the world of Sexual disorder, Normal Perspectives and the Contributing factors...

2. Part Two
Sexual Dysfunctions
Harold Caramat

3. What is sexualdysfunction?
The term “sexual dysfunction” describes a set of
conditions that affect your sex life. Among other
problems, sexual dysfunction can reduce your
desire for sex, or your ability to become sexually
aroused. It may prevent you from achieving an
orgasm, cause premature ejaculation, or it may
cause pain during intercourse.

4. Sexual dysfunction gets in the way of a
pleasurable sex life, which can affect your
mood, relationships, and overall well-being.

5. Disorder of Desire
The Desire phase of the sexual
response cycle consists of an urge to
have sex, sexual fantasies and sexual
attraction to others.

6. SEXUAL DESIRE DISORDERS
Two classes
1. Hypoactive sexual desire disorder,
– characterized by a deficiency or absence of sexual
fantasies and desire for sexual activity; and
– more common among women than among men
Causes – HSDD
Physical Conditions
Psychological and Emotional Conditions

7. Physical causes
1. Hormonal fluctuations or surgery that changes
a women’s body image.
2. Illness such as Diabetes, cancers,
arthritis and coronary artery disease.
3. MENOPAUSE
4. After and during Pregnancy

8. Psychological and emotional conditions
A number of psychological and emotional factors
can affect a woman’s sex drive. She may have
anxiety, depression, or poor self-esteem.
She might be under a lot of stress. Or, she might
be a VICTIM of physical abuse, sexual
abuse, or rape

9. 1. Sexual aversion disorder
– characterized by an aversion to, and avoidance of,
genital sexual contact with a sexual partner or by
masturbation
Sexual aversion according to A.P.A
Causes of Sexual Aversion Disorder
Symptoms of Sexual Aversion Disorder

10. Symptoms of Sexual Aversion
Disorder
1. Avoidance of sexual activity
2. Fear, revulsion, or disgust of sexual activity
3. Relationship problems
4. Panic attacks when confronted with sexual
activity

11. Hypoactive sexual desire disorder &
Sexual aversion disorder
Biological causes - a number of hormones
interact to produce sexual desire and behaviour,
and abnormalities in their activity can lower the
sex drive.
Psychological causes – a general increase in
anxiety or anger may reduce sexual desire in both
men and women.
Sociocultural causes – the attitudes, fear, and
psychological disorder that contribute to HSDD
and Sexual aversion.

12. Disorder of excitement
The excitement phase of the sexual
response cycle is marked by changes in the
pelvic region, general physical arousal,
and increases in heart rate, muscle tension,
blood pressure and rate of breathing.

13. Concept of excitement disorder
In centuries past, excitement disorders were
called frigidity in women and impotence in
men.(first used; 15th century) But in the second
part of the 20th century, psychologists decided
that those terms were too judgmental, so they
changed them to male erectile disorder and
female sexual arousal disorder.

14. Female sexual arousal disorder
 Persistent difficulties becoming sufficiently
lubricated in response to sexual stimulation
 Can be lifelong or situational
 May have physical causes
 Usually has psychological causes, such as anger,
resentment, or trauma
The DSM-IV-R defines female sexual arousal disorder in
terms of the physiological arousal response.
A woman complaining of lack of arousal may lubricate
vaginally, but may not experience a subjective sense of
excitement.

15. Normally, when a woman is aroused and sexually excited, the
first physiological change that she experiences is expansion
of the blood vessels in the pelvic region, allowing more
blood to flow to her lower abdomen and genitals. Some
women notice this as a feeling of fullness in the pelvis and
either consciously or involuntarily contract the
muscles in the genital area.
The increased blood flow also causes a phenomenon
called transudation, which refers to the seepage of
fluid through the walls of the blood vessels.

17. Causes and symptoms
The symptoms of FSAD include lack of or
insufficient transudation. A woman diagnosed
with FSAD does not produce enough fluid to
lubricate the vagina. As a result, intercourse is
often painful and unsatisfactory.

