What’s wrong with me?
English Literature (Discovering Human Sexuality)
Chapter 14
English articles
- Kingsberg et al. (2017). Female Sexual Dysfunction - Medical and Psychological Treatments,
Committee 14. Journal of Sexual Medicine, 14, 1463-1491.
- Graham, C., Boynton, P.M., & Gould, K. (2017). Women’s Sexual Desire: Challenging
Narratives of “Dysfunction”. European Psychologist, 22, 27-38.
- Laan, E., & Rellini, A.H. (2011). Can we treat anorgasmia in women: The challenge to
experiencing pleasure. Sexual and Relationship Therapy, 26, 329-341.
- Dewitte, M., Borg, C., & Lowenstein, L. (2018). A psychosocial approach to female genital
pain. Nature Reviews Urology, 15, 25-41.
- Althof, S.E. (2016). Psychosexual therapy for premature ejaculation, Translational Andrology
and Urology, 5, 475-48.
- Hackett, G, Kirby, M, Wylie, K, Heald, A, Osei-Gerning, N, Edwards, D, & Muneer, A. (2018).
British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction in
Men—2017. Journal of Sexual Medicine, 15, 430-457.
- Mark, K.P. (2012). The relative impact of individual sexual desire and couple desire
discrepancy on satisfaction in heterosexual couples. Sexual and Relationship Therapy, 27,
133-146.
- Bogaert, A.F. (2013). Asexuality: What It Is and Why It Matters. Journal of Sex Research, 52,
362-379.
- Kaplan, M.S. & Krueger, R.B. (2010). Diagnosis, assessment, and treatment of hypersexuality.
Journal of Sex Research, 47(2-3), 181-198.
Discovering Human Sexuality – Chapter 14 – sexual disorders
A sexual difficulty must occur at least 75% of the time over a period of at least 6 months to be a
disorder. Sexual difficulties can usually be alleviated, by psychological treatment, drug therapy, or
some combination of the two.
, Woman: Men:
- Lack of interest in sex - Climaxing too early = premature
- Inability to experience orgasm ejaculation. The causes are poorly
- Problems with physiological arousal understood.
- Pain during sex - Anxiety about performance
- Lack of interest in sex
Treatment:
A sex therapist is a physician who treats genital or hormonal disorders.
And a physiotherapist who can give instruction on exercises and other methods of improving genital
function. Sex therapist commonly use a standard core of therapeutic techniques.
For example, sensate focus = involves graduated touching exercises.
This is the core/basic sex therapy. You learn to enjoy sexual sensations again without experiencing
distress/anxiety.
The goal is not seeking arousal or orgasm. It’s about seeking sensations. It’s the core/basic sex
therapy. It’s in most of the sexual dysfunction cases a good treatment.
Success is most likely when both partners participate in therapy.
Treatment may involve some combination of drugs, psychotherapy and sex therapy exercises.
Sex disorders can be:
- Primary = not preceded by any period of healthy function
- Secondary = follows some period of healthy function
- Situational = appears only in certain circumstances
Stop-start method = treatment of premature ejaculation. Alternating between stimulating and not
stimulating the penis.
Delayed ejaculation can have biological causes, such as neurological damage. It can also result from
the use of certain drugs. If caused by drugs, it can be treated by switching to a different drug of by
adding a second drug that counteracts this side effects. There is no drug treatment for lifelong
delayed ejaculation.
Erectile disorder (ED) = a persistent inability to achieve or maintain an erection sufficient to
accomplish a desired sexual behaviour such as coitus or orgasm. Can be partial/complete and
primary, secondary or situational. It can have physical and psychological causes, it often is an
intercourse of both factors.
- Behavioural/lifestyle factors; smoking, alcohol abuse, obesity etc.
- Medial conditions; diabetes, hypertension etc.
- Drugs; antidespressants, recreational drugs etc.
- Injuries; spinal cord, nerves and blood vessels that supply the penis
- Psychological factors; performance anxiety, distraction etc.
- Developmental issues; childhood trauma, sexual orientation issues etc.
,Treatment of ED:
There are 3 drugs in the same class as Viagra;
- Levitra
- Cialis
- Stendra
= Improving the quality of life of men with erectile dysfunction
They increase the responsiveness of the erectile tissue to nitric oxide = neurotransmitter responsible
for penile erection. They can cause undesirable side effects, such as headache, facial flushing, or
visual disturbances.
Prostaglandin E1 = hormone that is injected into the penis to produce an erection.
Devices and implants
- Vacuum constriction system;
Produce an erection by drawing blood into the penis.
The vacuum draws blood into the erectile tissue. Once an erection has been attained, the
man slips a constriction band around the base of the penis to maintain the erection after the
cylinder is removed, though the presence of the constriction band may interfere with
ejaculation.
- Penile implant;
More invasive and expensive, it is a surgical insertion.
Hypoactive sexual desire disorder = when low sexual desire causes problems like low interest in sex.
- Asexuality
- Hormonal factors
- Lack of attraction
- Bereavement
- Illness
- Disability
- Depression
- Inculcated sex-negative attitudes
Dyspareunia = pain during coitus.
It is not seen as male sexual disorder in the DSM-5.
It can be avoided by using a condom, minor surgery or by performing a circumcision.
Causes of dyspareunia:
- Developmental malformations, intersexed conditions, persistent unbroken hymen
- Scars from vaginal tearing during labour or from episiotomy, hysterectomy, sexual assault, or
female circumcision
- Vaginal atrophy
- Acute/chronic infections or inflammation of the vagina
- Vulvodynia = painful sensitivity of the vulva to touch
- Endometriosis
- Allergic reactions
- Insufficient genital arousal
- Vaginismus = inability to experience coitus due to spasm of the muscles surrounding the
outer vagina, combined with pain, or fear of pain.
B = treatment for vaginismus. The woman uses progressively larger dilators in combination
with relaxation exercises. This is a plastic cylinder to enlarge the vagina.
, Female sexual arousal disorder = lack or insufficiency of psychological sexual arousal in woman.
Refers to difficulties with vaginal lubrication or engorgement or with clitoral erection.
Sexual interest/arousal disorder = lack of interest in sex or insufficient sexual arousal, when it causes
distress.
Persistent genital arousal disorder = long-lasting, physiological arousal in woman, unaccompanied by
subjective arousal or pleasure.
Anorgasmia = difficulty experiencing or inability to experience orgasm. In woman female orgasmic
disorder.
Treatment for woman:
- Coital alignment technique (CAT) = a variation of the man-above position for coitus that
increases clitoral stimulation.
- Kegel exercises = exercises to strengthen pelvic floor muscles, with the aim of improving
sexual function or alleviating unary leakage. Improves the quality of orgasm. Woman learn to
construct and relaxed the pelvic muscles, it strengthens the muscles. Woman achieve better
quality orgasm due to these exercises. Pelvic floor is involved in sexual arousal and orgasm.
In genital pain, you have to loosen up your pelvic floor. When problems with orgasm, you
have to strengthen the pelvic floor.
Hypersexuality
Discrepant sexual desire = when one partner has much more interest in sex than the other.
Compulsive sexual behaviour = sexual behaviour perceived subjectively as involuntary and
diagnosed as a symptom of a compulsive disorder.
- Can often be treated with SSRIs
Low/absent desire for sex is more common inn woman than in men.
The proportion of woman who are uninterested in sex increases with age.
Lesbians in long-term relationships are especially likely to lose interest in sex over time.