bb dysfunc - 15.1 NHSLS Study: Sexual Dysfunctions: Past...

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Unformatted text preview: 15.1 NHSLS Study: Sexual Dysfunctions: Past year % Men % Women Pain During Sex 3 14 Sex not Pleasurable 8 21 Unable to Orgasm 8 24 Lack of interest 16 33 Performance anxiety 17 12 Climax too early 29 10 Unable to keep erection 10- Trouble lubricating- 19 In phone survey, women distressed @ sexuality/ r-ship 43% of women had a dysfunc. Factors to consider: Sexual desire disorders Hypoactive SDD: no interest in any type of sex- activity. Doesnt mean they cant Rarely fantasize, dont attempt sex, and seldom masturbate. Difficult to define and assess b/c lack of clear standard, and different levels for each partner. Relies on clinical judgement. Within 18-59 age, 1/3 women and 1/6 men say they lack interest in sex; Probably increase beyond 59. If it interferes w/ r-ship or is distressing then it is HSDD. # of people w/the disorder disorder is much lower than those who say they lack interest in sex. (3% of men?). Many people (e.g., elderly) not troubled by their lack. Medical disorders can contribute to HSDD: hormonal deficiencies (loss of adrenal and T), depression, thyroid, TLE. Men tend to be older. Gradual T change abrupt change with psych factors (anx most common). Marital problems. Sexual aversion disorder : more severe than HSDD; the thought of sex evokes fear, panic, disgust. May be due to traumatic history (e.g., rape) or panic attack history (fear of heart attack). Hypoactive desire treatment Hormones: T for low levels. Of women w/ low libido, some have low levels of T. Some postmenopausal women on estrogen therapy can combine with T. Psych and Behav Therapy: Treatment of depression. Relationship therapy Sensate focus therapy (will cover later). Sexual arousal disorders: not desire but lack of arousal and feelings of pleasure (pejorative name for men is impotence and women, frigidity) . male erectile dis : difficulty achieving/maintaining an erection. (unusual to have total lack of E). Full possible during masturbation. E.d. is common (some/occasional in 40-50% of men in 40s and up) majority in men over 50. Most common reason why men seek help . Can be acquired vs. lifelong. ED is not either physical or psych but usually a combo. ED increases w/ age; Premature ejac. decreases w/ age . Psych causes:Performance anx: Vicious cycle. ED and anx feed off each other. Out of touch w/ body: show decreased arousal during perf demand, not accurate as to own arousal. (underreport arousal; distract themselves with neg thoughts). In PE, the sympathetic over-arousal may make the prob worse. Physical causes of Erectile Dysfunction Alc/drugs: Low doses: decrease social inhibitions. At Alc/drugs: Low doses: decrease social inhibitions....
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bb dysfunc - 15.1 NHSLS Study: Sexual Dysfunctions: Past...

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