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3.Many therapists remain opposed to this treatment method for ethical reasons.
Chapter 17: Challenges in Sexual Function: Sexual (Dys)function1.Differences in the way that males and females experience sexual dysfunctionsa.Females tend to experience lack of interest in sex, an inability to orgasm, and problems with lubricationb.Males are more likely to experience premature ejaculation (climaxing too early), performance anxiety and lack of interest of sex2.Two categories of sexual dysfunctiona.Deficienciesi.Lack of interest in sexii.Inability to achieve orgasmiii.Difficulty with erection, lubrication, orgasmb.Overexcitementi.Premature ejaculationii.Excessive sexual behavior3.Sexual dysfunctions in lesbian, gay and transgender individualsa.Lack of interest in sexcan be an especially relevant problem in lesbian relationships.i.However the sex tends to be more varied, lasts longer, is more likely to lead to orgasm and is less likely to occur because of pressureii.Lesbian Bed Death: lesbian couples in committed relationships have less sex than other categories of couples and they generally experience a decline in sexual intimacy the longer the relationship lastsb.Gay men who suffer from erectile dysfunctionmay have an especially hard time maintaining an erection during anal sexc.Transgender people may struggle from anxietyif they are unhappy with the way their genitals look, or if they have had sex reassignment surgery and this has caused them to lose sexual function. 4.Premature ejaculation: ejaculation before the male wants it to
i.Average male lasts between two to eight minutes of thrusting before ejaculation, with the average being 5minutesi.Often just a matter of perception: average #minutes of thrusting isless than people expected1.Unrealistic expectations about how long they should "last" during sexual intercourse from pornography and the mediaii.Often a learned response: traditional view1.Usually when it’s a situational disorder2.For males whose early sexual experiences were frequently rushed and filled with anxiety, climaxing quickly was simplyan automatic conditioned response. iii.It may result from dysfunction in certain receptors of serotonin1.Usually when it’s a primary disorder2.When serotonin levels are too low and dopamine is too high, males can ejaculate too quickly.c.Treatment of premature ejaculationi.Most effective when it combines sex therapy and drugs1.SSRIs(Selective serotonin reuptake inhibitor): especially Paxil, are typically effective2.Stop-Start Method: a technique that instructs males to stimulate the penis but stop just before they feel they are about to ejaculate3.Sensate focus: a touching exercise, where couples take turns gently touching each other all over their whole bodieswhile focusing, in a non-evaluative way, on the sensations involved5.Delayed Ejaculation- the exact opposite of premature ejaculationa.Causes:i.