Bio 310: Unit 8

Sex Therapy

Aims to modify dysfunctional cognitions (beliefs and attitudes) and behaviours as quickly as possible -Usually involved both partners

Performance Anxiety

*A prominent cause of erectile disorder* -Anxiety concerning one's ability to perform behaviours that may be evaluated by other people

Psychosocial causes

-Cultural Influences -Psychosexual trauma -Emotional factors -Myths and misinformation -ineffective sexual techniques -Boredom and routine -Lack of sexual communication -Realationship issues -Performance Anxiety

Treatments for sexual arousal disorder

-To reduce performance anxiety the partners engaged in undemanding sexual contacts that don't demand lubrication or erection and slowly work their way up to sexual intrcourse. -If the man loses his erection the stop intercourse and the women continues to tease the man into erection and begins intercourse again

Master's and Johnson's Approach

A female and male therapy team focuses on the couple as the unit of treatment during a 2 week residential program -They consider the couple dysfunctional, not the individual -Anxiety and resentments are aired but the focus of treatment is behavioural change -a couple performs daily sexual home work assignments, such as senate-focus exercises, in the privacy of their own bedroom

Vulvodynia

A gynaecological condition characterized by vulval pain, particularity a chronic burning sensation, irritation and soreness -Does not require external contact for pain to be triggered Not considered a sexual dysfunction

Genital Arousal Disorder

A minority of women can become aroused by many different kinds of stimuli but don't find stimulation of their genitals arousing -Can still be highly interested in sex, and become sujectively aroused, as long as they experience non-genital stimulation

Vulvar Vestibulitis (VV)

A pain that can be experienced through both sexual and non-sexual contact at the entrance of the vagina (ex at the vestibule, which is bordered by the inner vaginal lips) -Usually seek treatment, because they experience pain when penetration is attempted

Sexual Dysfunction

A persistent or recurring lack of sexual desire or difficulty becking sexually aroused or reaching orgasm -Temporary or occasional problems with sexual response do not qualify as a sexual dysfunction *Only considered a dysfunction if the problem persists over time and causes distress*

Vaginismus

A sexual dysfunction characterized by involuntary contractions of the muscles surrounding the vaginal barrel, preventing or making penetration painful -Usually caused by fear of penetration -Often have histories of sexual trauma, sexual assault or botched abortions that have resulted in vaginal injury -They may desire sexual relations and may be capable of becoming sexually aroused and achieving an orgasm, but their fear of penetration triggers an involuntary spasm of the vaginal musculature at the point of insertion of something into their vaginas *can also be a cause or effect of Dyspareunia

Dyspareunia

A sexual dysfunction characterized by persistent or recurrent pain during sexual activity -Also includes persistent pain with the stimulation of the vaginal area -Pain is a sign that something is wrong-physically or psychologically *The most common cause of pain is inadequate lubrication -Pain during deep penetration may be caused by internal issues -Psychological issues may be from unresolved guilt or anxiety related to sex, or the lingering effects of a sexual trauma

Rapid Ejaculation "Premature Ejaculation"

A sexual dysfunction in which ejaculation occurs with minimal sexual stimulation, and before the man desires is

Biopsychosocial Model

An approach to explaining sexual dysfunction that looks at the interactions of biological, psychological and sociocultural factors

Hypogonadism

An endocrine disorder that decreases that output of testosterone

Physical causes of Female/Male Sexual Arousal Disorders

Any neurological, vascular, or hormonal problem that interferes with the lubrication or swelling response of the vagina/penis to sexual stimulation may contribute to sexual arousal disorder Ex) Diabetes may lead to diminished sexual excitement, because the nerves that service that clitoris degenerate and the blood vessels become damaged -Childhood sexual abuse is especially prevelent among women with this disorder

Sexual-Pain Disorders

Both men and women may suffer from dyspareunia (pain during sex) -Women may experience Vaginismus (involuntary contraction of the muscles surrounding the vaginal barrel, which makes penetration painful

Senate Focus Exercises

Exercises in which sexual partners take turns giving and receiving pleasurable stimulation in non genital areas -The giving partner is free to engage in trial and error while the receiving partner is free to enjoy the stimulation without feeling rushed to reciprocate or obliged to respond by becoming sexually aroused.

Nocturnal Tumescence

Healthy men usually have erections during REM sleep, which occurs every 90-100 minutes -Men with biology based erectile disorder do not have nocturnal erections

Sexual-Aversion Disorder

Histories of erectile problems can cause sexual aversion in men -They may be overly anxious in sexual situations, because these situations trigger feelings of shame -Histories of sexual trauma, such as rape, childhood sexual abuse, or incest, often figure prominently in cases of sexual aversion, especially in women

Sexual-arousal Disorders

In men, these involve persistent difficulty in obtaining or sustaining erections sufficient to engage in satisfactory sexual activity -In women, they typically involve insufficient vaginal lubrication

Generalized Male Erectile Disorder

In rare cases, the dysfunction is found during any sexual activity, including masturbation.

