Chapter 13.pdf

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Department
Family Relations and Human Development
Course Code
FRHD 2100
Professor
Cynthia Clark

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Chapter 13 -Sexual Dysfunctions Types of Sexual Dysfunction Sexual Dysfunction: Apersistent or recurrent difficulty with a lack of sexual desire or arousal, or difficulty reaching orgasm Sexual Desire Disorder • These involve lack of interest in sex or aversion to sexual contact • Often report absence of sexual thoughts or fantasies • Found that the incidence of low sexual desire was 26.7% for premenopausal women and 52.4% for postmenopasusal women • The problem is more common among women than men • Some people wiht low sexual desire can beocme sexually aroused and reach orgasm when adequately stimulated • Hypoactive sexual desire is one of the most commonly diagnosed sexual dysfunctions • When discrepancies in desire arise for heterosexual couples, the men are more likely than the women to have higher levels of desire • It is speculated that gay and lesbian couples may have fewer discrepancy troubles Sexual – Aversion Disorder • People with low sexual desire may have little or no interest in sex but they're not repelled by genital contact • Overly anxious in sexual situations can cause sexual aversion in men because these situations trigger geelings of shame • Sexual trauma such as rape or childhood sexual abuse or incest, ofen figure prominently in cases of sexual aversion, among women Sexual-Arousal Disorder • Vasocongestion: Engorgement of blood vessels with blood, which swells the genitals and breasts during sexual arousal • People with sexual-arousal disorder fail to achieve to sustain the erections or lubrication necessary to failitate sexual activity Male Erectile Disorder • Persistent difficulty getting or maintaining an erection sufficient to allow the man to engage in or complete sexual activity.Also term erectile dysfunction • It is found during any sexual activity, including masturbation • It increases with age • Survey found that about 30% of men in their 40s, a little over 40% in their 50s and about 65% in their 60s have some degree of erectile dysfunction • PerformanceAnxiety:Anxiety concrning one's ability to perform behaviours, especially behaviours that may be evaluated by other people ◦ This anxiety can contribute to repeated difficulty in gaining and maintaining an erection, resulting in a vicious circle of anxiety and erection problems Female Sexual-Arousal Disorder • Women may encounter persistent difficulties becoming sexually excited or sufficiently lubricated in response to sexual stimulation • Difficulties are pervasive and occur during both masturbation and sex with partners • According to Basson (2004), most women with arousal disorder experience little or no subjective arousal or sexual excitement • These women can be categorized into two groups ◦ Combined arousal disorder experience no subjective arousal and feel no genital response ◦ Women with subjective arousal disorder are aware that their genitals phyiscally respond to stimulation, but feel no subjective arousal • The skin of some women with sexual arousal problems is less sensitive to touch than the skin of women who don't have such problems ◦ Such women might seek to increase their sexual stimulation by psychological as well as physical means • More often has psychological causes ◦ Women may harbour deep-seated anger and resentment toward their partners ◦ They may fail to become aroused during sexual activity simply because they're no longer sexually attracted to their parnters, or because they're experiencing non-sexual conflicts in their relationships Orgasmic Disorders • Include female orgasmic disorder, male orgasmic disorder and premature or rapid ejaculation • The problem is more commong among women than men • In some cases, a person can reach orgasm without difficulty while engaging in sexual relations with one partner, but not with another Female Orgasmic Disorder • Unable to reach orgasm, or have difficulty reaching orgasm after waht would usually be adequate sexual stimulation • Women who have never reached orgasm through any means are sometimes called anorgasmic or pre-orgasmic • Awoman who reaches orgasm through masturbation or oral sex might not reach orgasm during intercourse with a male partner • Penile thrusting may not provide sufficient clitoral stimulation to facilitate orgasm • Awoman who doesn't reach orgasm during intercourse but can reach orgasm through other types of sexual stimulation doesn't have an orgasmic disorder • Researcher B.J.Rye found that 93% of university women sometimes are usually needed direct clitoral stimulation during intercourse to reach orgasm • 46% of the women surveys had orgasms during at least half of their intercourse experiences, and 49% said it often took them a long time to have orgasms Male Orgasmic Disorder • Been called delayed ejaculation, retarded ejaculation and ejaculatory incompetence • Problem may be lifelong or acquired, generalized or situational • The disorder is limited to intercourse • Men may be capable to ejaculating during masturbation or oral sex but find it difficult or impossible to ejaculate during intercoursee, despite high levels of sexual excitement • May cause by physical problems such as multiple sclerosis or neurological damage that interferes with neural control of ejaculation • Pscyhological factos that play a role: ◦ Performance anxiety ◦ Sexual guilt ◦ Hostility toward a partner Rapid Ejaculation (RE) • Asexual dysfunction in which ejaculation occurs with minimal sexual stimulation, and before the man desires it. It's also called premature ejaculation • Guy Grenier and Sandra Byers (2001) studied the ejaculatory behaviour of a