What sexual difficulties could you have? © Robert J. Atkins, Ph.D. Sexual problems are common. Sexual problems if you are a woman What if you can not climax? 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) What if sex hurts? Vaginismus Symptoms Involuntary spasmic contraction of the muscles surrounding the outer third of the vagina. Painful intercourse Treatment Manual dialation Hegar dialators What if you have deep pelvic pain? 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 What if you are constantly turned on? Persistent Sexual Arousal Syndrome (PAIS) Frequent, intrusive sexual arousal Tingling or other sensations – without sexual desire Not always relieved by orgasm Relatively rare diagnosis Treatment Antidepressants sometimes helpful What if you have pelvic inflammatory disease? Symptoms Abdominal pain Pain during intercourse Treatment Antibiotics What if your vagina and vulva becomes inflamed ? Vaginitis Symptoms Inflammation and infection Redness Itching Irritation Treatment Based on the cause Often antibiotic pills and creams Do you remember? What can you do if you can not climax? What might cause painful vaginal contractions? How can you treat it? What might cause deep pelvic pain? What might cause redness and irritation in your vulva? Sexual problems possible for both sexes (More for women) What if the thought of sex makes you sick? Sexual aversion disorder Occurs when sexual activity is predicted Symptoms Nausea High anxiety Sexual repulsion Treatment Systematic desensition What if you have no sexual desire? Hypoactive sexual desire Most difficult to treat Symptoms Lack of sexual interest Many causes Physical (e.g. medications) Psychological Possible symptom of unresolved relationship problems 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 What if sex hurts? Dyspareunia Symptoms Painful intercourse Treatment Based on cause Vaginismus Vaginal dryness STD’s Foreskin tightness & irritation Do you remember? What are the symptoms of sexual aversion disorder? What would cause you to lose interest in sex? What would cause sex to hurt? Sexual problems if you are a man What is 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. Penile implants Male arousal disorder (Cont.) Treatment Medical Viagra Levitra Cialis Squeeze technique Relationship difficulties What are penile implants? Men more satisfied with the inflatable prosthetic device than semi-rigid rods. Penile implants Semi-rigid rods What is peyronie’s disease? Symptoms Thickening of the length of the top of the shaft of the penis. Treatment Surgery What is premature ejaculation? Symptoms Inability to delay ejaculation Treatment Squeeze technique Avoid using the man above “Missionary” position. What is 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. Do you remember? What can men do to last longer and avoid premature ejaculation? What is it called if the penis bends up because of thickening on the top? Do men prefer inflatable implants or semi-rigid rods for surgical E.D. treatment?