The document discusses various topics related to sexual health including gender identity, gender roles, transsexualism, paraphilias, sexual addiction, sexual dysfunctions, nursing care for sexual dysfunctions, and sex therapy. It defines key terms and describes characteristics and treatment approaches for various conditions. The overall purpose is to provide information on these topics to healthcare providers.
Sexual Disorders
Sexuality
One of the most personal area of life. Each of us is sexual being with preferences and fantasies that may surprise or even shock us from time to time. Usually these are part of normal sexual functioning. But when our fantasies or desire begin to affect or other in unwanted or harmful ways, they begin to qualify as abnormal.
For perspective, we begin by briefly describing norms and healthy sexual behavior. Then we consider two forms of sexual problems: sexual dysfunctioning and paraphilias.
Sexual Norms and Behavior
Consider contemporary Western worldviews that inhibition of sexual expression causes problems. Contrast this with nineteenth-and-early-twentieth-century views that excess was culprit; in particular excessive masturbation in childhood was widely believe to lead to sexual problems in adulthood. Von Krafft-Ebing (1902) postulated that early masturbation damage the sexual organs and exhausted a finite reservoir of sexual energy, resulting in diminishing ability to function sexually in adulthood. Even in adulthood, excessive sexual activity was thought to underlie problems such us erectile failure. The general Victorian view was that sexual appetite was dangerous and therefore had to be restrained.
Sexual Norms and Behavior
Other changes over time have influence people attitudes and experiences of sexuality.
Aside from changes over time and across generation, culture influences attitudes and beliefs about sexuality. In some culture, sexuality is viewed as an important part of well-being and pleasure, wheras in others, sexuality is viewed as relevant only for procreation (Bhurga, Popelyuk & McMullen, 2010). Cultures also vary in their acceptance of variation in sexual behavior.
In other culture it is common to stigmatize same-gender sexual behavior. Clearly, we must keep varying cultural norms in mind as we study human sexual behavior.
Gender and Sexuality
Across wide range of indices, men reported more engagement in sexual thought and behavior that do women.
Compared to women, men report thinking about sex, masturbation, and desiring sex more often, as well as desiring more sexual partner and having more partners.
Beyond these differences in sex drive Peplau (2003) has described several other ways in which the genders tend to differ in sexuality. Women tend to be more ashamed of any flaws in their appearance than the men, and this shame can interfere with sexual satisfaction (Sanchez & Kiefer, 2007)
Gender and Sexuality
For women, sexual appears more closely tied to relationship status and social norms that for men (Baumeister, 200).
Among women with sexual symptoms, more than half believe their symptoms are caused by relationship problems (Nicholls, 2008).
Men are more likely to think about their sexuality in terms of power than are women (Andersen, et al. 1999).
Gender and Sexuality
There are many parallels in men’s and women’s sexuality.
Mental health is not just about overt behaviours---exposed socially, but there are more volatile intimate emotions that could devastate any human relations forever-though not overtly observed as abnormal--!
We will discuss about such emotions which are banned in social discussions and stigmatized.
"Sexual disorders and dysfunctions" could be present in any socioeconomic classes--not age, education, gender, culture specific.
Understanding these critical emotions on time and accepting it would save human relationships--avoiding suffering, inferiority complex, gender harassment and abuse.
Educate yourself and save relationships!!!
Mental health subject is originally stigmatized, moreover talking to someone about sexual disorders is as critical as finding a pearl into a deep ocean.........
Sexual disorder - ICD10 gender identity disorders, disorders of sexual preference and sexual development and orientation disorders are listed under disorders of adult personality and behavior (f6), while sexual dysfunctions are listed under behavioral syndromes associated with physiological disturbances and physical factors (f5).
It is a disturbances in the sexual desire.
Sexual Disorders
Sexuality
One of the most personal area of life. Each of us is sexual being with preferences and fantasies that may surprise or even shock us from time to time. Usually these are part of normal sexual functioning. But when our fantasies or desire begin to affect or other in unwanted or harmful ways, they begin to qualify as abnormal.
For perspective, we begin by briefly describing norms and healthy sexual behavior. Then we consider two forms of sexual problems: sexual dysfunctioning and paraphilias.
Sexual Norms and Behavior
Consider contemporary Western worldviews that inhibition of sexual expression causes problems. Contrast this with nineteenth-and-early-twentieth-century views that excess was culprit; in particular excessive masturbation in childhood was widely believe to lead to sexual problems in adulthood. Von Krafft-Ebing (1902) postulated that early masturbation damage the sexual organs and exhausted a finite reservoir of sexual energy, resulting in diminishing ability to function sexually in adulthood. Even in adulthood, excessive sexual activity was thought to underlie problems such us erectile failure. The general Victorian view was that sexual appetite was dangerous and therefore had to be restrained.
