1. SEXUAL DIFFICULTIES & THERAPIES HSC 425 Team 8

2. WHAT IS A SEXUAL DIFFICULTY? Sexual function dissatisfaction: a disturbance in sexual desire and in psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty. The “difficulty” is considered a dysfunction only when two people are dissatisfied. Difficulties include pleasure, desire preference, arousal or orgasm.

3. CATEGORIES OF SEXUAL DYSFUNCTIONS There are four sexual dysfunctions 2. Sexual Pain Disorders ●Vaginismus: Spasm of outer vaginal muscular in women, prevent any insertion through the vaginal opening. ●Dyspareunia: persistent or recurrent genital pain that gets more severe. Occurs in 30% of women, 6% of men. 1. Desire Disorders ●Normal Asexuality: a natural feeling of low sexual desire, no interest. ●Hypoactive Sexual Desire (HSDD): deficiency or lack of sexual fantasies or desire, low sexual desire. ●Sexual Aversion Disorder: caused by anxiety and phobias like genital contact or a cares.

4. 3. Arousal Disorders Problems in achieving a suitable level of sexual arousal. ●Male Erectile Dysfunction: ●Female Sexual Arousal Disorder: lack of vaginal lubrication and swelling. 4. Orgasmic disorders Problems in triggering orgasm, creating an inordinate orgasmic delay or a complete inability to reach orgasm. ●Male Orgasmic Disorder: - Inhibited Ejaculation - Delayed Ejaculation ●Female Orgasmic Disorder ●Premature Ejaculation

5. FEMALE SEXUAL AROUSAL DISORDER “Frigid” Difficulty maintaining arousal Poor lubrication Clitoris engorged FOD The PINK Viagra

6. FEMALE ORGASMIC DISORDER (FOD) Discussion: Theories of female human orgasm? persistent absence of or delay in orgasm anorgasmia, inorgasmia, pre- orgasmia, inhibited female orgasm lifelong problem lack experience with self touch

7. MALE ORGASMIC DISORDER The persistent or recurrent delay in or absence of orgasm Relatively rare & least understood May have orgasm; however, do not have the genital response of ejaculation or it is delayed 2 types of male orgasmic disorders - inhibited - delayed

8. MALE ORGASMIC DISORDER: INHIBITED During sexual intercourse, a man cannot ejaculate. Multiple attempts and longer stimulation will not work. Able to ejaculate with other means such as oral or manual stimulation

9. MALE ORGASMIC DISORDER: DELAYED Inability to ejaculate easily Typical time it takes to ejaculate is 40 minutes Requires increased thrusting for ejaculation to occur

10. MALE ORGASMIC DISORDER VS NORMAL ORGASM A sensation that includes emission followed by ejaculation Intense feeling of well-being and muscle relaxation after orgasm Unable to respond to sexual stimulation for a short period of time

11. CAUSES OF MALE ORGASMIC DISORDER Illnesses that may cause this disorder include… Hypogonadism, in which the testes do not produce enough testosterone. Thyroid disorders Pituitary conditions Diseases that affect the nervous system Surgery affecting the prostate and other pelvic organs. Diseases of the penis. Substance abuse, including alcohol.

12. CAUSES OF MALE ORGASMIC DISORDER Some psychological causes may include… Feelings of guilt, anger, fear, and low self-esteem Stress Relationship with sexual partner is unsatisfactory Past history of traumatic sexual encounters such as sexual abuse, rape or incest

13. PREMATURE EJACULATION early ejaculation rapid ejaculation involuntary ejaculation minute men self-masturbation vs. coitus sexual experience and aging #1 sexual function complaint in young men

14. Contributing Factors Inexperience in negation with sex partner Inadequate understanding of sexual responses Unwittingly training oneself to ejaculate quickly during masturbation Inability to relax during sex Non-sensual lovemaking Minimum focus on genitals during sex Confusion Bewildered Unhappy Women may be sexually dissatisfied Avoid sexual contact with each other Erectile problems due to anxiety May withdraw from sexual activity completely Can lead to…

15. PHYSICAL CAUSES : MEN ●Leading Causes of erectile dysfunction: alcoholism and diabetes ●Anything that interferes with nerve impulses (lumbar disc disease, multiple sclerosis, etc.) ●Any disease interfering with circulatory systems, the heart, or blocking arteries (atherosclerosis, etc.) ●Spinal cord injuries ●Bicycle-induced: flattens main penile artery, temporarily blocking the blood flow required for erections

16. PHYSICAL CAUSES : WOMEN ●Causes: o diabetes o heart disease o hormone dficiencies o neurological disorders o spinal cord injuries o multiple sclerosis o general poor health o extreme fatigue o drug use o alcoholism o vigorous masturbation o partner roughness o infection Results in a decrease in sexual response, vaginal lubrication, pain or infection.

