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Sexual Difficulties And Solutions PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Sexual Difficulties and Solutions”.

This medical PowerPoint presentation is about sexual difficulties which can affect individuals and couples of all ages and can be caused by physical, psychological, or emotional factors. Some common sexual difficulties include:

Erectile Dysfunction (ED): This is the inability to achieve or maintain an erection firm enough for sexual intercourse. Solutions can include medication, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra), lifestyle changes such as exercise, diet, and quitting smoking, or psychological interventions such as cognitive-behavioral therapy (CBT).
Premature Ejaculation (PE): This is when ejaculation occurs too quickly during sexual intercourse. Solutions can include behavioral techniques, such as the stop-start method or the squeeze technique, medication such as dapoxetine (Priligy), or counseling.
Low Sexual Desire: This is a lack of interest or desire for sexual activity. Solutions can include addressing any underlying medical or psychological issues, improving communication and intimacy with a partner, or trying new sexual activities.
Painful Intercourse: This can be caused by a variety of factors, including infections, menopause, or vaginal dryness. Solutions can include medical treatments, such as hormone therapy or lubricants, or psychological interventions, such as counseling or mindfulness-based therapies.
Sexual Anxiety: This is the fear or anxiety related to sexual activity, such as performance anxiety or fear of rejection. Solutions can include cognitive-behavioral therapy (CBT), mindfulness-based therapies, or communication and intimacy-building exercises with a partner.

Its important to note that sexual difficulties can be complex, and seeking professional help from a healthcare provider, therapist, or sex therapist may be necessary to address the issue effectively.

Tags : Sexual Difficulties, Erectile Dysfunction, Premature Ejaculation, Low Sexual Desire, Painful Intercourse, Sexual Anxiety, sex therapist, Obstetrics and Gynecology, Obstetrics and Gynecology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 993 | Downloads : 2

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Slide 1-

Chapter 14Sexual Difficulties and Solutions
Slide 2-

Sexual problems are quite common Statistically, occur more frequently in: Younger women, older men People w/less education Perception of sexual problems is subjective Not everyone experiencing a sexual problem is necessarily distressed or sexually dissatisfied
Slide 3-

Pfizer Study of Sexual Attitudes & Behaviorsglobal survey of >26,000 people in 29 countries
Slide 4-

Types of specific sexual difficulties • In reality, these overlap considerably - problems w/desire and arousal often affect orgasm; - problems w/orgasm easily affect desire and arousal Desire-phase difficulties Excitement/arousal-phase difficulties 3) Orgasm-phase difficulties 4) Dyspareunia Painful intercourse
Slide 5-

Desire-phase difficulties 1) Hypoactive sexual desire disorder (HSDD) lack of interest both prior to sexual activity as well as lack of desire during the sexual experience If “sexual appetite” is low, but person can become aroused/desirous after sexual experience begins, then person does not have HSDD Used to be defined as generally low sexual appetite In these terms, very common sexual difficulty Contributing factors: Life stress Relationship problems Medical problems History of sexual abuse or trauma
Slide 6-

Desire-phase difficulties (cont.) 2) Dissatisfaction w/frequency of sexual activity 2005 Global Sex Survey: 41% of men and 29% of women want sex more frequently Couples normally have some differences in preferences re: sexual frequency (may go back & forth) When these differences are significant source of conflict or dissatisfaction in the relationship, couple can have major difficulties 3) Sexual Aversion disorder: extreme and irrational fear of sexual activity Thought of sexual activity can induce intense anxiety and panic
Slide 7-

Excitement-phase difficulties 1) Female Sexual Arousal Disorder: 2 types Genital sexual arousal disorder: persistent inability to attain or maintain lubrication-swelling response _ Subjective sexual arousal disorder: absent or diminished awareness of physical arousal Physical signs are there, but feelings of excitement and pleasure are missing 2) Persistent Sexual Arousal Disorder Spontaneous, intrusive, and unwanted genital arousal in the absence of sexual interest Uncomfortable tingling, throbbing, pulsating; not relieved by orgasms--can last hours or days
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Excitement-phase difficulties (cont.) 3) Male erectile disorder (ED) Consistent or recurrent inability to have or maintain an erection sufficient for sexual activity for >3 months. Quite common 1 in 5 men over age of 20 experience ED Incidence of ED increases with age (see graph)
Slide 9-

