Chapter Seven
Sexual Problems
and Solutions
Historical Perspectives
Before Masters and Johnson…
What Is a Sexual Problem?
How Common Are Sexual Problems?
Evaluating a Sexual Problem: A ThreeDimensional Model
• Duration: Primary or Secondary
• Context: Global or Situational
• Frequency: Partial or Total
What Is a Sexual Problem? (cont.)
What Is a Sexual Problem? (cont.)
What Is a Sexual Problem? (cont.)
Sources of Sexual Problems:
Biological or Physiological Causes
Neurological
Hormonal
Vascular
Use and Abuse of Alcohol and other Recreational
Drugs
SSRIs (Selective Serotonin Reuptake Inhibitors)
Sources of Sexual Problems:
Biological or Physiological Causes
(cont.)
Sources of Sexual Problems:
Biological or Physiological Causes
(cont.)
Sources of Sexual Problems:
Psychological Causes
Frequency
Types
•
•
•
•
•
Fear Of . . .
Anxiety About . . .
Guilt Over . . .
Stress Due to . . .
Other Psychological Causes
Sources of Sexual Problems:
Psychological Causes (cont.)
Sources of Sexual Problems:
Relationship Issues
•
•
•
•
Loss of Trust
Poor Communication
Anger and Resentment
Conflicting Sexual
Expectations
• Lack of Respect
• Loss of Love
• Interactions Among the
Above 6 Factors
Sources of Sexual Problems:
Cultural Expectations
Sexuality and Culture: Forbidden Love
General Treatment Principles
Sensate Focus
• Self-Discovery A Sex Therapist’s Instructions for
Sensate Focus Exercises
Masturbation as Treatment
• Directed Masturbation
Communication
• Self-Discovery Mirroring: A Potential Problem with
Nonverbal Communication
Specific Problems and Solutions:
Sexual Desire
Hypoactive Sexual Desire (HSD)
• Description
• Causes
• Solutions
– Cognitive Behavioral Therapy
• In Touch with Your Sexual Health Uncovering Possible
Causes of Hypoactive Sexual Desire
Specific Problems and Solutions:
Sexual Desire (cont.)
Specific Problems and Solutions:
Sexual Arousal in Men
Male Erectile Disorder
• Description
• Causes
– Spectatoring
• Solutions
– Nocturnal Penile
Tumescence (NPT)
• Self-Discovery SelfScreening for Erectile
Dysfunction
Specific Problems and Solutions:
Sexual Arousal in Men (cont.)
Specific Problems and Solutions:
Sexual Arousal in Women
Female Sexual Arousal Disorder
• Description
• Causes
• Solutions
Specific Problems and Solutions:
Sexual Arousal in Women (cont.)
Specific Problems and Solutions:
Orgasm
Female Orgasmic Disorder
• Description
• Causes
• Solutions
Premature Ejaculation (in Males)
• Description
• Causes
• Solutions
Male Orgasmic Disorder
Specific Problems and Solutions:
Painful Sex
Dyspareunia
• Deep Dyspareunia
– Endometriosis
– Pelvic Inflammatory Disease (PID)
Vaginismus
A “New View” of Female Sexual
Problems
Recall the “New View” of Women’s Sexual
Response from Chapter 3?
Reverse the Current Trend to “Medicalize” Sexual
Problems
A “New View” of Female Sexual
Problems (cont.)