SOC 152A Midterm #3 Study Guide

Causes of Premature Ejaculation

traditional view was that it results from learning (boys masturbating quickly) Psychological theories more plausible for situational PE biological more plausible for lifelong

Study in Chicago & NYC on Birth Control

- 60% of these high school students were sexually active - 10% had 3 or more partners in the past 6 months - Chicago = didn't get condoms & education on sex Increase bc use? No Having more sex? No - New York = did get condoms and edu. Increase bc use? Yes Having more sex? No - Many studies show: teaching about condoms & giving them away free does not promote increase in teen sex

Box 9.3: Contraceptives and Environment

- A legitimate concern of how contraceptive use will affect the environment - Synthetic hormones (ex: the estrogen in combination pills) leave a woman's body in urine and end up at wastewater treatment plants - They end up in lakes and rivers - They can disrupt the sexual development of fish and other aquatic animals - However, the contribution of estrogenic load imposed by contraceptives is very small in comparison to the amounts of it naturally - This means if everyone stopped using them it would have a minute beneficial effect - Contraceptive hormones have also been detecting in drinking water but at low harmless levels - Condoms: main issue is biodegradability. Plastic ones don't biodegrade, and others take years to do so, HOWEVER, contraceptives that lessen menstrual flow have a positive impact bc less tampons

Box 14.2: Dyspareunia: A Case History

- Case history describe by colleagues at McGill University Health Center - A couple went to their gynecologist with a diagnosis of vulvar vestibultis - Planned to have children - similar family histories - Heather had genital pain that worsened during a stressful period of her career - Seen for a total of 18 sessions - Need to find ways to connect beside through sex - After therapy, develop coping strategies - Steven became less passive, and Heather learned how to deal with her emotions - By increasing emotional intimacy and decreasing the focus on intercourse, the couple was able to reinject passion into their sex life

Combination Pill

- Contains estrogen and progestin - Prevents ovulation and causes cervix to secrete thick mucus to prevent sperm from entering uterus - Constant dose: all pills contain same drug dose - Continuous use may eliminate period - 1 pill everyday for 21 days - Bleeding is common - Extended use regimens (seasonal: 1 pill every day for 12 wks. w 7 menstrual pills; 4 periods a yr.) Advantages: - extremely reliable w perfect use - convenient and reversible - may have significant health benefits (decrease risk of ovarian/endometrial cancer) - lighter menstrual flows (decrease acne and iron deficiency) Disadvantages: - no STD/HIV protection - remember to take pill every day - 0.3% PUFR - nursing mothers shouldn't use - risky with women over 35, who smoke, and overweight - headaches, weight gain/loss, nausea

Treatments for Premature Ejaculation

- Drug treatments may be effective (SSRIs or other antidepressants) - Sex therapy may help men regulate excitation: Stop-Start Procedure: technique involves alternating between stimulating the penis and not stimulating. Kegel exercises may also be useful

Box 9.2: Male Contraceptives of the Future?

- Heat: sperm production is impaired at elevated temperatures - Intra-Vas Devices (IVD): these are plugs that are placed inside the vas deferens, blocking the flow of sperm. Gel can also be injected to block the vas deferens - Androgens: testosterone and other androgens causes a reduction in sperm counts. These androgens may be delivered by injection - "Dry Orgasm" Pills: several drugs have been developed that can prevent sperm from being mixed into the semen or cause the semen to be ejaculated backwards into the bladder - Immunology: It's possible to trick the immune system of healthy men into developing antibodies directed against sperm or other elements of the male reproductive system - Retinoic acid blockers: drugs that prevent the attachment of retinoic acid to its receptors in the testicles have been shown to block sperm production in lab animals - Adjudin: drug that blocks spermatogenesis sperm immobilizer: a drug that acts like semenogelin; it binds to sperm and blocks their forward motion

Box 14.3: Kegel Exercises

- Helps strengthen the muscles of the pelvic floor - Dr.Arnold Kegel developed these exercises in 1950s to help women overcome involuntary urination (muscles involved sexual functions too) - First step→ identify muscles that need to be exercised and contracted - A set of ten 3-second contractions 3x a day - Women's capacity for sexual arousal was assessed both subjectively and by measurement of vaginal engorgement

Box 9.5: Feticide

- Indiana woman charged with feticide for taking drugs to cause abortion - Feticide laws can now be used against pregnant women for causing death of fetus (another lady drank rat poison in suicide attempt) intentionally or recklessly - Feticide laws establish fetuses as people with distinct rights, creates paradox with legal abortions