17. PSYCHOLOGICAL CAUSES Sexual function difficulties come from a different number of causes. Difficulties may come from immediate causes, conflict within oneself and from a particular sexual relationship. Immediate causes include: fatigue/stress, ineffective sexual behavior, sexual anxieties and an excessive need to please a partner Fatigue & Stress can be tiredness and have no desire to have sex. Ineffective sexual behavior is ignorance, miscommunication/ misinformation with partner Sexual anxieties are failure in erection or orgasm Excessive Need to Please a Partner is mainly found in men when trying to achieve an orgasm for his partner

18. Relationship Causes: Sexual causes are normal, even healthy Married couples usually attend sex therapy because couples may find it easier to break up then to solve their sexual problems Conflict Within the Self: Negative parental views have big impact on sexual difficulties Fear of being intimate with someone Internalized homophobia Sexual abuse, sexual assault, rape. Guilt alienating an individual from their sexuality

19. TREATING SEXUAL DYSFUNCTIONS Behavior modifications and psychosexual therapy William Masters & Virgina Johnson developed a program that was a treatment for sexual functions difficulties Sexual function problems = Sexual ignorance Faulty techniques Relationship problems

20. TREATING SEXUAL DIFFICULTIES Sensate Focus Focusing on touch and the giving/receiving of pleasure The Squeeze Technique Used to treat early ejaculation

21. MALE ORGASMIC DISORDER Treated by having the man’s partner manipulate the penis FEMALE ORGASMIC DISORDER The woman’s partner focuses on what the woman says she needs VAGINISMUS Easiest to overcome Woman uses a set of dilators

22. TREATING SEXUAL DIFFICULTIES PLISSIT Model of Therapy Permission, Limited Information, Specific Suggestions, & Intensive Therapy Medical Approaches Microsurgery Drugs – Viagra, Cialis & Levitra

23. BUILD THE PENIS GAME

24. FIRST QUESTION A woman who has female orgasmic disorder can be sexually fulfilled True or False TRUE

25. SECOND QUESTION What is vaginismus? A. Inability to orgasm due to an oversized vagina B. Lacking sexual fantasies and desires C. Vaginal tightness causing discomfort, burning, pain, penetration problems or inability for intercourse C.

26. THIRD QUESTION How many sexual dysfunctions are there? A. 2 B. 5 C. 4 D. 7 C.

27. FOURTH QUESTION What does the “P” in PLISSIT Model Therapy stand for? A. Parental B. Permission C. Penile D. Pleasure B.

28. FIFTH QUESTION What is hypoactive sexual desire? A. Genital pain B. Lack of sexual fantasties/activies C. Inhibited ejaculation D. Addiction to sexual activities B.

29. SIXTH QUESTION Which of the following is NOT an erection enhancing drug? A.Viagra B.Levitra C.Cialis D.Cleocin D.D.

30. SEVENTH QUESTION Which is not a psychological cause of sexual dysfunction? A. Anxiety B. Fatigue C. Alcoholism D. Internalized Homophobia C.

31. EIGTH QUESTION Male orgasmic disorder is the most common disorder in men following erectile dysfunction. True or False false

32. SOURCES The Sexual Response Cycle. (2014, January 1). Retrieved April 26, 2015, from http://my.clevelandclinic.org/health/healthy_living/hic_Steps_to_Staying_Well/hic _The_Importance_of_Sexual_Health/hic_The_Sexual_Response_Cycle http://my.clevelandclinic.org/health/healthy_living/hic_Steps_to_Staying_Well/hic _The_I Mental Disorders. (2011, August 11). Retrieved April 24, 2015, from http://www.minddisorders.com/Kau-Nu/Male-orgasmic-disorder.html http://www.minddisorders.com/Kau-Nu/Male-orgasmic-disorder.html Understanding and Treating Retarded Ejaculation: A Sex Therapist's Perspective. (2009, February 1). Retrieved April 25, 2015, from http://www.issm.info/news/review- reports/understanding-and-treating-retarded-ejaculation/http://www.issm.info/news/review- reports/understanding-