _____

relationship between the partners before addressing a specific sexual dysfunction, such as lack of orgasm

sexual destiny

the belief that couples “naturally” have a good sexual relationship—-not the result of working on their relationshop and their sex life

sexual growth

posits that good sexual relationships result from the partners working on their relationship

endorsing greater sexual destiny beliefs was linked_____

to lower relationship satisfaction

Female sexual interest/arousal disorder (FSAD)

The inability to attain or maintain sexual excitement due to subjective or physical factors and responses

• This historically was known as “hysteria” or “frigidility”

• This is a service connected disorder—-comorbidity with like anxiety, PTSD, depression which is why it's commonly diagnosed in women serving

• It impacts your mood, your relationship, among other things—-women may take a low dose of testosterone for women with FSAD but the jury is still out on this

treatment for FSAD includes

• check hormones

• couples therapy

• sensate focus

• education

• masturbation

• rest

male hypoactive desire disorder

persistent or recurrent deficiency (or absence) of sexual fantasies, thougths, and desire for (or receptivity to) sexual activity, which causes personal distress

treatment for MHDD

couples therapy, examine other causes (ED, PE)----going to check hormone levels and this is mostly seen as a testosterone level issue so they give them testerone as treatment, etc.

premature ejaculation

ejaculation within 60 seconds of penetration

FSAD may result from_____

estrogen deficiency——the most common cause is menopause

sensate focus

an exercise where the partners focus on pleasuring each other in non-genital ways

masturbation is a way to ____

treat FSAD

FSAD was previously known as _____

hypoactive sexual desire disorder

poor communication in a relationship is a contributing factor to _____

male hypoactive sexual desire disorder

male hypoactive sexual desire disorder involves_____

an absence of sexual thoughts or fantasies

erectile dysfunction

the inability to have or maintain an erection for sexual expression and/or decrease in rigidity

****Often caused by chronic health issues, performance anxiety, condom use

diagnostic criteria of premature ejaculation requires that the _____

condition is NOT a consequence of severe relationship distress

some men are_____

genetically wired to ejaculate quickly because they have a constitutionally hypersensitive sympathetic nervous system

Female orgasmic disorder

A marked delay in, marked infrequency of, or absence of orgasm

• Markedly reduced intensity of orgasmic features

• Symptoms have persisted for a minimum of 6 months and cause distress.

the main reasons for why women had infrequent orgasms included______

• stress/anxiety

• insufficient arousal

• lack of time their partner spent stimulating their clitoris

psychosocial and cultural factors associated with orgasmic dysfunctions in women include:

• restrictive upbringing

• learning a passive female sexual role

spectatoring

aka sexual self-monitoring—- can result in erectile dysfunction

the most effective interventions for helping a woman become orgasmic include_____

• sexuality education

• communication on general and sexual issues

• attention to relationship and body image

• directed masturbation

delayed ejaculation

****marked delay in ejacalution

• Marked infrequency or absence of ejaculation

• Symptoms have persisted for a minimum of 6 months and cause distress.

inhibited male orgasm is another term for ____

delayed ejaculation

persistent genito-pelvic pain/penetration disorder

***persistent difficulties in:

• vaginal penetration

• marked vulvovaginal or pelvic pain during vaginal intercourse or penetration attempts

• Marked fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during, or as a result of vaginal penetration

• Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetration

******The above symptoms have persisted for a minimum duration of approximately 6 months, and the individual is distressed about the symptoms.

vaginismus

recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that makes vaginal penetration difficult

in men, dyspareunia may be caused by_____

retrograde ejaculation

dyspareunia

a type of genital sexual pain, is pain during sexual intercourse. The pain may occur as soon as penile entry begins, during penile containment/movement, at ejaculation by the partner, or after intercourse

****may be experienced by either women or men

the most common cause of painful intercourse among postmenopausal women is ____

a lack of estrogen

reduced estrogen levels can cause_____

shrinkage of the vaginal mucosa, resulting in the narrowing of the vaginal opening

dyspareunia may also be caused by _____

vaginal or pelvic infections or inflammations or by allergic reactions to deodorants, douches, and contraceptive devices

vulvodynia

a chronic discomfort or pain of the vulva——major cause of dyspareunia