Box 9.1: Margaret Sanger and Birth Control Method

- Nurse Margaret Sanger's mother had 11 children, and Sanger connected that to her early death - In 1914, Sanger began publishing a radical feminist monthly called "The Women Rebel" which talked about the right of birth control - Went on a national lecture tour to promote birth control - In 1916, Sanger opened the country's first birth control clinic in Brooklyn, NY - Clinic was closed down after 9 days of operation, and Sanger was arrected & spent 30 days in - Her case received a lot of attention, and the court ruled that physicians could provide contraceptive information for medical reasons - She founded the american birth control league; forerunner of Planned Parenthood

Box 11.2: You Know Future of Your Marriage

- People don't seem to have any clue about how their marriages are going to work out - Went through a study where couples were showed either the face of their spouses or control faces. Then they had to classify emotionally loaded words as either being good or bad. The more positive feelings they had towards their spouses, the less time it took them to associate "love" with "good." - They were then followed for 4 years, and every 6 months asked how satisfied they were with their marriages. - The participants CONSCIOUSLY expressed feelings showed no correlation w their later satisfaction while their "automatic" feelings did - This was an implicit association test

Box 14.1: Sensate Focus

- Quiet time with you and your partner with no distractions - Touching exercises for couples that want to build closer intimacy & overcome sexual difficulties - Exercises involves focusing on the physical sensations of gently touching & being touched 1. Start off w/ relaxed breathing and one partner touches the other in nonerogenous zones 2. Switch roles, 2nd partner touches the other (*key to focus on the feeling of being touched) -At the end of session, discuss what you felt/thought

Stop-Start Procedure

- Sex therapy technique for the treatment of premature ejaculation - Ejaculation that involves alternating stimulating and not stimulating the penis 1. male masturbates himself using stop-start going 15 min & then to orgasm (done 3-4 times a week) 2. same as step 1 except males uses KY jelly on penis 3. masturbate w "subtle adjustments" 4. masturbate w vivid sex fantasies & use stop-start 5. masturbate w vivid sex fantasies & subtle adjustments 6. have a "quickie" THEN the male practices these w partner

Box 7.2: Straight Women, Gay Sex

- Sexual intimacy between young women who are not lesbians: heteroflexible - Previously 1 in 20 women had sex with another women, in 2014 1 in 8 said they did - One purpose of it is to the arouse the interest of males - Other women engage in this as a means of experimentation - Sexual orientation more fluid in women than men

Box 14.4: Sexual Minorities and Sexual Disorders

- Sexual minority is a group whose sexual identity, orientation, practices differ from the majority of the surrounding society - Shame and self hatred about their orientation - Fear of sex, performance anxiety, and guilt b/c AIDS (gay men have developed unreasonable fear of sex bc aids epidemic) - Performance difficulties: anal penetration make it difficult for gas because of fear of pain makes relaxing spinchter difficult - Transgender dissatisfied w/ genitals and concerned about sexual practices - Lesbians lose interest in sex more than other kinds of couples

Box 6.4: Dry Sex

- South Africa: dry sex is preferred by men - Women place drying substances in their vaginas such as crushed stone, tobacco, herbs, etc - Dry sex is painful for women and causes small tears in the vaginal mucosa - Dry sex increases her likelihood of becoming infected with his because of the small tears - Dry sex is done to please the male partner bc the drying substances swells and tightens the vagina - Custom of dry sex reflects women's lack of power - This custom is thankfully going out of favor

Box 12.2: Why Gay Genes?

- Why don't gay genes die out if they cause you to not reproduce as much as heterosexuals? - Not everyone who possesses a gay gene is actually gay - Man's gay gene could be transmitted to the next generation albeit not via the gay man's own offspring - Gay males increase their sisters' reproductive success by their behavior - not being able to be parents themselves they might devote their resources to their sisters enabling them to have more children and helping those children survive and reproduce in their turn - Boys who have older brothers are more likely to grow up gay than boys who don't

Intrauterine Devices (ParaGard/Copper T & Mirena)

