1. Sexual Function Difficulties
HsC 425
Professor Matza
Sample Presentation
Fall, 2014

2. Sexual Dysfunctions Sexual Desire Arousal Orgasmic Sexual pain
Are sexual dysfunctions common?

3. Arousal Issues
Sexual Arousal Disorder-the inability to respond normally during sexual arousal
Symptoms in men include the inability to maintain an erection during a sexual act
Symptoms for women include the inability to create vaginal lubrication to start or finish a sexual act

4. Sexual Desire Dysfunctions
Most sexual problems stem from or thoughts and emotions
Sexual desire disorder is a psychiatric condition marked by a lack of desire for sexual activity over a prolonged period
Symptoms include the failure to initiate or respond to sexual stimulus.

5. Orgasm Dysfunctions
Orgasmic dysfunction is when a person either can't reach orgasm, or has difficulty reaching orgasm when he/she is sexually excited.
Orgasmic dysfunction is often found in women rather than in men.
There can be many factors that stop a person from reaching orgasm including : a history of sexual abuse, drug abuse, hormonal imbalances, monotony in sexual routine, etc.
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6. Sexual Pain
Dyspareunia-refers to pain in the pelvic area during or after sexual intercourse. This can occur in both men and women.
Causes-aggressive love making,premature sexual activity after surgery, genital tract infections
Vaginismus refers to an involuntary spasm of the musculature surrounding the vagina causing it to close, resulting in penetration being difficult and painful, or impossible.
Vaginismus causes-past sexual trauma or other psychological factors, or a long history of discomfort with sexual intercourse related to another disorder. Sometimes no cause can be determined.

7. Formal Diagnosis
Statistics - Hypoactive Sexual Desire Disorder is one of the most common presenting problems in the practice of sex therapy. It is estimated that approximately 20% of men and 33% of women are affected by low or absent sexual desire.
Sexual Desire Disorders
is the most common type of female sexual dysfunction and often has a psychological or physiological cause.

8. Psychological Disorders
Hypoactive Sexual Desire (HSD)
Lack of sexual fantasies and desire for sexual activity that causes marked distress or interpersonal difficulty
-Sexual Aversion Disorder
-Persistent and recurrent aversion to and avoidance of genital contact with a partner that causes marked distress
-Sexual contact may cause anxiety, disgust, or fear.

9. Of Sexual Dysfunction (Dissatisfaction)
Psychological Causes
Of Sexual Dysfunction (Dissatisfaction)
Causes
•Stress & Fatigue
•Ineffective Sexual Behavior
•Sexual Anxieties

10. Stress & Exhaustion Sexual Apathy/Disinterest Children
Prolonged Illnesses
Sexual Apathy/Disinterest
“Commonplace Issues”
Economic Hardships
Financial Distress
Long-term effects
Lowered Sexual drives
Reduced responsiveness

11. Ineffective Sexual Behaviors
Substandard Sexuality Education
Misinformation
Negative Childhood Learning
Parents’ attitudes toward sex,
level of affectionate interaction with each other
Religion
Labeling sex as sinful or shameful
Sexual difficulties Later in life
Double- Standards
Opposing sexual expectations for women and men create problems
Men feel that they should want sex all the time, that asking for guidance from their partner isn’t ‘manly’
Women may learn to be sexually restrained for fear of being labeled a ‘slut,’ resulting in less exploration of their sexuality, not asking their partner for what they want

12. Sexual Anxieties Performance anxiety
About not being able to achieve erection or orgasm
Excessive needs to please a partner
Perceived inability to meet expectations regarding “correct” Sexuality
Cycle of Sexual Dysfunction
One transitory problem with performance can cause a vicious cycle where anxiety about repeat problems causes problems next time
Spectatoring
-Evaluating one’s own sexual performance.

13. Sexual Anxieties Anxiety over pregnancy, STIs
unwanted, or desired pregnancy
Contracting a STI
Problems accepting one’s sexual orientation
Internalized Homophobia
As a result of trauma
Childhood Sexual abuse
Adult Sexual assault
Rape
Guilt & Conflict

14. Relationship Problems
Unresolved resentments
trust issues
disrespect for partner
One partner feels pressured
Over-dependency
balance of togetherness and separateness
Lack of Communication
Conflicts within the Self
Attachment
Rejection
Cooperation
Entitlement

15. Psychosexual Therapy Identify the problem Educate people
Modify Behavior
Communication
Find the sources of the problem
Help counteract negative thought

16. Treating Sexual function Difficulties
Behavior Modification
Master and Johnson
Cognitive-behavior approach
Ignorance and relationship problems
Treat couples rather than individuals