Orgasm-phase difficulties 1) Female orgasmic disorder Absence, marked delay, or diminished intensity of orgasm--despite appropriate stimulation (usually clitoral) Lack of orgasm during intercourse is not a disorder Approx. 5-10% of adult women in U.S. More common among women who are younger, unmarried, and have less education Can be a learned skill, or learned w/the right partner: One survey found that 62% of women were 18 years or older before they first experienced orgasm Among college students, 13% of women have not had an orgasm (compared w/6% of men) Situational female orgasmic disorder: Refers to woman who is orgasmic when masturbating but not when stimulated by a partner
Slide 10-

Orgasm-phase difficulties 2) Male orgasmic disorder Inability of a man to ejaculate during sexual activity Approx. 8% of men experience this 3) Premature ejaculation The most common male sexual difficulty Pattern of ejaculations within 2 minutes and an inability to delay ejaculation, resulting in impairment of man’s or his partner’s pleasure Approx. 20-30% of men worldwide age 18-59 Men w/P.E. experience rapid arousal and often ejaculate before reaching full sexual arousal; report less enjoyment of orgasm than men w/o P.E. Suggests some physiological component
Slide 11-

Orgasm-phase difficulties 4) Faking orgasms Usually discussed in reference to women, though some men also fake orgasms Reasons given: avoid disappointing or hurting their partners get sex over with need for partner approval Can lead to vicious cycle Partner continues same method (presumably ineffective) of stimulation, which he/she believes to be effective Creates emotional distance during physical intimacy Female Heterosexual Female Lesbian/Bi Male Gay/Bi Male Heterosexual Table 14.3 Asked college students, “Have you ever faked an orgasm?”(%)
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14-A: Discussion question PART 1: Is faking an orgasm ever okay to do? Why or why not? PART 2: What do you consider premature ejaculation? Is there a time limit? If sexual activity continues after ejaculation of a male partner, does it matter if it is “premature”? What is sexual activity does not continue?
Slide 13-

Dyspareunia: Pain or discomfort during intercourse Much more common in women (see next slide) > 60% of women experience dyspareunia at some point In men, dyspareunia is unusual but does occur If foreskin is too tight (phimosis), erection can be painful Poor hygiene of uncircumcised penis can cause infection that can irritate the glans during sexual activity Infections in urethra, bladder, prostate gland, or seminal vesicles can cause pain w/ejaculation Peyronie’s disease: fibrous tissue and calcium deposits develop in space above/btwn cavernous bodies of penis Usually caused by traumatic bending of penis during intercourse Results in pain and curvature of penis upon erection
Slide 14-

Dyspareunia in women Situational discomfort Inadequate arousal or lubrication Physiological, hormonal conditions can reduce lubrication (nursing, menopause) Vaginal infections can cause inflammation of vaginal walls that makes intercourse painful Contraceptive foam/jelly, latex condoms/diaphragms can irritate vaginas of some women Vulvar vestibulitis syndrome Small, reddened area at entrance of vagina that causes severe pain Experienced by ~10% of women Sometimes caused by neurological problem that can be “retrained” by myofascial release, biofeedback,
Slide 15-

Dyspareunia in women (cont.) Deep pelvic pain During coital thrusting, may be due to jarring of the ovaries or stretching of uterine ligaments May occur only in certain sexual positions or at certain times during a woman’s cycle (usu. ovulation or menstruation) Endometriosis Endometrial tissue that normally only grows on walls of uterus implants on various parts of abdominal cavity Infections in uterus e.g. gonorrhea Gynecological surgeries for uterine and ovarian cancer Torn uterine ligaments Due to rape or problem during childbirth
Slide 16-

Dyspareunia in women (cont.) Vaginismus Involuntary spasmodic contractions of the muscles of the outer third of the vagina Result in extreme pain upon insertion of a penis, or even a finger, into the vagina Caused by a number of different possible physiological, psychological, and situational factors Women can learn to minimize or prevent the contractions with treatment
Slide 17-