- a T-shaped device placed in uterus - causes low grade inflammation of the uterus that interferes with sperm transport - two models of IUD's available in the US - less than 1% of Americans use IUD's - ParaGard can be left in for up to 12 yrs. - Mirena (a progestin releasing IUD) lasts for 5 yrs. Advantages: - as effective as female sterilization - few side effects/ no systematic hormonal side effects - convenient/ non intrusive (only have to check thread once a mo.) - reversible immediately on removal - significant protection against endometrial cancer Disadvantages: - one time cost is fairly high ($200 to $600), although a money saver in the long run - cramping/irregular bleeding may occur - w/ ParaGard, ↑ menstrual flow - no STD protection - for W with an STD, an IUD can ↑ likelihood of PID - ↑ risk of ectopic pregnancy - perfect use failure rate 0.2 - 0.6%

Box 6.3 - Research Highlights: Sex and the Seasons

- animals show variations in sexual behavior around the year, driven by day length, temperature, etc - human conception peaks at times of moderate temp and 12-hour daylight, at least for those that live close to nature - these spring and fall peaks not really seen in US cuz ppl spend most of their time indoors - one study found that there are peaks in sex behavior of humans in summer and winter; could be caused by social factors like vacation time in summer and alcohol/partying in December - peak in births caused by December peaks only; most likely bc alcohol causes less caution

Masturbatory Sleeves

- basically the opposite of dildos - for men - designed to resemble the vulva, anus or mouth - have an inner sleeve with a flesh like feel

Spermicides (foams, creams, suppositories)

- chemical that kills sperm - placed into the vagina no more than 2 hours ahead of time for which it must remain for at least 6 hours afterwards - available as a contraceptive in a variety of forms - sponge acts as both a physical barrier & spermicide releasing agent Advantages: - available w/o a prescription - inexpensive - few side effects (allergic reactions/irritation from frequent use) Disadvantages: - failure rates are high when used as a solo method (25%) - best used in combo with barrier methods - no significant STD protection - perfect use failure rate 9-18%

Progestin-Only Pills

- contains a low dose of progestin and no estrogen - alters cervical mucus - interferes w/ implantation in endometrium Advantages: 1. Reliable, reversible, convenient 2. Similar to combination pills, but lacks estrogenic side effects Can be used by breastfeeding mothers (6 weeks after birth) Disadvantages: 1. 0.3% failure rate if used perfectly 2. Must be taken everyday 3. Disrupts menstrual cycles for W who were previously regular 4. no std/hiv protection

Male Condom

- disposable sheath placed over penis before coitus - prevents semen from entering the vagina Advantages: - cheap/readily accessible - reliable when properly used - STD protection - no side effects of hormone based contraception -fully/immediately reversible Disadvantages: - may ↓ spontaneity - male must maintain erection for duration of condom use - may ↓ erotic sensation - reliability is less than ideal with typical use - perfect use failure rate 2% - most are made of latex, although natural tissue condoms are available - some are coated with spermicide - strategies to prevent breakage: regular inspection of condom, use of lubrication, thicker condoms, changing condoms

Diaphragms

- dome shaped latex or rubber barrier placed over the cervix - preventing sperm from entering the cervix Advantages: - more spontaneity than condoms (because it can be inserted beforehand) - does not usu. affect sensation - relatively cheap - long term use associated w/ a lower risk of cervical cancer Disadvantages: - inconvenient (needs to be fitted by professional) (also, a need to insert, remove & clean) - occas. dislodged during coitus - less STD protection than condoms - spermicide can cause irritation - occasional UTI occurrence - 6% perfect use failure rate

Treatment for Hypoactive Sexual Desire Disorder

- hormone treatment may restore sexual desire (psychological factors probably play a significant role in HSDD for men) - estrogen and androgen treatment may improve sexual desire in women - sexual therapy may be helpful for low sexual desire in women (therapist often use a combo of cognitive/behavioral approaches

Vaginal Dilators

- inserted into vagina while doing relaxation exercises - used to counteract vaginismus

Box 7.1 - Who May Marry?

- old debate over interracial marriage (Loving vs. Virginia, won in Supreme Court) —>current debate over same sex marriage

Female Sexual Arousal Disorder

- overlapping term for insufficient physiological arousal in women, such as to make sex unpleasant or painful - insufficient lubrication during sex is common

Cock Rings

- placed around the base of the penis - used to enhance erection or extend time before ejaculating bc they restrict flow of blood out of the penis