Sexual Norms and Behavior
Other changes over time have influence people attitudes and experiences of sexuality.
Aside from changes over time and across generation, culture influences attitudes and beliefs about sexuality. In some culture, sexuality is viewed as an important part of well-being and pleasure, wheras in others, sexuality is viewed as relevant only for procreation (Bhurga, Popelyuk & McMullen, 2010). Cultures also vary in their acceptance of variation in sexual behavior.
In other culture it is common to stigmatize same-gender sexual behavior. Clearly, we must keep varying cultural norms in mind as we study human sexual behavior.
Gender and Sexuality
Across wide range of indices, men reported more engagement in sexual thought and behavior that do women.
Compared to women, men report thinking about sex, masturbation, and desiring sex more often, as well as desiring more sexual partner and having more partners.
Beyond these differences in sex drive Peplau (2003) has described several other ways in which the genders tend to differ in sexuality. Women tend to be more ashamed of any flaws in their appearance than the men, and this shame can interfere with sexual satisfaction (Sanchez & Kiefer, 2007)
Gender and Sexuality
For women, sexual appears more closely tied to relationship status and social norms that for men (Baumeister, 200).
Among women with sexual symptoms, more than half believe their symptoms are caused by relationship problems (Nicholls, 2008).
Men are more likely to think about their sexuality in terms of power than are women (Andersen, et al. 1999).
Gender and Sexuality
There are many parallels in men’s and women’s sexuality.
Mental health is not just about overt behaviours---exposed socially, but there are more volatile intimate emotions that could devastate any human relations forever-though not overtly observed as abnormal--!
We will discuss about such emotions which are banned in social discussions and stigmatized.
"Sexual disorders and dysfunctions" could be present in any socioeconomic classes--not age, education, gender, culture specific.
Understanding these critical emotions on time and accepting it would save human relationships--avoiding suffering, inferiority complex, gender harassment and abuse.
Educate yourself and save relationships!!!
Mental health subject is originally stigmatized, moreover talking to someone about sexual disorders is as critical as finding a pearl into a deep ocean.........
Sexual disorder - ICD10 gender identity disorders, disorders of sexual preference and sexual development and orientation disorders are listed under disorders of adult personality and behavior (f6), while sexual dysfunctions are listed under behavioral syndromes associated with physiological disturbances and physical factors (f5).
It is a disturbances in the sexual desire.
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
Overview: Sexual dysfunction; sexual response cycle; types of sexual dysfunction - male: erectile dysfunction, pre-mature ejaculation, ejaculatory incompetence and female: vaginismus, dyspareunia, anorgasmia; causes- organic and psychosocial factors and management: sensate focus and management of specific dysfunction.
Impulse-control disorders (ICDs) are psychological disorders characterized by the repeated inability to refrain from performing a particular action that is harmful either to oneself or others.
The individual fails to resist performing a potentially harmful act and it is usually accompanied by a sense of tension or arousal before committing the act and a sense of relief or pleasure when it is committed.
The hallmark in describing any of the ICDs is a tendency to gratify an immediate desire or impulse regardless of the consequences to one's self or to others.
Antisocial personality disorder is a mental condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others.
Overview: Sexual dysfunction; sexual response cycle; types of sexual dysfunction - male: erectile dysfunction, pre-mature ejaculation, ejaculatory incompetence and female: vaginismus, dyspareunia, anorgasmia; causes- organic and psychosocial factors and management: sensate focus and management of specific dysfunction.
Sexual dysfunction or sexual malfunction is difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including physical pleasure, desire, preference, arousal or orgasm.It requires a person to feel extreme distress and interpersonal strain for a minimum of 6 months.
This module helps you explore the physical and emotional impact of sexual abuse.
Lessons
Physical Impact of Sexual Abuse.
Psychological Impact of Sexual Abuse.
Impact on Partners, Family, and Close Friends.
Individual Factors That Affect Reactions to Rape.
Learning Objectives
By the end of this module, you will be able to
Assess the physical and psychological impact of sexual abuse.
