Sexual-Dysfunction Human sexuality-F2013.ppt

Human sexuality

1. Sexual Sexual
DysfunctionDysfunction
© 2013 John B. Pryor, Ph.D.
Department of Psychology
Illinois State University

2. Causal Factors in Sexual Causal Factors in Sexual
DysfunctionDysfunction

3. Delayed Ejaculation
–A marked difficulty or inability to achieved desired
ejaculation lasting more than 6 months during partnered
sexual activities
–More common in men over 50
–Only 75% of men report always ejaculating during
sexual activity, >1% report problems lasting more than 6
months
–Lifelong vs. acquired; generalized v. situational; mild,
moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

4. Erectile Disorder
–Failure to obtain or maintain erection during
partnered sexual activities
–More common in men over 50
–Most problems remit without professional
intervention
–Lifelong vs. acquired; generalized v.
situational; mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

5. Female Orgasmic Disorder
–Delay, infrequency or absence of orgasm or
reduced intensity of orgasm sensations lasting
more than 6 months
–Wide estimates of prevalence: 10%-42%
–10% of women do not report experience of orgasm
–Lifelong vs. acquired; generalized v. situational,
also never; mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

6. Female Sexual Interest/Arousal Disorder
–Absent/reduced interest/arousal related to
sexual activities, thoughts, encounters, cues,
etc.
–Becomes persistent problem for relationships
–Lifelong vs. acquired; generalized v.
situational; mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

7. Genito-Pelvic Pain/Penetration Disorder
–Difficulties with a vaginal penetration during
intercourse, b pain during intercourse, c fear or
anxiety about pain or penetration, or contraction of
pelvic floor muscles during sex
–lasting more than 6 months
–15% of women report some pain during
intercourse
–Lifelong vs. acquired; mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

8. Diagnostic and Statistical Manual of
Mental Disorders DSM
Sexual Pain Disorders
•Dyspareunia
•Vaginismus

9. Treatment of VaginismusTreatment of Vaginismus
dilators

10. Male Hypoactive Sexual Desire Disorder
–Persistent deficient or absent sexual thoughts,
fantasies or desires
–lasting more than 6 months
–6% of younger 18-24 and 41% of older men 66-74
report problems with sexual desire; persistent
problem in only 1.8% of men
–Lifelong vs. acquired; generalized v. situational;
mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

11. Premature Early Ejaculation
–Persistent or recurrent pattern of ejaculation during
partnered sexual activity within 1 minute following
penetration or before individual wishes it
–lasting more than 6 months
–20%-30% of men report concern about ejaculation
speed; 1%-3% have persistent problem
–Lifelong vs. acquired; generalized v. situational;
mild, moderate or severe
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

12. Substance/Medication-Induced Sexual
Dysfuntion
–Some common causes: a alcohol, b sedative,
hypnotic, or anxiolytic, c amphetamine or other
stimulant, c cocaine
–Mild 25%-50% of sexual encounters, moderate
50%-75% or severe 75% or more
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

13. Other Specified Sexual Dysfunction
Other Unspecified Dysfunction
Diagnostic and Statistical Manual of
Mental Disorders DSM-5 2013

14. How common is sexual How common is sexual
dysfunction?dysfunction?
Laumann, Paik,& Rosen 1999Laumann, Paik,& Rosen 1999
estimate about 43% of womenestimate about 43% of women
and about 31% of men haveand about 31% of men have
experienced sexual experienced sexual
dysfunction based on a dysfunction based on a
national survey of Americans.national survey of Americans.
This makes sexualThis makes sexual
dysfunction the most common dysfunction the most common
psychological problem in US.psychological problem in US.

15. Males Females
Female Orgasmic Disorder --
 
22.0-26.0%
Male Orgasmic Disorder 7.0-9.0%--
Male Erectile Difficulty 7.0-18.0%%--
Hypoactive Sexual Desire 13.0-17.0%30.0-32.0%
Dyspareunia -- 8.0-21.0%
Female Sexual Arousal Disorder-- 18.0-27.0%
Sexual Dysfunction Assessed in a Sexual Dysfunction Assessed in a
National SurveyNational Survey
Laumann, Paik, & Rosen 1999Laumann, Paik, & Rosen 1999

16. Sexual Dysfunction Assessed in a Sexual Dysfunction Assessed in a
National SurveyNational Survey
Laumann, Paik, & Rosen 1999Laumann, Paik, & Rosen 1999
Sexual dysfunction is highest among younger
women, with 21 percent of women aged 18 to
29 reporting physical pain with intercourse.
Twenty-seven percent reported experiencing
non-pleasurable sex, and 16 percent reported
sexual anxiety.
Women aged 50 to 59 are one third as likely
as younger women to experience pain during
sex and half as likely to report non-
pleasurable sex and sexual anxiety.

17. Men experience greater difficulty as they age,
with men aged 50 to 59 being three and a half
times more likely to experience erection
problems than the 18 to 29 age group. However,
increasing age is not a factor for men who report
climaxing too early, anxiety about performance
and non-pleasurable sex.
 Married men and women report fewer problems
with sex than those unmarried. Unmarried
women are one and a half times more likely to
have trouble climaxing than married women.
Unmarried men are more likely to report lack of
desire or erection problems than married men.
Sexual Dysfunction Assessed in a National Sexual Dysfunction Assessed in a National
SurveySurvey- - Laumann, Paik, & Rosen 1999Laumann, Paik, & Rosen 1999

18. High school dropouts are the most likely to
have sexual problems. Among women, 42
percent who did not complete high school
reported lacking the desire for sex, while only
24 percent of female college graduates had
such an experience. Among men, college
graduates were two-thirds as likely to report
climaxing too early as compared to men who
did not complete high school.
Sexual Dysfunction Assessed in a Sexual Dysfunction Assessed in a
National SurveyNational Survey
Laumann, Paik, & Rosen 1999Laumann, Paik, & Rosen 1999

19. Some psychological Some psychological
processes that contribute to processes that contribute to
sexual dysfunction problemssexual dysfunction problems

21. Specific techniques:Specific techniques:
1. Increase 1. Increase Self-Self-
UnderstandingUnderstanding
Education re: anatomy, physiology,
sexual response cycle
Instruction on how to masturbate
Homework to masturbate in private
& later in partner’s presence

22. Specific techniques:Specific techniques:
2. Sensate Focus Exercises 2. Sensate Focus Exercises
Both partners remove clothes
One partner “gives” while the other “receives
” & gives feedback
Initially, no “sexual” touching gradually
build up to touching genitals, orgasm &
intercourse
Gradual reawakening of sexual
interest

23. Specific techniques:Specific techniques:
3. Stop-Start Technique3. Stop-Start Technique
Manually stimulate penis until close
to orgasm
Stop stimulation until calmer
Repeat
May be done by a partner or by
masturbation

24. Specific techniques: 4. Change positionSpecific techniques: 4. Change position

25. Specific techniques:Specific techniques:
5. Communication5. Communication
Why is it hard to talk about sex?
People sometimes lack the specific
language
Use of “I” statements instead of
speaking abstractly