Female Condom

- polyurethane plastic pouch inserted into the vagina - condom covers the entirety of the vagina & adjacent parts of the vulva - to use: the inner ring is first squeezed between the fingers & then pushed into the vagina with a finger until it can't be felt. This draws most of the condom into the vagina, but the larger end should remain outside Advantages: - only female controlled contraceptive to offer STD protection - allows for spontaneity (can be inserted up to 8 hours before) - does not require male to maintain erection - easily & immediately reversible - can be used for anal sex Disadvantages: - may ↓ erotic sensation/ may generate distracting noise - possibility of inserting penis unwillingly outside of condom - possibility of entire condom being drawn into vagina - male & female condoms should not be used simultaneously (creates friction) -perfect use failure rate 5% - male condom still preferred over female condom

Erectile Dysfunction (Disorder) (men)

- recurrent inability to achieve an adequate penile erection sufficient enough to accomplish a desired sexual behavior - much more common as men age (commonly a secondary disorder)

Compulsive Sexual Behavior

- sexual behavior perceived subjectively as involuntary and diagnosed as a symptom of a compulsive disorder

Anal Beads

- silicone or plastic beads on a string that are inserted into the anus and then pulled out slowly - can be highly arousing

Cervical Cap

- small rubber or plastic cap that holds like a suction cup onto the cervix - spermicide is placed on the inside of the cap prior to insertion - must be prescribed & individually fitted - FemCap approved in 2003 - like the diaphragm, it is good for W who need to be in charge of their own contraception, without using hormones Advantages: - similar to those of the diaphragm but with some differences: - cervical cap as an alternative to the diaphragm (as some W have much difficulty using a diaphragm) Disadvantages: - failure rate is higher, especially in W who have had children - difficult to insert properly - can be dislodged during coitus - perfect use failure rate 18%

Coital Alignment Technique (CAT)

- variation of the man-above position for coitus that increase clitoral stimulation

Box 11.1: Mormon Polygamy

-Mormons believed polygamy was a necessary path to highest salvation -US gov't opposed this; passed anti-polygamy laws and refused to grant Utah its statehood - In spite of the official end of mormon polygamy, "mormon fundamentalists" still practice it in isolated areas. - There is a recent trend toward greater respect for the individual freedom in sexual arrangements -2013: a federal district court ruled that plural marriage cannot be criminalized if none of the participants are legally married - Children in polygamous families are more likely to experience a variety of mental health problems, educational difficulties, and social problems in comparison to children in monogamous families - Polygamous communities create a situation where there are too many young men for the number of available women

Anal Sex

1. Anal sex - penetration of the anus by the penis 2. Not rare in heterosexual sex 3. Usually necessary to go slowly and learn to relax sphincter as well as use lots of lube 4. Anus can be penetrated with objects other than a penis (dildo, fingers, etc.). Inserting any large, hard, or sharp object may be very dangerous

Disabled Sex Lives

1. Disabilities generally do not interfere with sexual desire 2. Arthritis is the #1 disability affecting sex (15% of US pop.). Planning can help make sex more positive 3. Spinal cord injuries present a major challenge to sexual expression. a) use of parts of the body whose movement and sensation are not impaired. b) unimpaired partner may have to do a lot of the work 4. Many intellectually disabled people are competent to make sexual choices.

Rules for Men to Follow During Oral Sex

1. Do not push partner's head down 2. Consent is needed 3. While receiving fellatio, do not thrust into partner's mouth unless otherwise stated... can lead to gag reflex 4. While doing cunnilingus, it's all about tongue work. Do not bite 5. Talk about oral sex before; set up rules; what are your values; take precautions; be sensitive to questions of taste & odor 6. Give a warning before you ejaculate; px may not want to get ejaculated on or in mouth

Oral Sex

1. Fellatio - oral stimulation of the penis. a) May run lips up and down the shaft or use the tongue to stimulate sensitive areas (ex: corona and frenulum) b) Good communication is key to avoid gagging/ejaculation in mouth c) Men typically enjoy fellatio more than women. d) Demographic difference: more educated people enjoy it more 2. Cunnilingus- Oral stimulation of the vagina. a) Explore vulva with lips and tongue. b) For some women, this is the only way in which they can regularly orgasm 3. 69 - mutual oral sex in a head to genitals fashion 4. Anilingus- mouth-anal contact *** Sambia tribe of New Guinea - performing fellatio and swallow semen as part of "maturing" in their culture (seen as life force)

Petting and Fondling

1. Foreplay/afterplay 2. Necking (kissing/caressing of the head and neck), petting (sexually touching body excluding genitalia and breasts), heavy petting (fondling genitalia and breasts) 3. Outercourse, dry humping, tribadism (rubbing vulvas)

M & W have different preferences for sex...

