1. Sexual difficulties
© Robert J. Atkins, Ph.D.

2. Sexual problems are common
Causes
Organic
Cultural
Individual
Relationship

3. Most commonly reported sexual problems
By men
Erectile dysfunction
By women
Inability to climax
Lack of sexual desire

4. Medications related to sexual problems
High blood pressure medications
Depression & antipsychotics
Barbiturates and narcotics

5. Emotional difficulties producing negative affects on sexuality
Depression
Extreme work stress
Fear of intimacy

6. Types of sexual disorders (summary)
Desire Phase
Excitement phase
Orgasm phase

7. Desire phase Hypoactive sexual desire Related to:
Lack of trust
Lack of power and control
Imbalance in independence and dependence
Never fantasizes, rarely masturbates, never initiates sex
Sexual aversion disorder (SAD)
Physiological symptoms
Nausea
Sweating
Diarrhea
Irrationally fearful
Feel disgusted or repulsed by sexual activity

8. Excitement phase Erectile dysfunction
Most likely to be physiologically based (have an organic component)
Viagra
Primary
Secondary
Situational

9. Erectile dysfunction (ED) cont.
As many as 25% of cases are related to medication side effects
Tobacco appears to be one causative factor
Age - A man is 50’s = twice as likely to experience ED as a man in his 20’s

10. Performance anxiety
Can turn a transitory problem into a serious one

11. Sexual self confidence
Women who are least self-conscious about their bodies as compared to similarly shaped women were more assertive with their partners

12. Orgasm phase - Men Men Premature ejaculation Ejaculatory inhibition
Squeeze technique
Ejaculatory inhibition
Merc manual

13. Orgasm phase - Women Orgasmic disorder (preorgasmic)
Primary
Secondary
Situational
E.g. Orgasm with masturbation, but not with oral sex
Orgasmic with manual stimulation, but not with intercourse is typical, not a sexual dysfunction

14. Dyspareunia (For women)
Painful intercourse
Vaginismus
Hegar dilators
Merc Manual
Smegma
Smegma collecting under the clitoral hood may cause discomfort when hood is moved during sexual stimulation

15. Dyspareunia (For men) Phimosis - tight foreskin
Infected or irritated foreskin
Peyronie’s disease - Fibroses in penis
Pelvic or genital infections
E.g. STD’s

16. Deep pelvic pain in women during intercourse
Caused by
Jarring of ovaries
Stretching of uterine ligaments
Endometrioses
STD’s

17. Average duration of intercourse for American couples
Five to ten minutes