sample of men ◦ The men reported that intercourse lasted for about 8 minutes before they ejaculated ◦ Also reported that ejaculation happened more quickly than they wished in about one-third of their acts of sexual intercourse ◦ They attempted to delaye the timing of their ejaculations during about half of their intercourse experiences ◦ 23% of the men in study said they had problems with premature ejaculation • Helen Singer Kaplan (1974) suggested that the label “premature” be applied to cases in which men persistently or recurrently lack voluntary control over their ejaculations ◦ May sound like contradiction in temrs, given that ejaculation is a reflec, and reflexes needn't involve thought or conscious control ◦ Men might control their ejaculations by learning to regulate the amount of stimulation they experienced, keeping it below the threshold at which the ejaculation reflex was triggered Sexual-Pain Disorders Dyspareunia • Defined as painful intercourse • Incldues persistent pain associated wiht any sitmulation of the vaginal area • Women with female partners can also experience gential pain during sexual activities, epsecially during the insertion of fingers or didldo into the vagina • Painful intercourse is less common in men, and then its generally associated with gentital infections that cause bruning or painful ejaculation • Most common sexual dysfunction and a common complaint of women seeking gynecological services • May result from physical causes, emotional factors, or an interaction of the two • Mose common cause of pain during intercourse is inadequate lubraication • Women with this disorder tend to have lower tolerance for pain, not only in the vaingal area but also on the upper arms, suggsting that a genralized hypersensitivty may contibute to this problem • Binik (2005) argues that dyspareunia should be categorized as a pain disorder, rather than a sexual dysfunction ◦ Believes every case has both physiological and psychological components • Researchers have found that women who believe their pain is due to psychosocial factors report highe rlevels of pain and more sexual problems than women who believe their pain is due to physical causes Vaginismus • Involves an involuntary contraction of the pelvic muscles that surround to outer one-third of the vaginal barrel, resulting in paing • Avoidance of penetration seems to be the key factor differentiating vaginismus from dyspareunia • Occurs reflexively during attempts at vaginal penetration, makiing entry by a penis, fingers or a dildo painful or impossible • Usually casued by a fear of penetration, rather than by physical injury or defect • Women who have this often have histories of sexual trauma, sexual assault or botched abortions that have resulted in vaginal injury Vulvodynia • Vulval pain, particularly a chronic burning sensaiton, irritation and soreness • Pain that can be experienced through both sexual and non-sexual contact at the entrance of the vagina • Women with Vulvar Vestibulitis (VV) usually seek treatment because they experience pain when penetration is attempted • Unlike VV, vulvodynia does not requite some kind of external cotnact for pain to be triggered • Low sexual-esteem, anxiety and hyper-vigilance (obsessional focus on pain) may conribute to VV Origins of Sexual Dysfunction • Biopsychosocial Model: An approach to explaining dysfunction that looks at the interactions of biological, psychological, and sociocultural factors Biological Causes • Low sexual interest, along with erectile difficulty, is common among men with hypogonadism • Hypogonadism:An endocrine disorder that reduces the output of testosterone • Reduction in testosterone levels that occurs in middle and later life may in part explain the gradual decline in male sexual desire • Female desire may also decline with age, because of physical and psychological changes • Tumescence: Swelling; erection • Healthy men usually have erections during REM sleep which occurs every 90 to 100 mintues • Men with biologically based erectile disorder often don't have nocturnal erections • Fatigue may lead to erectile disorder and orgasmic disorder in men and to inadequate lubrication and orgasmic disorder in women Health Problems • Painful sex often reflects an underlying infection • Medical conditions that affect sexual response include heart disease, diabetes mellitus, multiple sclerosis, spinal-cord injury, complications from surgery • Psychological factors include anger, depression • Cardiovascular problems can lead to erectile disorder by affecting the flow of blood to and through the penis, a problem that becomes more common as men age • Damage to the nerves involved in erection can also play a role • Erectile problems can arise when clogged or narrow arteries leading to the penis deprive it of oxygen • Rimm (2000) studied 2000 men and found that erectile dysfunction was connected with a large waist, physical inactivity, and to much alcohol consumption ◦ Cholesterol can impede the flow of blood to the penis, just as it impedes the flow to the heart • For both men and women, hypertension (high blood pressure) and the durgs used to treat it can negatively effect sexual functioning Aging • Men who exercise regularly seem to ward of erectile dysfunction Drugs • Anti-depressent medicaitons and anti-psychotic drugs can impair erectile functioning and cause orgasmic disorders • Tranquilizers such as Valium and Xanx may cause orgasmic disorder in either sex SSRIS and Sexual Response • Selective seotonin reuptake inhibitors (SSRIS) are prescribed not only for depression, but also for panic disroder, obsessive-complusive disorder, anorexia nervos and other conditions ◦ may prevent sexual desires Psychological Causes • Factors such as
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