1. Ideal duration of foreplay is the same in men and women, but real duration is much shorter. 2. A man may delay ejaculation by a number of methods (going slowly, less stimulating positions, PE techniques, etc.) 3. Lesbian sex marked by a greater duration as well as a greater variety of behaviors. a) Gay and lesbian couples may find it easier to express sexual desires and needs

Therapy and Enrichment for Female Orgasm Issues

1. Masters & Johnsons methods a. first step: man is behind female & is touching her as a method of trial & error (asking what is the most sensitive part of her body?) i. oral sex: man is figuring out what is best for her ii. man then has penis in her vagina but is still providing stimulation (rubbing clitoris) iii. female superior position: female on top, good position bc she adjusts as she desires 2. Self help methods for females w/o partners, time for extensive therapy or $$ for therapy a. for yourself; the fulfillment of female sexuality book b. becoming orgasmic book c. guide to get it on d. guide to orgasm for women self help methods 1. masturbation - women are encouraged to touch themselves to learn more - learn what feels good and what doesn't - learn what leads to sexual arousal & orgasm - develop erotic turn-ons & fantasies 2. experiment w different patterns a. diff patterns of clitoral stimulation i. circular movements ii. up & down movements iii. back & forth movements b. different levels of pressure i. gentle, stronger, pulsing c. the "three finger technique" i. (3-4-5) d. oral stimulation i. tongue = most & not too strong 3. vibrators i. females can have 20-50 orgasm w vibrators vs. 3-5 orgasms via manual stimulation 4, 5, 6 apply to both female & male 4. increase effective muscle stimulation by i. kegel exercises; exercise the pc muscles 15 min/day, 3 period of 5 min each; put pressure on the pc w/o neglecting the clitoris 5. fantasy i. increase the turn-ons for sex ii. distract her from (-) thoughts 6. increase your "positive internal monologue" i. internal monologue= the words we hear in our heads as we think; women often have negative internal words which inhibit sexual arousal while making love

Different Cultures on Sexual Behavior

1. Sex education in schools controversial 2. Kama Sutra- "love guide" classic work on how to make love 3. The Aka people is an example of a sex-positive society. a) Engage in sex ~3x a week. Seminal nurture- believe the fetus needs repeated exposure to semen in order to grow. b) Attach no value to masturbation

Sex Toys

1. Vibrators - electrically powered device used to provide sexual stimulation. Very important to clean. Both men and women may use vibrators either during masturbation or as a variation in sexual activity. 2. Dildos - sex toys that are designed for penetration of the vagina or anus. a) Strap on dildos are designed for sex between women or a woman penetrating her male partner. b) Cleanliness important. c) use gently and with lube 3. Others - anal beads, erotic dolls

Most Sexual Encounters Include Coitus

1. Wide variety of positions to achieve different goals 2. Man above traditional favorite (missionary) may provide more erotic stimulation to the man than the woman 3. Women's movement has encouraged alternative positions. a) Woman above - gives woman greater control, woman may receive more erotic stimulation. b) Side by side- relatively relaxed for prolonged sexual exposure, but man can "fall out" and limbs can fall asleep. c) Rear entry coitus- doggy style; No direct stimulation of clitoris, but may be desirable for G spot stimulation

Stages of Sexual Addiction or Hypersexuality

1. an increased craving for sex 2. the ritualized search for sex, such as spending time on online chat rooms 3. sexual behavior itself, which might be masturbation or sex with partners 4. a period of guilt or despair after the bout of sexual behavior

Box 6.4 - What is Great Sex?

1. being present and focused 2. connection 3. intimacy 4. communication-verbal & nonverbal 5. authenticity, transparency 6. transcendence, bliss 7. exploration, risk taking 8. vulnerability Researchers found... - orgasm and intense attraction are also important - concluded that performance and technique came second in importance

Box 7.3: Lasting Relationships - Gottman's Seven Principles

1. enhance your love map: develop a detailed mental representation of your partner's history, habits, desires, fears, etc. this love map enhances empathy bc you can guess what is bothering your px. 2. nature fondness and admiration: even when things get rough, keep a sense of admiration and value your px. 3. turn toward each other: when your px seeks attention or support, give it 4. let your px influence you: treat your px w honor and respect, and be ready to compromise 5. solve your solvable problems: when there is a difficulty between the both of you, approach it positively and fix it 6. overcome gridlock: if your conflict goes on and seems to defy resolution, think about whether there is something beneath the surface 7. create shared meaning: although you are 2 different ppl, nurture the values you have in common

