chapter 13.doc

Chapter 13 – Sexual Dysfunction Sexual disorders Sexual disorders The following notes outline key issues in this chapter. Challenges to sexual relationships - Feelings about Sexual Dysfunction Consider the following questions prior to reading the chapter: : If I were unable to have an orgasm or erection, I would: Why do you think you feel this way? If my partner were unable to have an orgasm or erection, I would: Why do you think you would feel this way? If a friend were experiencing a sexual dysfunction, this is the advice I would give him or her? Sexual Dysfunctions Sexual Dysfunctions Sexual Dysfunctions are persistent or recurrent difficulties in becoming sexually aroused or reaching orgasm. Many people with sexual dysfunctions have difficulty taking about it. Factors which may negatively impact sex lives of individuals Too tired Too busy Relationship problems Lack of desire Health problems Partner’s lack of desire Lack of partner Money or job problems Partner’s appearance Partner’s feelings about your appearance Types of Sexual Dysfunctions Four categories of sexual dysfunctions: Sexual desire disorder Sexual arousal disorder Orgasmic disorder Sexual pain disorder What are the factors involved in each type of sexual dysfunction? 1 Sexual Desire Disorder Involve lack of sexual desire or interest May also include an aversion to genital sexual activity Many appreciate the affection and closeness of physical intimacy but have no interest in genital stimulation Hypoactive sexual desire most frequent diagnosis although no consensus among researchers regarding the definition of low sexual desire Biological factors and psychosocial factors also contribute to lack of desire Examples of these may be hormonal deficiency, depression, marital satisfaction Abrupt changes in sexual desire are more often explained by psychological and interpersonal issues than biological Anxiety and medication may also contribute to low sex drive Sexual Aversion Disorder Some researchers consider it to be sexual phobia or sexual panic state with Intense, irrational fears of sexual contact Desire to avoid sexual stimulation History of sexual trauma often figure prominently Sexual Arousal Disorder Sexual dysfunction Individuals persistently or recurrently failed to become adequately sexually aroused Unable to engage in or sustain sexual intercourse May include male or female erectile disorder May include performance anxiety Orgasmic Disorders Male orgasmic disorder Female orgasmic disorder Premature ejaculation The man or woman is persistently delayed in reaching orgasm or does not reach orgasm at all, despite achieving sexual stimulation that would normally be of a sufficient intensity to result in orgasm. More common among woman than men Male Orgasmic Disorders 2 Male term has been labeled: Delayed ejaculation Retarded ejaculation Ejaculatory incompetence Problem may be generalized, acquired or situational Female Orgasmic Disorder Unable to reach orgasm or have difficulty reach orgasm Women who have never hand an orgasm – term- Ana orgasmic Premature Ejaculation Men ejaculate too rapidly to permit their partners or themselves to enjoy sexual relations fully Sexual dysfunction in which ejaculation occurs with minimal sexual stimulation and before the man desires it Sexual Pain Disorders For some coitus gives rise to pain and discomfort Dyspareunia: impact men and women Pain during sexual intercourse Indicates that something is wrong physically or psychologically For women often inadequate lubrication, or sexually transmitted infections, vaginal infections or allergies In men, generally associated with genital infections that cause burning or painful ejaculation Sexual Pain Disorders Vaginismus: involuntary contraction of the pelvic muscles that surround the outer third of the vaginal barrel. Occur reflexively during attempts a vaginal penetration Psychological fear of penetration Organic Causes Fatigue and lowered testosterone levels Physical and emotional health Use of drugs and alcohol Prescription or illicit drugs 3 Psychosocial factors Cultural influences: children raised in repressive culture and home feel more negative about sex, feel less pleasure, for children who masturbate and get in trouble for it may feel less pleasure about it, many cultures teach that sex is a duty not a pleasure, in repressive cultures hard to tell our partners what we want Psychosexual trauma: when a person who was sexual victimized as a children become sexual aroused later in life, sexual simuli can cause anxiety Sexual orientation: sometimes gay people test their orientation by testing their sexuality first with hetero-relationships Ineffective sexual techniques: couples may follow a narrow sexual routine, maybe because a dominant partner controls everything ie timing, couples who do not experiment or do not tell their needs and wants may lose interest Emotional factors: some people have a fear of losing control which may make them hold back an organsm, stress, depression Problems in the relationship: couples find that sex is no better than the other parts of the their relationships ie if the communication is bad the sex is bad, communication of sexual desires important, using sex to argue such as withholding orgasm to show their inadequacy Psychological conflicts: Lack of sexual skill: people may not develop skills because of lack of opportunities, even in a committed relationship, sexual disfunctions can get in the way of developing skills Irrational beliefs: Performance anxiety: when a person becomes overly concerned about how they do at a certain task, instead of focusing on the pleasure they focus on self doubt