17. Kaplan Physchosexual Therapy
Arousal and orgasmic difficulties
Mild to midlevel sexual anxieties
Behavioral will not work for more traumatic experiences
ie. Sexual abuse

18. Psychosexual Therapy Information heterosexual couples Sexual Aversion
Therapy for childhood trauma
Sexual abuse
Gender identity
Greater Treatment efficiency
Greater patient satisfaction

19. Psychosexual Therapy Brief sex therapy PLISSIT model
1 Giving Permission
2 giving limited information
3 Making specific suggestions
4 Undergoing intensive therapy
Self-help
Group therapy

20. LGBT Psychosexual Therapy
Go to therapist that are LGBT
Go with therapist that will be free of bias and value judgment

21. Drugs
Lubricating gel or estrogen therapy
Erection enhancing drugs
Microsurgery for men to maintain erection

22. Physical Disorders -Men
Erectile dysfunction:
•Can no longer get or keep an erection for intercourse
•Erection trouble from time to time isn't a problem
•Usually caused by stress or exhaustion, but medical problems cause it too
•May also be a sign of emotional or relationship problems

23. Physical Disorders -Men
Male orgasmic disorder:
Delay in or absence of an orgasm during intercourse
It is considered to be rare
Males with this disorder can have full erections and can have sex normally
Fear of impregnation or guilt
Antidepressants are the major type of medication that cause it

24. Physical Disorders -Men
Priapism (Painful erections):
Erections that last for more than four hours and occurs without sexual stimulation
Two types low flow and high flow
It is important that you seek medical care immediately
Antidepressants or medications may cause some of these disorders

25. Physical Disorders -Women
Vaginal dryness:
The lack of a layer of moisture that coat the vaginal walls
Affects many women
Urinary frequency
Recurrent urinary
tract infections

26. Physical Disorders -Women
Endometriosis:
Tissue that normally lines the inside of the uterus grows outside of the uterus
Could cause painful sex
The exact cause is not certain
Possible after a surgery, such as a C-section, endometrial cells may attach to a surgical incision.
Possible to happen if one or more relatives with endometriosis

27. Sexual Function Enhancement
Goal? To improve the quality of a sexual relationship.
Development of Self Awareness
What is Good Sex?
We are raised with stereotypes on how to behave sexually.

28. Sexual but Not Sexual Woman
Sexually Dominant Man
Sexual but Not Sexual Woman

29. What’s a condition you require for good sex?
Following these scripts may impede our unique responses and preferences.
Therapist Carol Ellison defines “good sex” as the moment we feel good about ourselves, our partners, our relationships, and our behaviors.
Discovering Conditions for Good Sex
“In order to enjoy our sexuality we need to explore our conditions for good sex.” (Zilbergeld)
Each individual has their own set of unique condition in order to attain good sex.
Range of conditions may vary; type of situation need to be more relaxed, confident, excited, familiar to your experiences, etc.
What’s a condition you require for good sex?

30. Homework Exercises!
Sexual function - enhancement programs often assign certain exercises for couples to partake in.
Mirror Examination - get naked in front of a mirror!
Body relaxation and exploration - Explore your body after a relaxing shower.

31. Sexual Voice - Each person has their own voice
Sexual Voice - Each person has their own voice. Especially important for woman.
Masturbation - Use oils or lotion to enhance sensation.

32. Kegel exercises for women and men - Tightening of the P
Kegel exercises for women and men - Tightening of the P.C muscle increases sexual awareness in women. Improves erection and ejaculatory control.

33. Erotic aids - Sex toys designed to enhance your erotic responsiveness
Erotic aids - Sex toys designed to enhance your erotic responsiveness. Dildo’s, vibrators, fake vaginas or mouths, nipple clamps, oils, etc...

34. The End

35. Sexual Arousal Disorders
Physiologic and subjective arousal may be unrelated, education is a key component in the treatment of female sexual arousal disorder
Another treatment option is the Eros Clitoral Therapy Device, made by UroMetric

36. Sexual Pain Disorders (Dyspareunia)
Dyspareunia has many potential etiologies, including infection, vaginal atrophy, and endometriosis
Addressing multidimensional and multidisciplinary and reflects the interplay o physiological, emotional and relational factors

37. Orgasm Disorders
Anorgasmy has been successfully treated with directed masturbation, cognitive behavior therapy, and sensate focus
Cognitive behavior therapy focuses on decreasing anxiety and promoting changes in attitudes and sexual thoughts, which increase the ability to achieve orgasm and to gain satisfaction from orgasm

38. Treatment Sexual Function Enhancement
Treatment of Sexual Function Difficulties.