Treatments for Erectile Dysfunction

1. lifestyle changes (quitting smoking or losing weight) 2. viagra (or similar drugs have become leading treatment), simply swallowing viagra-like tablet does not produce and erection, there has to be sexual excitement as well, must not be taken in conjunction with certain other substances (poppers), can cause a variety of undesirable side effects (headache, facial flushing, visual disturbances) 3. locally applied drugs: require only that erectile tissue be functional. Hormone treatments injected directly into corpora cavernous to produce erection 4. devices and implants: implants- inflatable or solid and bendable; devices- vacuum constriction system to draw blood to penis 5. psychological treatment- sex therapy to reduce anxiety, sensate focus, resolving relationship problems, may be combined with drug treatments

7 Non-Threatening Steps to Learning Self-Pleasure

1. look at her own body (in private) 2. feel her body 3. touch parts that feel arousing 4. try to get sexual arousal 5. extended masturbation 6. male watches her masturbate 7. male imitates what he saw the female was doing while masturbating

Box 9.4 (continued): Reasons for Abortion from Most Common-Least

1. not ready for a(nother) child; timing is wrong 2. can't afford a baby 3. have completed childbearing 4. don't want to be a single mother/having relationship issues 5. feel too young/not mature enough 6. interfere w/ education/career plans 7. physical problem w/ health 8. possible problems affecting the health of the fetus 9. was a victim of rape

Box 10.4: Sex Education, What Teens Say

69 studies in multiples countries showed that the reaction of teens on sex education classes were uniform: 1. Subject is embarrassing for both teacher and student 2. Teachers deal w/ this by being too scientific 3. Teachers deal w/ this by moralizing (ex: they only talk about the dangers of it, but not the pleasure side) 4. Teachers avoid a lot of important topics 5. Students from ethnic minorities, and much younger children, value sex ed more 6. Peer educators and outside experts do a better job than regular teachers

Emergency Birth Control

Hormone methods: working after 5 days of unprotected sex 1. Ella: equally effective all 5 days; this one needs a doctor's prescription 2. Plan B one-step: less effective each day; over the counter; "next step" = the generic, prevents 95% of pregnancies if taken in 1st 24 hrs, prevents 89% if taken within first 72 hrs 3. Copper IUD insertion: can be inserted up to 5 days after unprotected sex, lasts 10 yrs

Pros and Cons of Vibrators

Pros: - Easy way to have 1st orgasm -helping her learn what feels good & when she is nearing orgasm - Male and female may be able to integrate the vibrator as part of their sex lives & both enjoy it Cons: - Some females lose their ability to fantasize, since vibrator gives such easy stimulation - Some females get "hooked" on the vibrators, get dependent on it & cannot orgasm w/o it - Vibrator can cause problems in relationship; male may feel jealous of it, blame her for not being able to orgasm w him, w/o vib - Excess use of vibrator can lead to tactile anesthesia of the genitals (temporary loss of sensitivity)

Box 11.3: Seniors on Sex

Remarks giving an idea on the diverse ways in which aging affects women's sex lives - 1st person: lack of self drive liberated them and they now place their attention on other things such being a software engineer - 2nd person: sad bc they have outlived their vitality - 3rd person: had zero sex drive until gyro prescribed testosterone cream. are now having the best sex of their lives Accounts from men: - Experiencing the best sex

Treatment for Sexual Addiction

SSRIs- selective serotonin reuptake inhibitors (antidepressants)- a class of drugs, including antidepressants such as Prozac and Lexapro, that depress sexual frustration

Constant Dose/Monophasic (combination pill)

all pills contain same drug dose

Secondary disorder (sexual disorders)

appears after some period of normal function

Situational Disorder (sexual disorders)

appears in some circumstances but not others

Vacuum Constriction System

creates a partial vacuum around the penis, thus drawing blood into the erectile tissue

Treatment for Dyspareunia

depends on diagnosis antibiotics, lubrication, prolonging foreplay

Reasons for Sexual Pain in Women

developing malformations, intersexed conditions, persistent unbroken hymen scars from vaginal tearing during labor, episiotomy, hysterectomy, sexual assault, or female circumcision vaginal atrophy (thinning of vaginal walls that occurs with aging) acute or chronic infections or inflammation of the vagina, internal reproductive tract, including several STIs and pelvic inflammatory disease vulvodynia- a poorly understood condition in which pain is experienced when the vulva is even lightly touched endometriosis (the growth of endometrial tissue at abnormal locations such as the oviducts

