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?