18. Physiological causes of FSAD include
damage to the blood vessels of the pelvic region resulting in
reduced blood flow
damage to the nerves in the pelvic area resulting in diminished
arousal
general medical conditions that damage blood vessels
(coronary artery disease, high blood pressure, diabetes
mellitus)
nursing a baby (lactation)
general medical conditions that cause changes in hormone
levels (thyroid disorders, adrenal gland disorders, removal of
the ovaries)
lower levels of sex hormones due to aging (menopause)
side effects of medications (antidepressants, antipsychotic
drugs, drugs to lower blood pressure, sedatives, birth control
pills, or other hormone-containing pills)

19. Psychological causes of FSAD include:
chronic mild depression (dysthymia)
emotional stress
past sexual abuse
emotional abuse
bereavement
self-image problems
relationship problems with partner
other mental health disorders (major depression,
post-traumatic stress disorder or obsessive-
compulsive disorder )

21. Part THREE
Sexual Dysfunctions
Abnormal Psychology
Harold Caramat

22. Male erectile disorder
or erectile dysfunction
 Persistent difficulty achieving or
maintaining an erection sufficient to
complete sexual activity
- Can be situational or generalized
 May occur due to performance anxiety
- Anxiety concerning one’s ability to
perform behaviors, especially behaviors
that may be evaluated by other people
 May have physical causes

23. Male Erectile Dysfunction:
Causes
Erectile dysfunction may becaused byphysical or
psychological factors, or acombination ofboth.
Sometimes thecausecannot be determined.
Diabetes mellitus
Circulation abnormalities
Neurological causes
Hormonal or endocrine causes
Penile diseases
Medications
Psychological factors
Lifestyle

24. Physical factors - that may cause erectile
dysfunction include (but are not limited to)
hypertension, diabetes, problems with
the prostate, heart problems, a side
effect of certain medications, a
deformity of the penis, lesions in the
spine, and substance use/abuse.
However, most common cause
of erectile dysfunction is a condition called
atherosclerosis.

26. Atherosclerosis is caused by damage to the
cells that line blood vessels (endothelial cells).
The damage to these endothelial cells causes a
decrease in nitric oxide production which is the
key neurotransmitter (in the brain) during the
normal erectile process.
Endothelial cells are damaged by oxidative stress
which can be caused lifestyle choices: a diet that
includes excessive fats and sugars, smoking, and
excessive consumption of alcohol.

27. Disorder of Orgasm
during the Orgasm phase of the sexual
response cycle, an individual’s sexual
pleasure peaks and sexual tension is
released as the muscle in the pelvic
region contact, or draw together,
rhythmically.

28. Orgasmic Disorders Introduction And
Myths
Many things can impact one's ability to have an
orgasm. Having a negative body image, low
self-esteem, or having a psychological disorder
are just a few things that can impact orgasmic
ability.

29. Myth # 1:
Women can achieve orgasm
through penetration alone.
Only 25% of women are consistently orgasmic
during vaginal intercourse alone." Clearly the
myth remains.
Estimates range between 40 to 70% of women
will never orgasm via intercourse alone
and will require clitoral stimulation to
climax. Clitoral stimulation cannot always be
achieved during penetration

30. It is important to keep in mind that orgasm
can be achieved many different ways and
the act of penetration can be pleasurable
and arousing, despite the absence of
orgasm. In fact, stimulation of the so-called
G-spot (named after Dr. Grafenberg),
located about 1-3 inches on the anterior wall
of the vagina, is thought to cause intense
sexual pleasure and mind-blowing
orgasms; however, experts are divided
about whether such a "spot" even exists.

31. Myth #2: He should be able to
last longer.
There is definitely a debate regarding what
defines premature ejaculation. On a more
practical level we can simply look to the media to
see that there is a large emphasis on how long a
man can "last" during sex.

32. Male & Female Orgasmic
Disorder
The DSM IV-TR defines both female and
male orgasmic disorder as a persistent
delay or absence of orgasm after a normal
excitation phase

33. Female orgasmic disorder
Female orgasmic disorder, sometimes called inhibited
female orgasm or Anorgasmic
- defined as the recurrent or persistent inhibition
of female orgasm, as manifested by the
recurrent delay in, or absence of, orgasm after a
normal sexual excitement phase that a clinician
judges to be adequate in focus, intensity, and
duration -- in short, a woman's inability
to achieve orgasm by masturbation
or coitus .