Anorgasmia

difficulty in reaching orgasm, very common among women

Delayed Ejaculation

difficulty or inability to achieve orgasm or ejaculation (aka male orgasmic disorder) fairly uncommon

Penile Implants

either permanent or inflatable plastic rod that keeps the permanently stiff enough for coitus, relatively easy to have surgically, but the permanent erection may be difficult to conceal and therefore embarrassing in some circumstances hydraulic that is filled from a reservoir that is implanted under the groin muscle, the pumps and the valves that control the filling and emptying are placed in the scrotum, where they can be assessed manually through the skin, costlier and more prone to malfunction, erect penis not usually as long as it was originally, more discreet and produces a more natural seeming erection

Premature Ejaculation

ejaculation that occurs before the man wants it to

Hypersexuality

excessive sexual desire, may take over peoples lives, often associated with paraphilic behaviors

Kegel Exercises

exercises to strengthen the pelvic floor muscles, with the aim of improving sexual function or alleviating urinary leakage

Treatments for Vaginismus

favored treatment is mix of psycho/sex therapy exercises

Persistent Genital Arousal Disorder

frequent, unwanted, or near-continuous physiological arousal (very rare)

Prostaglandin E

hormone that is injected into the penis to produce an erection, delivered by self injection into the corpora cavernosa

Vaginal Rings (NuvaRing)

hormone-based ring placed in the vagina that releases a combo of estrogen and progestin ring in place for 3 weeks then one week break can be taken out before coitus but must be replaced within 3 hrs Advantages: - similar to that of patches except no skin reactions - lower estrogen exposure - nothing is visible - increase in spontaneity - convenient/reversible Disadvantages: - 0.3% PUFR - ring may slip out - may cause vaginal irritation/discharge - reports of feeling the ring during coitus - ring must be protected from heat

Sexual Addiction

idea that a person may be addicted to certain forms of sexual behavior similar to that of substance addiction

Vaginismus

inability to experience coitus due to: -spasm of the muscle surrounding the outer vagina - pain -fear of pain may make intercourse impossible

Erectile Dysfunction (women)

lack of clitoral erection

Primary Disorder (sexual disorders)

lifelong

Hypoactive Sexual Desire Disorder

low or absent interest in sex, not necessarily a problem 1 in 3 women and 1 in 6 men lack any interest in sex

Eos Clitoral Therapy Device

miniature version of the vacuum system used to treat male ED, increases blood flow to the clitoris and the surrounding area by producing a partial vacuum

Causes of Delayed Ejaculation

neurological damage, use of certain drugs, psychological causes

Depo-Provera

non oral hormone based contraceptive slow release form of progestin -provides contraception for 3 months -.3% PUFR hormone based adv of depo-provera requires an injection every 3 months, increases spontaneity lack of estrogenic side effects cessation of menstrual periods repeated medical visits needed no std/hiv protection irregular, prolonged bleeding loss of bone density reversible but once injected cannot be removed and may take 3 months for side effects to go away

Dyspareunia

pain during coitus, far more common in women

Transdermal Patches (Ortho Evra)

patch containing hormones that diffuse slowly into the body through the skin W uses one patch every week for 3 weeks, then one week w/out -.3% PUFR contains estrogen and progestin hormone based similar to combo pills except easier to use, compliance is better and increase in spontaneity local skin reactions, patch may work loose or fall off not advised for smokers over 35 twice as expensive as combo pills incr risk of heart attack

Causes of Erectile Dysfunction

physical/psychological, behavioral/lifestyle factors, medical conditions, developmental issues

Phimosis

problems with retracting of foreskin

Treatments for Anorgasmia

psychotherapy and directed masturbation may be helpful, may or may not have any obvious biological cause, clinician or therapist will suggest different strategies depending on the details of the problem

Mutual Masturbation

reciprocal simultaneous manual stimulation of a partners genitals

Implants (Impanon)

rods containing contraceptive hormones, implanted under the skin releases progestin inserted under skin of upper arm Advantages: - protection against pregnancy for 3 yrs - .05% PUFR - reliable as sterilization - no action required on part of user Disadvantages: - causes bump in skin that can be felt - costs are higher (400-800) - reliability is uncertain for W over 220 lbs - no protection against std

