Sexual Function Difficulties, Dissatisfaction, Enhancement, and Therapy
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Chapter 14: Sexual Function Difficulties, Dissatisfaction, Enhancement,
and Therapy
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Copyright 2016 © McGraw-Hill Education. Permission required for reproduction or display
Sexual Function Difficulties,
Dissatisfaction, Enhancement, and Therapy
- Sexual function difficulties: Definitions, types, and prevalence
- Physical causes of sexual function difficulties and dissatisfaction
- Psychology causes of sexual function difficulties and dissatisfaction
- Sexual function enhancement
- Treating sexual function difficulties
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Sexual Function Difficulties:
Definitions, Types, and Prevalence
- Sexual function dissatisfaction – Alternative term to sexual dysfunction
- Common outcome of a difficulty in sexual functioning
- Classifications of difficulties and dissatisfaction based on medical and feminist models
- DSM-IV-TR
- Working Group for a New View of Women’s Sexual Problems
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Sexual Function Difficulties:
Definitions, Types, and Prevalence
- DSM-IV-TR definition of sexual dysfunction
- Disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty
- Working group for a new view of women’s sexual problems – Women-centered definition
- As discontent or dissatisfaction with any emotional, physical, or relational aspect of sexual experience
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Table 1: DSM-5 Sexual
Dysfunctions/Disorders
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Figure 1: Percentage of Sexually Active Men and Women in Britain, Aged 16-74; Reporting Selected Sexual Problems Lasting 3 Months or More in the Past Year
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Figure 1: Percentage of Sexually Active Men and Women in Britain, Aged 16-74; Reporting Selected Sexual Problems Lasting 3 Months or More in the Past Year
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Figure 2: Percentage of Self-Reported Sexual Functioning at Most Recent Partnered Sexual Event Among U.S. Adults Aged 18-59.
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Figure 2: Percentage of Self-Reported Sexual Function Difficulties in the Past 12 Months Among U.S. Adults Aged 18-59, by Gender and Age
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Figure 4: Percentage of Finnish Adults Who Indicated That They Feel Sexual Desire at Least a Few Times a Week
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Figure 5: Percentage of Finnish Adults Who Indicated That If They Could Choose Freely They Would Like to Have Intercourse at Least Twice a Week
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Other Disorders
- Anodyspareunia – Pain occurring during anal intercourse
- Peyronie’s disease – Condition in which calcium deposits and tough fibrous tissue develop in the corpora cavernosa within the penis
- Priapism – Prolonged and painful erection, occurring when blood is unable to drain from the penis
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Physical Causes of Sexual Function Difficulties and Dissatisfaction in Men
- Diabetes
- Alcoholism
- Lumbar disc disease
- Multiple sclerosis
- Atherosclerosis
- Spinal cord injuries
- Prostate-cancer treatment
- Smoking
- Bicycle-induced sexual difficulties
- Diseases of the heart and circulatory system
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Physical Causes of Sexual Function Difficulties and Dissatisfaction in Women
- Diabetes and heart disease
- Hormone deficiencies and neurological disorders
- General poor health, extreme fatigue, drug use, and alcoholism
- Spinal cord injuries
- Multiple sclerosis
- Dyspareunia
- Weak pubococcygeus – Pelvic floor muscle surrounding the urethra and the vagina
- Endometriosis, ovarian, uterine tumors, and cysts
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Psychological Causes of Sexual Function Difficulties and Dissatisfaction
- Immediate causes
- Fatigue and stress
- Ineffective sexual behavior
- Sexual anxieties
Spectatoring – Person becomes a spectator of her or his own sexual performance
- Excessive need to please a partner
- Conflict within self
- Internalized homophobia – Self-hatred because of one’s homosexuality
- Relationship causes
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Sexual Function Enhancement
- Improving the quality of a sexual relationship
- Developing self awareness
- What is good sex?
We feel good about ourselves, our partners, our relationships, and our sexual behaviors
- Discovering your conditions for good sex
- Doing homework exercises
Mirror examination
Body relaxation and exploration
Masturbation
Develop your own erotic “sexual voice”
Kegel exercises
Erotic aids or sex toys
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Sexual Function Enhancement
- Intensifying erotic pleasure
- Developing bridges to desire
- Sexual arousal
- Alternatives to intercourse
- Changing a sexual relationship
- Focus on the tasks of daily living that you share
- Expand your repertoire of sexual behaviors
- Address issues with partner
- Deal with unresolved personal issues
- Do not become overly concerned with possible sexual problems
- Embrace a deeper connection
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Treating Sexual
Function Difficulties
- Masters and Johnson: A cognitive-behavioral approach
- The majority of sexual function problems are the result of sexual ignorance, faulty techniques, or relationship problems
- Treated difficulties using a combination of cognitive and behavioral techniques
- Treated couples rather than individuals
- Sensate focus – Focus on touch and the giving and receiving of pleasure
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Table 2: Strategies to Cope
With Sexual Difficulties
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Treating Sexual
Function Difficulties
- Treating male function difficulties
- Erection difficulties
- Early ejaculation
- Squeeze technique – Penis is brought manually to a full erection
- Male orgasmic disorder
- Treating female function difficulties
- Female orgasmic disorders
- Vaginismus
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Common Erection Myths
- Erection is something that is achieved
- Men are sex machines, always ready, always hard
- During a sexual encounter, you get only one shot at an erection
- I blew it last time; I will never get it up again
- If I can’t have an erection, my partner can’t be sexually satisfied
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Treating Sexual
Function Difficulties
- Kaplan: Psychosexual therapy
- Modified Masters and Johnson’s behavioral treatment program to include psychosexual therapy
- Other nonmedical approaches
- PLISSIT model of therapy
Permission, limited information, specific suggestions, and intensive model of therapy
- Self-help and group therapy
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Table 3: Women’s Most Frequent Activities to Facilitate Orgasm During Intercourse
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Treating Sexual
Function Difficulties
- Medical approaches
- Lubricating jelly or estrogen therapy
- Microsurgery to improve a blood flow
- Viagra
- Homeopathic products
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Gay, Lesbian, and
Bisexual Sex Therapy
- Different issues than heterosexuals
- Homophobia, societal and internal, may be an issue
- Sex and HIV infection
- Require sex therapists to expand their understanding and treatment of sexual function problems
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Final Thoughts
- Sexual function difficulties: Definitions, types, and prevalence
- Physical causes of sexual function difficulties and dissatisfaction
- Psychology causes of sexual function difficulties and dissatisfaction
- Sexual function enhancement
- Treating sexual function difficulties
