Sexual Disorders and Sex Therapy Chapter 19 Sexual Disorders and Sex Therapy Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-1

Sexual Disorders Sexual disorder - a problem with sexual response that causes a person mental distress The term sexual dysfunction is also used Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-2

Kinds of Sexual Disorders Erectile disorder - the inability to have an erection or maintain one Primary erectile disorder - man has never had an erection sufficient to have intercourse Secondary erectile disorder - man at one time was able to have satisfactory erections but now no longer is Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-3

Kinds of Sexual Disorders Premature ejaculation - sexual disorder in which the man ejaculates too soon and he feels he cannot control when he ejaculates Male orgasmic disorder - male cannot have an orgasm, even though he is highly aroused Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-4

Kinds of Sexual Disorders Female orgasmic disorder - inability to have an orgasm Primary orgasmic disorder - woman has never experienced an orgasm Secondary orgasmic disorder - woman had orgasms at some time in her life but no longer does so Situational orgasmic disorder - woman has orgasms in some situations but not others Female sexual arousal disorder - lack of response to sexual stimulation Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-5

Painful Intercourse Dyspareunia - pain experienced during intercourse Vaginismus - spastic contraction of the muscles surrounding the entrance to the vagina, sometimes so severe that it makes intercourse impossible Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-6

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Disorders of Sexual Desire Sexual desire or libido - interest in sexual activity Hypoactive sexual desire - inhibited or low sexual desire Discrepancy of sexual desire - partners have considerably different levels of sexual desire Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-8

What Causes Sexual Disorders? Physical causes Psychological causes Interpersonal Factors Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-9

Physical Causes Organic factors Drugs; alcohol, illicit or recreational drugs, prescription drugs Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-10

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Psychological Causes Prior learning - the things that people have learned earlier Immediate causes - various things that happen in the act of lovemaking itself that inhibit the sexual response Anxieties such as fear of failure Cognitive interference - thoughts that distract person from focusing on erotic experience Failure of the partners to communicate Failure to engage in effective, sexually stimulating behavior Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-14

Interpersonal Factors Disturbances in a couple’s relationship Anger or resentment toward one’s partner Intimacy problems in the relationship Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-15

Therapies for Sexual Disorders Behavior therapy - eliminates goal-oriented sexual performance Cognitive behavior therapy - combines behavior therapy and restructuring of negative thought patterns Couple therapy Biomedical therapy Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-16

Specific Treatment for Specific Problems The stop-start technique Masturbation Kegel exercises Bibliotherapy Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-17

Biomedical Therapies Drug treatments Viagra - treats erectile disorder Intracavernosal injection - treats erectile disorder; injects a vasodilator drug into the corpora cavernosa of the penis Suction devices - treats erectile disorders Surgical therapy - the inflatable penis - implants a prosthesis into the penis Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-18

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Critiques of Sex Therapy Masters and Johnson never clearly defined “successful treatment” Lack of carefully controlled studies Possible harmful effects of therapy on patients Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-21

Sex Therapy in the AIDS Era Encouraging the use of condoms Communication skills training Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-22

Some Practical Advice Principles that emerge from sex therapists’ work: Communicate with your partner Don’t be a spectator Don’t set up goals of sexual performance Be choosy about the situations in which you have sex Failures will occur Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-23

Choosing a Sex Therapist There is no licensing for sex therapists Your local medical association or psychological association can provide a list of psychiatrists or psychologists Professional organizations of sex therapists Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1-24