Psychological Treatments for Erectile Dysfuntion

sex therapy: goal is to reduce anxiety, sensate focus, efforts to resolve relationship problems, may be combined with drug treatment

Discrepant Sexual Desire

the situation in which one partner in a relationship has much more interest in sex than the other

Triphasic (combination pill)

varies dose of estrogen and progestin

"The Squeeze Technique"

when the man is close to orgasm, he communicates this fact to his partner with a prearranged signal. the partner then grasps the man's penis with a thumb on the frenulum and squeezes firmly for a few seconds. this diminished the mans urge to ejaculate and possibly causes a partial loss of his erection

Personal Points of View

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Box 9.3: Abortion in the United States: Key Statistics

• 21% of established pregnancies in the US are terminated by abortion • Most are done for social reasons • ½ of the women were using contraceptive techniques but not perfectly • 33% of all abortions are performed within the first 6 weeks of pregnancy and 89% within the first 12 weeks • 1 in 1,000,000 chance of causing mothers death • Legal in all US states but 27 states have 4 major restrictions

Box 12.5: Gay and Homeless

• 40% of homeless youth in the US identify as gay, lesbian, bisexual or trans • Why are LGBTs homeless? 1. Ran away bc of family rejection of sexual orientation or gender identity (46%) 2. Forced out by parents bc of sexual orientation (43%) 3. Left bc of physical, emotional or sexual abuse at home (32%) 4. Aged out of the foster care system (17%) 5. Left because of financial or emotional neglect from family (14%) • New York's Ali Forney Center- nations largest provider of shelter and support for LGBT youth • Homeless gay youth who are mostly people of color- represent the invisible underside of a community that people are more likely to associate with security and affluence

Box 6.5: Seeing a Sex Surrogate

• Childhood polio had to spend life inside an iron lung • Sex surrogate Cheryl Cohen Greene • They talked, then she took off his clothes, then they discussed body awareness, touching, scented oils • Changed his life, made him feel deserving

Box 12.3: Gay Martyrs

• Harvey Milk→ city supervisor of SF and the first openly gay man to be elected to city government in the US Helped to reject proposition 6 which forced the state to fire openly gay teachers Shot dead by anti gay city supervisor Dan White • David Kato → Ugandan gay rights activist and the cofounder of sexual minorities Uganda Beaten to death by a man with a hammer

Box 12.4: Global Perspectives on Sexual Orientation

• Non-western cultures people's gender identity is more salient than their sexual orientation 1. Conventionally gendered people and transgender people • Cultures where unmarried women are highly sequestered and cirtually invisible to unmarried men, those men may have sex with male youths 1. Ie in ancient Greece or in Afghanistan during the period when the Taliban imposed strict Islamic codes of behavior -if non gender conformist person in western society has sex with same sex partners they may not be recognized as gay or lesbian. -in cultures where women are highly sought after and unavailable to young men, straight men may have sex with each other simply because women are unavailable -in western world same-sex adults around same age that are both gender conformist and identity as gay is the "standard" of homosexuality, but wasn't until ~1 century ago

Box 9.4: Does Abortion Traumatize Women?

• Pro-life activists claimed that a woman who chooses to terminate her pregnancy can expect to suffer serious consequences, etc. • Women in a study were more likely to suffer psychological problems, but this association resulted from the fact that certain infuences predisposed women to having an abortion and to suffering mental illness after the abortion • Another study in Denmark found that women who had an abortion were more likely to have psychological pronlems BEFORE the abortion then were women who carried a pregnancy to term • *a higher rate of psychological problems after abortion is simply a continuation of a history of psychological problems from earlier in the women's life NOT an effect of the abortion itself • "post abortion syndrome" does not exist

Box: Sex and the Seasons

• Variations in sexual behavior around the year • Key control element is gonadotropin releasing hormone (GnRh) 1. Release of GnRh by hypothalamus in response to seasonal factors 2. Promotes release of LH and FSH from the pituitary gland 3. Increase spermatogenesis and testosterone asecretion in males • Conceptions peak at times of moderate temperatures and 12 hour daylight • Spring and fall peaks are not seen In the US bc most Americans spend their time indoors and therefore have little exposure to seasonal signals • Peaked twice in the year onece in early summer and again in winter- peaks in condom sales, HIV tests, STI diagnoses • Driven by social factors such as vacation time and the alcohol fueled party season