Sexual Disorders Summary

Man has uncontrollable urge to wear woman’s clothing for sexual gratification.
Cross-dressing with compulsive quality consuming emotional energy.
Causes may include adolescent curiosity or initiation by a parent.
Nursing interventions: Approach with respect, offer a non-judgmental environment, and person-centered care.
Assessment: Mental health evaluation and understanding client's motivations.
Psychosocial support: Encourage open communication, empowerment, and validation.
Therapeutic communication: Educate on healthy sexual expression and address shame/guilt.
Coping mechanisms: Develop strategies for managing impulses and stress.
DSM 5 changes: No longer specifies “In a heterosexual male”; specifies fetishism or autogynephilia.

Sexual gratification from observing nudity or sexual activity of others without their awareness.
More common in men; often referred to as "Peeping Tom."
Diagnostic criteria include recurrent fantasies, urges, or behaviors over 6 months causing distress or difficulty.
Symptoms: Sexual frustration, feeling incapable of establishing regular sexual relationships.
Treatment: psychotherapy, marital therapy, group therapy, family therapy, cognitive therapy, psychoanalysis and pharmacotherapy.
Treatment: SSRIs are used to alter the balance of dysfunctional serotonergic system.
DSM 5 changes: nonconsenting person, or distress/ impairment; >18; specifier: controlled environment or in remission.

Refers to an abnormality in an individual's sexual responsiveness and reactions.
DSM-IV-TR diagnostic criteria include:
- Hypoactive Sexual Desire Disorder
- Sexual Aversion Disorder
- Female Sexual Arousal Disorder
- Male Erectile Disorder
- Female Orgasmic Disorder
- Male Orgasmic Disorder
- Premature Ejaculation
- Dyspareunia
- Vaginismus
Causes include:
- Physiological: neurological problems, cardiovascular disease, cancer, urogenital disorders, medications, fatigue, hormonal loss.
- Psychological: depression/anxiety, prior sexual or physical abuse, stress, substance abuse.
- Interpersonal Relationships: partner performance, lack of partner, relationship quality.
- Sociocultural Influences: inadequate education, conflict with values, societal taboos.
Treatment: Intensive therapy, cognitive therapy, cognitive behavior therapy.

Erectile Dysfunction (ED):
- Medications: Sildenafil (Viagra), Tadalafil (Cialis), Vardenafil (Levitra) to increase blood flow.
- Therapy: Cognitive behavioral therapy (CBT) for stress or anxiety.
- Lifestyle Changes: Quit smoking, reduce alcohol, maintain healthy weight, exercise.
Premature Ejaculation (PE):
- Medications: SSRIs (paroxetine, sertraline), topical anesthetic creams.
- Behavioral Techniques: "Start-stop" and "squeeze" techniques.
Female Sexual Dysfunction:
- Lubricants: Alleviate pain due to vaginal dryness.
- Estrogen Creams: For dryness due to menopause.
- Pelvic Floor Therapy: Strengthen pelvic floor muscles.
Painful Intercourse (Dyspareunia):
- Medical Treatments: Medications or hormone therapy based on cause.
- Pelvic Floor Therapy: Exercises to relax muscles.
- Sexual Therapy: Address anxiety, stress, or relationship issues.

Feeling one's emotional and psychological identity as male or female to be opposite to one's biological sex.
In children, manifested by:
- Desire to be other sex, cross-dressing, preference for cross-sex roles, rejection of typical toys, preference for playmates of other sex, dislike of sexual anatomy.
In adolescents and adults, manifested by:
- Desire to be other sex, passing as other sex, desire to live as other sex, conviction of having feelings of other sex.
Treatment for children:
- Family therapy, individual psychotherapy, parental support, group work, regular reviews, hormone therapy.
Treatment for adults:
- Mental health support, hormone treatment, speech therapy, hair removal, peer support groups.