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Sexuality Difficulties and Solutions

Sexuality Difficulties and Solutions. Defining Sexual Difficulties. Sexual satisfaction is subjective The way people are surveyed can skew results. Prevalence of Sexual Problems. Desire Phase Difficulties. Hypoactive sexual desire disorder (HSD) Lack of interest in sexual activity

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Sexuality Difficulties and Solutions

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  1. Sexuality Difficulties and Solutions

  2. Defining Sexual Difficulties • Sexual satisfaction is subjective • The way people are surveyed can skew results

  3. Prevalence of Sexual Problems

  4. Desire Phase Difficulties • Hypoactive sexual desire disorder (HSD) • Lack of interest in sexual activity • Usually temporary • Often due to relationship problems, or internalized negative attitudes about sex • Very common • Sexual aversion disorder (SAD) • Extreme, irrational fear of sexual activity • Often due to sexual abuse or assault

  5. Excitement Phase Difficulties among Women • Female genital sexual arousal disorder • Inhibited lubrication • Female subjective sexual arousal disorder • Physical signs of arousal are present, but feelings of sexual excitement and pleasure are absent or diminished • Combined genital and subjective sexual arousal disorder

  6. Excitement Phase Difficulties Persistent Sexual Arousal Disorder • Spontaneous, intrusive, and unwanted genital arousal in the absence of sexual interest • One or more orgasms do not relieve arousal • Arousal can persist for days • Individuals have normal physiological and psychiatric evaluations • First identified in 2001 • Causes and treatment are unknown

  7. Excitement Phase Difficulties:Male Erectile Dysfunction • Lack of an erection for at least 3 months • ED occurs in one in five men older than 20 years • Most often caused by combination of biological, psychological, and social factors

  8. Male Erectile Dysfunction

  9. Orgasm Phase Difficulties:Female Orgasm Disorder • Anorgasmia = absence of orgasm • Many cases are situational • Influenced by cultural factors • Younger and unmarried women most likely to experience difficulty with orgasm • For some, experiencing an orgasm is something learned

  10. Have You Ever Had an Orgasm?

  11. Orgasm Phase Difficulties:Male Orgasm Disorder • Male coital anorgasmia = difficulty with orgasm during intercourse • Partner anorgasmia = difficulty with orgasm by partner manual and oral stimulation • Premature ejaculation (PE) • Inability to control orgasm to either partners’ satisfaction • 20-30% men worldwide (ages 18-59) repeatedly experience PE

  12. Faking Orgasm • Common among women and men but usually discussed in reference to women • Reasons • Avoid disappointing or hurting partner • To get sex over with • Poor communication • Limited knowledge of sexual techniques • Attempt to hide deteriorating relationship

  13. Have You Ever Faked an Orgasm?

  14. Dyspareunia: Painful Intercourse • Men • Phimosis: tight foreskin • Infected or irritated foreskin • Pelvic or genital infections • Peyronie’s disease: fibrosis in penis • Women • Decreased lubrication • Infections in vagina & bladder • Vulvar vestibulitis syndrome • Endometriosis or STD • Gynecologic surgery, childbirth

  15. Vaginismus • Strong, involuntary contractions of outer third of vagina • Fear or ambivalence due to assault, hostility, pain or sexual taboos • Vicious cycle can be created

  16. Origins of Sexual Difficulties:Physiological Factors • Hormonal, vascular, neurological • Good health habits = good sexual functioning • Chronic illnesses & disabilities

  17. Origins of Sexual Difficulties:Cultural Influences • Negative childhood learning • Sexual double standard • Narrow definition of sexuality • Performance anxiety

  18. Origins of Sexual Difficulties:Individual Factors • Sexual knowledge and attitudes • Self-concept • Emotional difficulties • Sexual abuse and assault

  19. Origins of Sexual Difficulties:Relationship Factors • Unresolved problems • Ineffective communication • Fears about pregnancy or STDs • Sexual Orientation

  20. Basics of Sexual Enhancement and Sex Therapy • Self-awareness • Communication • Sensate focus • Sexual Orientation

  21. Sensate Focus

  22. Specific Suggestions for Women in Becoming Orgasmic • Through self-stimulation • Vibrator use • Eros clitoral therapy device • Allow time

  23. Eros Clitoral Therapy Device

  24. Experiencing Orgasm with Partner • Sexual assertiveness important • Masturbation in presence of partner • Sensate focus activity • Techniques to increase arousal

  25. Masturbating with Partner

  26. Specific Suggestions for Men: Delaying Ejaculation • More frequent ejaculation • “Come Again” • Change positions • Communication • Alternative activities • Stop-start technique • Medical Treatment

  27. Dealing with Erectile Dysfunction • Psychological: Reduce anxiety • Medical: Viagra and other treatments • Mechanical: suction pump, Rejoyn • Surgical treatment

  28. Seeking Professional Assistance:What Happens in Therapy? • Identify & clarify problems and goals • Medical, sexual, relationship history • Often given homework • NEVER includes sex with therapist

  29. Seeking Professional Assistance:Selecting a Therapist • Referral from trusted source • Ask about credentials, training & experience • Interview: practicalities & “fit”

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