Sexual Difficulties and solutions Sexual problems are common Causes Organic Cultural Individual Relationship Symptoms and treatment for various disorders Sexual aversion disorder Occurs when sexual activity is predicted Symptoms Nausea High anxiety Sexual repulsion Treatment Systematic desensition Hypoactive sexual desire Most difficult to treat Symptoms Lack of sexual interest Many causes Physical Psychological 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 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. 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. Male arousal disorder (Cont.) Treatment Medical Viagra Levitra Cialis Squeeze technique Relationship difficulties Penile implants Penile implants Men more satisfied with the inflatable prosthetic device than semi-rigid rods. Penile implants Semi-rigid rods Premature Ejaculation Symptoms Inability to delay ejaculation Treatment Squeeze technique Avoid using the man above “Missionary” position. Pelvic inflammatory disease Symptoms Abdominal pain Pain during intercourse Treatment Antibiotics Vaginismus Symptoms Involuntary spasmic contraction of the muscles surrounding the outer third of the vagina. Painful intercourse Treatment Manual dialation Hegar dialators Dyspareunia Symptoms Painful intercourse Treatment Based on cause Vaginismus Vaginal dryness STD’s Vaginitis Symptoms Inflammation and infection Redness Itching Irritation Treatment Based on the cause Often antibiotic pills and creams Peyronie’s disease Symptoms Thickening of the length of the top of the shaft of the penis. Treatment Surgery 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 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)