Human Sexuality – Function and Dysfunction

Question 1

How common is sexual dysfunction?

Answer 1

Roughly 40% of women and 30% of men report some kind of sexual dysfunction.

Question 2

Most of sexual behavior is __________.

Answer 2

learned

Question 3

What are Masters’ four phases of sex?

Answer 3

Excitement
Plateau
Orgasm
Resolution

(Helen Kaplan added the desire phase prior to excitement.)

Question 4

There are no measurable physiologic changes during the ___________ phase.

Answer 4

desire

Question 5

Disorders of the desire phase are most often due to ___________.

Answer 5

performance anxiety or aversion

Question 6

What physiologic changes occur during sex in women?

Answer 6

Clitoral engorgement
Vaginal expansion
Uterine elevation
Nipple erection

Question 7

What causes erection?

Answer 7

Relaxation of the penile arteries and the smooth muscle of the corpus cavernosa (mediated by NO release on endothelium which raises cGMP)

Question 8

During orgasm, there are rhythmic contractions of the _____________.

Answer 8

perineal muscles

Question 9

During orgasm, there are about _________ contractions of ejaculatory fluids.

Answer 9

3 to 7

Question 10

What percent of Americans aged 40 to 80 report that physicians had asked them about sexual concerns?

Answer 10

14%

Question 11

What questions are important to consider asking in a sexual history?

Answer 11

• Are you in a sexual relationship and how often do you have sexual intercourse?
• For women:
• Do you have pain with intercourse?
• How often do you have an orgasm with intercourse?

• For men:

• Do you have trouble getting or maintaining an erection?
• Do you ever ejaculate earlier or later than you want?

Question 12

In developing a differential diagnosis for sexual dysfunction, how should you proceed?

Answer 12

• First, try to determine where in the phases of sexual intercourse the problem is occurring.
• Second, look for associated conditions/problems.

Question 13

Describe the general presentation of sexual aversion disorders.

Answer 13

A person wants to have sex –as evidenced by stated desire or pursuit of sexual things –but when they get into a situation in which they might have sex they shut down.

Question 14

What things need to be present for an official diagnosis of erectile dysfunction?

Answer 14

• Difficulty maintaining or getting an erection or insufficient rigidity
• Cause distress
• Present for at least six months
• Not explained by another disorder

Question 15

What is dyspareunia?

Answer 15

Pain with intercourse

Question 16

Vaginismus is the ______________.

Answer 16

spasming of vaginal muscles with intercourse; it is associated with religiosity or negative attitudes about sex

Question 17

What four categories of sex therapy are there?

Answer 17

• Sensate focus exercises
• Bibliotherapy
• Marital therapy
• Pharmacotherapy

Question 18

What is sensate focus?

Answer 18

It is a process of doing defined behaviors to get couples unstuck from the repetitive, stylized behaviors that are problematic.

Question 19

Bibliotherapy is most successful in ____________.

Answer 19

women having trouble with orgasm

Question 20

In women with arousal disorder, there is usually ___________________.

Answer 20

a mismatch between what the woman reports and what objective measurements record; for instance, one study showed that many women who watched an erotic video had increased blood flow to their vaginas but reported no arousal

Question 21

Describe the role of testosterone in sexual dysfunction.

Answer 21

Testosterone supplementation has been shown to cause small improvements in female sexual dysfunction, but the risks do not outweigh the benefits.

Question 22

One cause of vaginal dryness is _____________.

Answer 22

excessive use of anticongestants

Question 23

Sexual physiology is not a _______________.

Answer 23

learned behavior

Question 24

The length of the ____________ phase in men tends to get prolonged with age.

Answer 24

resolution

Question 25

Low libido is often associated with ______________.

Answer 25

chronic diseases

Question 26

What four things need to be present for a diagnosis of delayed ejaculation?

Answer 26

• Delayed or absent ejaculation
• Cause distress
• Present for at least six months
• Not explained by another dis

Question 27

What three categories does the DSM-V recommend in evaluating a sexual disorder?

Answer 27

• Is the problem lifelong or acquired?
•Is the problem generalized or situational?
* Is the patient’s distress mild, moderate, or severe?

Question 28

Premature ejaculation is usually defined as _____________.

Answer 28

ejaculation within one minute

Question 29

All of the arousal/interest disorders in females are now lumped into the diagnosis ____________.

Answer 29

female sexual arousal/interest disorder

Question 30

Which category of drugs has been implicated in female sexual dysfunction?

Answer 30

Anti-epileptics (lamotrigine and topiramate, to be specific)

Question 31

What recreational substance has been shown to increase the incidence of anorgasmia in women?

Answer 31

Alcohol

Question 32

Use of PDE5 inhibitors in women has been __________________.

Answer 32

shown to have no improvement on arousal or orgasm

Question 33

What drug was recently approved for sexual dysfunction in women?

Answer 33

Flibanserin (serotonin receptor agonist)

Question 34

What is a huge caveat on flibanserin use?

Answer 34

Using flibanserin with even a little alcohol has been shown to cause serious hypotension.

Question 35

What is the PLISSIT model?

Answer 35

Permission giving ("It's ok to have sex.")
LImited Information (tell them only what they need to know) 
Specific Suggestions 
Intensive Therapy (e.g., sensate focus)