Origins of sexual difficulties:physiological factors Vascular, hormonal, neurological problems Poor general health, diet, and exercise For example, body fat, especially around the abdomen, reduces testosterone levels in men, and men who are obese are 90% more likely to have ED Drug use See table 14.4
Slide 18-

Physiological factors (cont.) General chronic illness Many different illnesses can impact sexual functioning, either due to direct impairment of nerves, hormones, or blood flow, or due to pain and fatigue suppressing desire Diabetes: Nerve damage and circulatory problems resulting from diabetes cause ~50% of diabetic men to have reduction or loss of capacity for erection Women w/diabetes often have problems w/sexual desire, lubrication, and orgasm Cancer Chemotherapy & radiation can damage hormonal, vascular, and neurological functions necessary for sexual functioning Nausea, fatigue, pain, negative body image after surgery Cancers of the reproductive system usually have the worst impact on sexual functioning
Slide 19-

Physiological factors (cont.) Multiple sclerosis (MS) Neurological disease of the brain and spinal cord due to damage to the myelin sheath covering nerve fibers Most MS patients experience problems w/sexual functioning, ranging from loss of sexual interest or genital sensation, reduced arousal or orgasm, or hypersensitivity to genital stimulation Strokes: Occur when brain tissue is destroyed as a result of blockage of blood to the brain or internal bleeding in the brain Often result in limited mobility, altered/lost sensation, impaired verbal communication Stroke survivors frequently report reduced sexual interest, arousal, and activity
Slide 20-

Effects of medications Over 200 prescription and OTC medications have negative effects on sexuality Health care practitioners don’t always discuss potential sexual side effects -- ask or do your own research Psychiatric medications Antidepressants: reduced sexual interest, arousal, delayed or absent orgasm in up to 60% of users Antipsychotics: frequent loss of arousal, orgasm Tranquilizers (valium, xanax, etc.): interfere w/orgasm Antihypertensive medications (treat high b.p.) Can interfere w/desire, arousal, and orgasm Other medications Prescription and OTC gastrointestinal, antihistamine medications can interfere w/desire, arousal, erection Methadone can reduce desire, arousal, orgasm
Slide 21-

Disabilities Have widely varying effects on sexual responsiveness Cerebral palsy Brain damage that occurs before/during birth or in early childhood Results in mild to severe lack of muscular control Genital sensation is unaffected, but some positions may be difficult, involuntary vaginal contractions can cause pain Sexual adjustment depends on support from partner, social network as much as on physical possibilities Spinal cord injury May result in impaired physical ability for arousal and orgasm--varies considerably depending on the specific injury Research: 86% of men and women w/SCI’s feel desire, over half experience arousal from stimulation, ~1/3 experience orgasm Research in women has shown that the vagus nerve provides an alternate pathway from vagina/cervix to brain that bypasses the spinal cord
Slide 22-

Disabilities Effect of spinal cord injury on erection depends on location of injury along spinal cord
Slide 23-

Disabilities (cont.) Blindness and deafness Can affect sexuality primarily when they interfere with learning social interaction skills, independence Other senses can play an expanded role Enhancement strategies for people with chronic illnesses and disabilities Acceptance of limitations & development of remaining options Pain control, either by minimization or treatment Expand definition of sexuality beyond genital arousal and intercourse Some people find that their illnesses/disabilities teach them fascinating new things about their sexuality, increase connection to partner
Slide 24-

Cultural influences Negative childhood learning Parents’ attitudes toward sex, level of affectionate interaction with each other Labeling sex as sinful or shameful can contribute to sexual difficulties later in life Sexual double standard Research: equality of gender roles is associated with greater sexual satisfaction in men & women Opposing sexual expectations for women and men create problems Men feel that they should want sex all the time, that asking for guidance from their partner isn’t ‘manly’ Women may learn to be sexually restrained for fear of being labeled a ‘slut,’ resulting in less exploration of their sexuality, not asking their partner for what they want
Slide 25-