34. Non-orgasmic women may be
otherwise symptom free or may
experience frustration in a variety
of ways; they may have such pelvic
complaints as lower abdominal
pain, itching, and vaginal
discharge, as well as increased
tension, irritability, and fatigue

35. Female Orgasmic Disorder
Normally, when a woman is sexually
excited, the blood vessels in the pelvic area
expand, allowing more blood to flow to the
genitals. This is followed by the seepage of
fluid out of blood vessels and into the
vagina to provide lubrication before and
during intercourse. These events are called
the "lubrication-swelling response."

36. Causes and symptoms
Physiological causes of FOD include:
 damage to the blood vessels of the pelvic region
 spinal cord lesions or damage to the nerves in the
pelvic area
 side effects of medications (antipsychotics,
antidepressants, narcotics) or illicit substance abuse
 removal of the clitoris (also called female genital
mutilation, a cultural practice in parts of Africa, the
Middle East, and Asia)

37. Psychological causes of FOD include:
• past sexual abuse, rape, incest, or other traumatic
sexual experience
• emotional abuse
• fear of becoming pregnant
• fear of rejection by partner
• fear of loss of control during orgasm
• self-image problems
• relationship problems with partner
• life stresses, such as financial worries, job loss, or
divorce
• guilt about sex or sexual pleasure
• religious or cultural beliefs about sex
• other mental health disorders such as major depression

38. FOD is more likely to have a psychological,
rather than a physical cause. Inadequate
time spent in foreplay, inadequate
arousal, lack of appropriate sexual
stimulation, poor sexual
communication with a partner, and
failure to continue with stimulation
for an adequate length of time may
cause failure to climax, but are not
considered causes of FOD.

39. Male Orgasmic Disorder
Also called inhibited orgasm or retarded ejaculation,
a man achieves ejaculation during coitus with great difficulty.
lifelong orgasmic disorder
has never been able to ejaculate during coitus.
acquired orgasmic disorder
it develops after previously normal functioning.
Some researchers think that orgasm and ejaculation should be
differentiated, especially in the case of men who ejaculate but
complain of a decreased or absent subjective sense of pleasure
during the orgasmic experience (orgasmic anhedonia).

40. Description
The individual affected by male orgasmic
disorder is unable to experience an orgasm
following a normal sexual excitement
phase. The affected man may regularly
experience delays in orgasm, or may be
unable to experience orgasm altogether

41. The physiological mechanism of
NORMAL ORGASM
The cycle of sexual response is under the control of
a balanced interplay between the two major
nervous systems, the sympathetic and the
parasympathetic. In general, the
sympathetic nervous system prompts
action whereas the parasympathetic
system's main action is recovery and
calming. In order for a penis to become erect, its
smooth muscles are relaxed and it becomes
congested with blood vessels. This process is
mediated by a complex cascade of humoral,
neurological and circulatory events in
which the parasympathetic nervous system
plays a key role.

42. Causes and symptoms
Organic causes of male orgasmic disorder include the
following:
• Hypogonadism, in which the testes do not produce enough
testosterone.
• Thyroid disorders (both hyperthyroidism—too much
thyroid hormone— and hypothyroidism, or abnormally low
levels of thyroid hormone).
• Pituitary conditions (Cushing's syndrome, excessive
production of the hormone that induces lactation called
prolactin).
• Diseases that affect the nervous system, such as strokes,
multiple sclerosis, diabetic neuropathy, spinal cord
injuries.
• Surgery affecting the prostate and other pelvic organs.
• Diseases of the penis.
• Substance abuse, including alcohol.