Sexual Desire Disorders

Involve lack of interest in sex or aversion to sexual contact

Orgasmic Disorders

Involve persistent problems reaching orgasm, or reaching orgasm more quickly then the individual would like Women= difficulty reaching orgasm Men= reaching orgasm to quickly

Treatments for Female Orgasmic Disorder

Masters and Johnson begins with senate focus exercises -Then, during genital massage and later during intercourse, the women guides her partner in the caresses and movements she finds sexually exciting *The goal is to learn to provide and enjoy effective sexual stimulation, not to reach orgasm -After a number of occasions of genital play, the couple has intercourse in the female-superior position which allows her freedom of movement and control over her genital sensations -Orgasm cannot be willed or forced. When a women received effective stimulation, feels free to focus on erotic sensations, and feels nothing is being demanded of her, she will generally reach orgasm. -Once she reaches orgasm in the female superior position she and her partner can try new positions

Male Orgasmic Disorder "Delayed ejaculation, retarded ejaculation, ejaculatory incompetence:

May be life long, acquired, generalized or situational

Hypo-active Sexual Desire Disorder

Most commonly diagnosed sexual dysfunction -Lack of sexual desire does not mean that a person is unable to get an erection, lubricate adequately, or reach orgasm -Some people with low sexual desire can become sexually aroused and reach orgasm when adequately stimulated -Many enjoy sexual activity even if they are unlikely to initiate it

PLISSIT Model

P:Permission- At the first level, the therapist gives the client permission to talk about sexuality and personal concerns LI: Limited Information- Some sexual problems may be rooted in myths and misinformation about sexuality. Proving a limited amount of correct information about sexual functioning is often a key step in resolving a problem SS: Specific Suggestions: Once the basic nature of the sexual problem is identified, the therapist provides suggestions to help resolve it. The client may be encouraged to read a book about sexual enhancement etc. With basic understanding of the clients sexual issues, the therapist may also make specific suggestions for incorporating specific sexual techniques, or suggest ways the couple can refocus their sexual interaction IT: Intensive Therapy- If the first three levels of therapy are unsuccessful in solving the problem, more intensive forms of sex therapy may be required. At this point, a therapist who doesn't specialize in sex therapy will refer the client to someone with more advanced training in treating sexual dysfunctions

Our bodies reactions when there is a sexual Dysfunction

People with sexual arousal disorders fail to achieve or sustain the arousals or vaginal lubrication necessary to facilitate sexual activity -Or they lack the subjective feelings of sexual pleasure or excitement that normally accompany sexual arousal

Male Erectile Disorder

Persistent difficulty getting or maintaining an erection sufficient to allow the man to engage in complete sexual activity -May be interrupted if the man realizes that occasional problems are normal, and does not overreact

Stop-Start Method

Start stimulating the penis then when the man signals to stop the partner stop stimulating and allows the arousal to subside before stimulation is resumed -This process enables him to recognize the clues that precede his point of ejaculatory inevitability and to tolerate longer periods of sexual stimulation

Situational Male Erectile Disorder

The failure is limited to sexual activity with partners, or with some partners and not others

Squeeze Technique

The partner holds the tip of the penis between the thumb and the 2 fingers of one hand -The thumb presses against the frenulum -The fingers straddle the coronal ridge on the other side of the penis -Squeezing the thumb and forefinger together fairly hard for about 20 seconds prevents ejactualtion

Treatments of Rapid Ejaculation "Masters Johnson Methd"

The partner teases the man to erection, and uses the *Squeeze technique* when he indicates that he's about to ejaculate -After about 2 to 3 days of these sessions, the couple is instructed to begin intercourse in the female superior position, bc it creates less pressure to ejaculate -The women inserts the penis -At first she contains it without thrusting, if he signals hes about to ejaculate she uses the squeeze technique -The man gradually learns to tolerate higher levels of stimulations without ejaculating -The alternate stop-start method

Subjective Arousal Disorder

These women are aware that their genitals physically respond to stimulation, but feel no subjective arousal

Combined-Arousal Disorder

These women experience no subjective arousal and feel no genital response

Female Orgasmic Disorder

Unable to reach orgasm, or have difficulty reaching orgasm by adequate sexual simulation -If a women can reach orgasm through masturbation or oral sex but not through intercourse, then she does not have a orgasmic disorder

What happens to our body during normal sexual stimulation without a dysfunction

When we are sexually stimulated, our bodies normally respond with vasocongestion, which produces erection in makes and vaginal lubrication in femals

Female-Sexual Arousal Disorder

Women may encounter persistent difficulties becoming sexually excited or sufficiently lubricated in response to sexual stimulation -According to *Basson*, most women with arousal disorder experience little or no subjective arousal or sexual excitement

Anorgasmic

Women who have never reached orgasmic by any means