Sexual Difficulties and solutions

1. Sexual Difficulties and solutions

2. Sexual problems are common • Causes • Organic • Cultural • Individual • Relationship

3. Symptoms and treatment for various disorders

4. Sexual aversion disorder • Occurs when sexual activity is predicted • Symptoms • Nausea • High anxiety • Sexual repulsion • Treatment • Systematic desensition

5. Hypoactive sexual desire • Most difficult to treat • 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. PSAS-Persistent Sexual Arousal Disorder • Frequent, intrusive sexual arousal • Tingling or other sensations – without sexual desire • Not always relieved by orgasm • Relatively rare diagnosis • Treatment • Antidepressants sometimes helpful • E.g. Pristiq

8. Male orgasmic disorder • Also called ejaculatory incompetence (older term) • Symptoms • Inability to ejaculate • Treatment • Stimulation to produce ejaculation immediately after penetration • Move penetration earlier and earlier.

9. Male arousal disorder “ED” Erectile Dysfunction • Also called Impotence (older term) • Symptoms • Inability to get an erection • Causes • Restriction of blood flow into the penis • High cholesterol • High blood pressure • Diabetes • Prostate surgery • Etc.

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

11. Penile implants • Men more satisfied with the inflatable prosthetic device than semi-rigid rods.

12. Penile implants • Semi-rigid rods

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 • Occurs when the cells of the lining of the uterus are disrupted, and often grow outside the uterus within the abdominal cavity. • 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 • Direct manual stimulation of the clitoris during intercourse. • Female initiated movements • (Woman on top position)