Cultural influences (cont.) Narrow definition of sexuality Idea that ‘real’ sex = penile-vaginal intercourse leads to inadequate clitoral stimulation for women, places unrealistic burden on intercourse When problems occur, too much focus is often placed on issues of erection problems, when emotional or relationship problems are very often the root cause Performance anxiety Usually, anxiety about not being able to achieve erection or orgasm One transitory problem with performance can cause a vicious cycle where anxiety about repeat problems causes problems next time
Slide 26-

Individual factors Sexual knowledge & attitudes Awareness of our bodies and how we receive pleasure minimizes future sexual difficulties Sexual abuse & assault 17% of women and 12% of men were sexually abused before adolescence 17.6% of women and 3% of men have been raped or were the victim of attempted rape Increases likelihood of sexual difficulties later in life, affecting self-esteem, desire, arousal, and orgasm Emotional problems Anxiety, depression, and stress have a strong negative effect on sexuality
Slide 27-

Individual factors (cont.) Self-image then now
Slide 28-

Individual factors (cont.) Self-concept Self-esteem, self-confidence correlate w/higher sexual satisfaction in women and men Body image strongly affects sexuality Affects women especially Many women feel sexually inhibited b/c they are uncomfortable with their bodies Media images of women have gotten further and further from the average size of women Early 1980s: average model weighed 8% less than the average American woman; today, it’s 23% less Men are increasingly affected as well Male models/stars typically have no visible body hair and are getting ‘beefier’ Porn gives men unrealistic idea of normal penis size
Slide 29-

Relationship factors Unresolved resentments, trust issues, disrespect for partner One partner feels pressured Partners are too dependent on each other Need balance of togetherness and separateness Ineffective communication Issues around pregnancy, STIs Anxiety about unwanted, or desired pregnancy Anxiety about contracting a STI Problems accepting one’s sexual orientation Homosexuals who fear societal or familial disapproval about being gay may attempt to live in heterosexual relationships despite their lack of desire for other sex
Slide 30-

Sexual enhancement/Sex therapy Cautionary statements self-help/sex therapy techniques described in book are often effective professional help may be needed in the form of sex therapy, couples’ therapy, or individual therapy see an MD to assess physical causes
Slide 31-

Sexual enhancement/Sex therapy Self-awareness Becoming well-acquainted with our sexual anatomy Experimenting with masturbation to learn about sexual response Communication Using strategies described in Chp. 7 to improve communication about sexual activities Learning how to tell or show partner what is desired, what type of stimulation is effective
Slide 32-

Sexual enhancement/Sex therapy (cont.) Sensate focus Prescribed by therapists for a number of male and female sexual difficulties Also helpful technique to increase intimacy in couples who aren’t experiencing sexual difficulty Principles of the technique: Non-goal-oriented physical intimacy Takes the pressure off of “performance” and achieving orgasm Focus on sensation of touching your partner Exploring sensual touching beyond the genitals Discovering whether aspects of intimacy bring up any feelings of discomfort
Slide 33-

Specific suggestions for women Becoming orgasmic: first alone First: body exploration, genital self-exam, Kegels Then: self-stimulation exercises (as described in Chp. 8) Vibrators can help women experience orgasm for the first time so she knows what it feels like After a few vibrator-assisted orgasms, helpful to return to manual stimulation --easier for a partner to replicate
Slide 34-

Specific suggestions for women (cont.) Then, w/a partner Masturbation w/partner present Mutual body/genital exploration, then experiment w/touch, communicating their responses Woman guides partner’s touch by placing her hand over partner’s hand on genitals At first, to show partner what feels good Eventually, woman may experience orgasm w/partner
Slide 35-

Specific suggestions for women (cont.) Facilitating orgasm during intercourse w/a partner Woman can initiate movements & pressure that feel most stimulating Woman (or partner) can also stimulate her clitoris manually or w/a vibrator during intercourse Table 14.5
Slide 36-

Specific suggestions for men:Strategies for delaying ejaculation More frequent ejaculation “Come again” Change positions woman-on-top, no male thrusting, to decrease muscle tension, delay ejaculation Communication man tells partner when to reduce or stop stimulation, then resume after a few moments Alternative activities intercourse is just one option Medical treatment Low doses of antidepressants--considerable side effects
Slide 37-

