1. Sexual Difficulties and solutions

2. Sexual problems are common  Causes?  Organic  Cultural  Individual  Relationship

3. “You are the Dr.”

4. Sexual aversion disorder  Symptoms Nausea High anxiety Sexual repulsion  Treatment Systematic desensition

5. Hypoactive sexual desire  Symptoms Lack of sexual interest  Many causes Physical Psychological

6. Hypoactive sexual desire (Cont.)  Treatment No “Viagra for women” Testosterone  Not FDA approved  Difficulties Dealing with whatever may be the cause  E.g. Menopause  Relationships

7. Male orgasmic disorder  Symptoms Inability to ejaculate  Treatment Stimulation to produce ejaculation immediately after penetration Move penetration earlier and earlier.

8. Male arousal disorder “ED” Symptoms Inability to get an erection  Causes Restriction of blood flow into the penis High cholesterol High blood pressure Diabetes Prostate surgery Etc.

9. Male arousal disorder (Cont.)  Treatment Medical  Viagra  Levitra  Cialis Squeeze technique Relationship difficulties Penile implants

10.  Men more satisfied with the inflatable prosthetic device than semi-rigid rods.

11. Penile implants  Semi-rigid rods

12. Priapism  Sustained erection  Over 4 hours  Not related to sexual interest

13. Premature Ejaculation  Symptoms Inability to delay ejaculation  Treatment Squeeze technique Avoid using the man above “Missionary” position.

14. Pelvic inflammatory disease  Symptoms Abdominal pain Pain during intercourse  Treatment Antibiotics

15. Vaginismus  Symptoms Involuntary spasmic contraction of the muscles surrounding the outer third of the vagina. Painful intercourse  Treatment Manual dialation Hegar dialators

16. Dyspareunia  Symptoms Painful intercourse  Treatment Based on cause  Vaginismus  Vaginal dryness  STD’s

17. Vaginitis  Symptoms Inflammation and infection Redness Itching Irritation  Treatment Based on the cause Often antibiotic pills and creams

18. Peyronie’s disease  Symptoms Thickening of the length of the top of the shaft of the penis.  Treatment Surgery

19. Endometriosis  Symptoms Deep pelvic pain, painful menstruation, painful sex, abdominal pain when walking, etc.  Laparoscopic surgery

20. Female orgasmic disorder  Symptoms Inability to climax at least half the time.  Treatment Self and partner education on what is enjoyable Use of a vibrator Or Eros Direct manual stimulation of the clitoris during intercourse. Female initiated movements  (Woman on top position)