43. Intrinsic psychological factors that may
cause male orgasmic disorder include:
depression
• feelings of guilt, anger, fear, low self-esteem, and anxiety
• fear of getting the partner pregnant or of contracting a
sexually transmitted disease or HIV
• Extrinsic psychological factors that may cause male
orgasmic disorder include:
• living under conditions that cause undue stress
• unsatisfactory relationship with sexual partner
• past history of traumatic sexual encounters such as sexual
abuse, rape or incest
• having been raised in an atmosphere of strict sexual
taboos

44. Premature Ejaculation
In premature ejaculation, men persistently or recurrently
achieve orgasm and ejaculation before they wish to.
No definite timeframe exists within which to define the
dysfunction; the diagnosis is made when a man regularly
ejaculates before or immediately after entering the
vagina.
man a premature ejaculator if he could not control
ejaculation sufficiently long enough during intra-vaginal
containment to satisfy his partner in at least half their
episodes of coitus. This definition assumes that the
female partner is capable of an orgasmic
response.

45. –Rapid female orgasm: Can women
reach orgasm too quickly?
• It is not classified as a sexual
dysfunction. However, it may result in
sexual relationship issues.

46. Some researchers divide men who experience
premature ejaculation into two groups:
1. Those who are physiologically predisposed to
CLIMAX QUICKLY because of shorter nerve
latency time
2. Those with a psychogenic or behaviorally
conditioned cause.
• Difficulty in ejaculatory control can be
associated
– with anxiety regarding the sex act,
– with unconscious fears about the vagina, or
– with negative cultural conditioning.

48. Sexual Pain Disorders
The O in OUCH! I thought Sex was
supposed to feel good!
The DSM-IV-TR lists two sexual pain
disorders:
dyspareunia and vaginismus
While they both share the component of pain,
vaginismus only applies to women as it
involves painful spamming of the outer third of
the vagina that interferes with sexual
intercourse. Sexual pain disorders rarely
affect men.

49. Dyspareunia
The DSM-IV-TR defines dyspareunia as
recurrent or persistent genital pain associated
with sexual intercourse. Dyspareunia is thought
to occur in 3-18% of women and for most women
the pain is located at the entrance of the vagina.
The nature, duration, and intensity of pain can
be different for different individuals but often
occurs during sexual intercourse

50. Dyspareunia
Persistent or recurrent pain during sexual
intercourse which is commonly caused by lack of
lubrication in women and genital infections in men
Recurrent or persistent genital pain occurring
in either MEN or women before, during, or
after intercourse.

51. Dyspareunia can also occur in men, but it is
uncommon and is usually associated with an
organic condition, such as herpes, prostatitis, or
Peyronie's disease, which consists of sclerotic
plaques on the penis that cause penile curvature.
Chronic pelvic pain is a common complaint in
women with a history of rape or childhood
sexual abuse.

52. Vaginismus
The DSM-IV-TR defines vaginismus as recurrent
or persistent INVOLUNTARY spasm of the
musculature of the outer third of the vagina that
interferes with sexual intercourse. Some
researchers have suggested perhaps sexual pain
disorders represent a continuum of pain and that
vaginismus might

53. Symptoms
Vaginismus can occur when any kind of
penetration of the vagina is attempted. This
includes attempted penetration by a penis,
speculum, tampon, or other objects. The outer
third of the vaginal muscles contract severely.
This either prevents penetration completely, or
makes it difficult and painful. The woman may
truly believe that she wants to have sexual
intercourse or allow the penetration. She may
find that her subconscious desires or decisions do
not allow her to relax the vaginal muscles.

54. Causes and symptoms
There are many possible causes of vaginismus. One
example is an upbringing in which sex was considered
wrong or sinful—as in the case of some strict religious
backgrounds. Concern that penetration is going to be
painful, such as during a first sexual experience, is
another possible cause. It is also thought that women
who feel threatened or powerless in their relationship
may subconsciously use this tightening of the vaginal
muscles as a defense or silent objection to the
relationship. A traumatic childhood experience, such as
sexual molestation, is thought to be a possible cause of
vaginismus. Acquired-type vaginismus is often the
result of sexual assault or rape.

55. EndofpartTHREE
Comingsoon…
1. The relationship sex and brain? How they work
together?
2. The psychological treatment of all Sexual Disorders!
3. Introduction of Paraphilia, different factors & its
psychological treatment
4. Origin of Gender Identity & sexual Orientations

56. Lets watch another videos
summary of our Study
1. Fourteen Factors That Cause
Female Sexual Dysfunction!
2. How The Female Orgasm Works