Specific suggestions for men:Strategies for delaying ejaculation (cont.) Stop-start technique Developed in the 1950s Technique involves stimulation to brink of orgasm; stop, wait for sensations to decrease, start again Man begins by working alone using masturbation Eventually, work on technique with partner
Slide 38-

Discussion question Read the two handouts describing the sensate focus exercises and the stop-start techniques to help men delay ejaculation. What are your reactions to these exercises? Do they seem beneficial? Are there any aspects of these exercises that seem uncomfortable if you were to imagine practicing them with a partner?
Slide 39-

Specific suggestions for men:Erectile dysfunction Reduce performance anxiety (most common cause) Sensate focus exercises take the pressure off “goal-oriented” intercourse Then, genital stimulation other than intercourse After man experiences full erection, partner stops stimulation, allows erection to subside Resume genital stimulation to allow erection to return Restores man’s confidence that erection will return Final phase of treatment is intercourse If man loses erection after penetration, return to oral or manual stimulation; if response is still blocked, return to nongenital sensate focus before moving forward again
Slide 40-

Erectile dysfunction (cont.) Medical treatments Viagra (1998); newer drugs: Levitra and Cialis Mechanism: smooth muscle relaxation in spongy bodies of penis, increasing blood flow, resulting in erection Similar side effects: flushing, headaches, nasal congestion Can cause priapism (erection doesn’t subside--can cause damage to penile tissue w/o treatment): takes effect < 3 hours, requires physical stimulation, effect may depend on quality of relationship Have increased awareness of ED Has led to some recreational use--has led to some increase in high-risk sexual behavior in combination w/drugs & casual sex Vasoactive medication Common ED treatment before Viagra-like drugs Work by relaxing smooth muscle in spongy body of penis, increasing blood flow --> erection Required injection into penis, or suppository inserted in urethra
Slide 41-

Erectile dysfunction (cont.) Mechanical devices Suction blood into penis and hold it there during intercourse External vacuum devices, with penile constriction bands Rejoyn Penile support sleeve made from soft rubber--fits over penis to provide support necessary for intercourse
Slide 42-

Erectile dysfunction (cont.) Surgical treatments Penile implants--2 types Semirigid rods inside a silicone covering placed inside cavernous bodies of the penis (disadvantage: penis always semierect) Inflatable prosthesis that can be pumped as needed (see below) Surgery cannot restore sensation or ability to ejaculate if it has been lost due to medical problems (similar to Fig. 14.7 in book)
Slide 43-

Treating Hypoactive Sexual Desire Some suggestions same as other dysfunctions encourage erotic responses Self-stimulation, fantasy reduce anxiety Sensate focus exercises enhance sexual experiences through improved communication about which activities feel pleasurable and which do not expand repertoire of activities Less “goal-oriented” sexual activity Moving beyond “genital-only” sensual/sexual activity Therapy Examine, resolve subconscious conflicts about pleasure Examine whether there are unresolved relationship issues
Slide 44-

Treating Hypoactive Sexual Desire Medical treatments Men: Testosterone supplementation to increase desire; Viagra to help with arousal/response Women: Both estrogen and testosterone therapies can increase sexual desire and arousal in postmenopausal women Testosterone can also increase desire in premenopausal women w/below-normal testosterone levels Zestra: oil applied to clitoris and vulva to increase sexual response ArginMax: nutritional supplement to increase clitoral sensation, desire, vaginal lubrication, orgasm frequency Bremelanotide: inhalant that acts on neural pathways to increase desire and genital arousal--still in research phase Creams containing alprostadil, prostaglandins, or L-arginine to inrease blood flow to genitals, enhance arousal and orgasm
Slide 45-

Seeking Professional Assistance What happens in therapy? identify & clarify problems & goals medical, sexual, relationship history often given homework NEVER includes sex with therapist Selecting a therapist referral from trusted source (some listed in text) ask about credentials, training, & experience interview: practicalities & "fit"