Describe the potential impact of rape on people with a range of individual factors.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Mr. Vincent Ejakait 2
GENDER IDENTITY
• This is an individual’s personal or private
sense of identity as female or male
• It develops from an interaction of biology,
identity imposed by others and self-identity
3. Mr. Vincent Ejakait 3
GENDER ROLES
• Refers to learning and performing socially
accepted sex behaviors, i.e., taking on a
feminine or masculine role
• Proponents of andogeny (flexibility in gender
roles), however, view most characteristics and
behaviors as human qualities that should not
be limited to a specific gender
4. Mr. Vincent Ejakait 4
TRANSSEXUALISM
• Is a gender identity disorder in which a
person has consistently strong feelings of
being trapped in a body of a wrong sex.
5. Mr. Vincent Ejakait 5
PARAPHILIAS
• A group of psychosexual disorders
characterized by unconventional sexual
behaviors
• These are abnormal expressions of sexuality
• They are not, by definition, pathologic
• They only become so when severe, insistent,
coercive and harmful to the self or others
6. Mr. Vincent Ejakait 6
NON-COERCIVE PARAPHILIAS
• Fetishism
• Autoerotic Asphyxia
• Sexual Masochism
• Transvestitism
7. Mr. Vincent Ejakait 7
NON-COERCIVE PARAPHILIAS -
FETISHISM
• Sexual arousal elicited by inanimate objects
(shoes, leather, rubber) or specific body
parts (feet, hair)
8. Mr. Vincent Ejakait 8
NON-COERCIVE PARAPHILIAS -
AUTOEROTIC ASPHYXIA
• Constriction of the neck to enhance a
masturbation experience; often leads to
accidental death
9. Mr. Vincent Ejakait 9
NON-COERCIVE PARAPHILIAS -
SEXUAL MASOCHISM
• Erotic interest in receiving psychological or
physical pain, real or fantasized
10. Mr. Vincent Ejakait 10
NON-COERCIVE PARAPHILIAS -
TRANSVESTITISM
• Using the apparel of the opposite sex
12. Mr. Vincent Ejakait 12
COERCIVE PARAPHILIAS -
EXHIBITIONISM
• Intentional exposure of the genitals to a
stranger or unsuspecting person
• May be accompanied by arousal and
masturbation either during or after the
exposure
13. Mr. Vincent Ejakait 13
COERCIVE PARAPHILIAS –
VOYEURISM
• Secret observation of an unsuspecting person
(usually a woman) engaged in a private act,
e.g., undressing or having sex.
• The voyeur often masturbates during or after
the viewing
14. Mr. Vincent Ejakait 14
COERCIVE PARAPHILIAS - FROTTEURISM
• Intense sexual arousal elicited by rubbing the
genitals against a non-consenting person
15. Mr. Vincent Ejakait 15
COERCIVE PARAPHILIAS –
OBSCENE PHONE CALLERS
• Calling a non-consenting person and making
sexual noises, using profanity, attempting to
seduce, or describing sexual activity.
• The caller often masturbates during or after
the call
16. Mr. Vincent Ejakait 16
COERCIVE PARAPHILIAS –
PEDOPHILIA
• Sexual interest in a child
• Behavior ranges from exposure, voyeurism,
and explicit talk to touching, oral sex and
intercourse
17. Mr. Vincent Ejakait 17
COERCIVE PARAPHILIAS –
UROPHILIA
• Urinating on the sexual partner
18. Mr. Vincent Ejakait 18
COERCIVE PARAPHILIAS - COPROPHILIA
• Smearing feces on the partner
19. Mr. Vincent Ejakait 19
COERCIVE PARAPHILIAS –
SADISM
• Erotic interest in inflicting physical pain
20. Mr. Vincent Ejakait 20
OTHER FORMS OF PARAPHILIA
• Anningulus
• Cunnillingus
• Fellatio
• Partialism
21. Mr. Vincent Ejakait 21
OTHER FORMS OF PARAPHILIA ANNILINGUS
• Tongue brushing of the anus
22. Mr. Vincent Ejakait 22
OTHER FORMS OF PARAPHILIA
CUNNILLINGUS
• Tongue brushing of the vulva
23. Mr. Vincent Ejakait 23
OTHER FORMS OF PARAPHILIA FELLATIO
• Inserting the penis into the mouth
24. Mr. Vincent Ejakait 24
OTHER FORMS OF PARAPHILIA PARTIALISM
• Inserting the penis into the other parts of
the body
25. Mr. Vincent Ejakait 25
TYPE OF THERAPY PERFORMED ON
PATIENTS WITH PARAPHILIAS
Behavior Modification
Aversion Therapy
Token Economy
26. Mr. Vincent Ejakait 26
SEXUAL ADDICTION
• The frequency of sexual activity can be viewed on
a continuum, with most people falling in the
middle range
• Some have sex frequently in a way that enhances
their lives; others have sex infrequently and
report contentment and satisfaction
• A sexual pattern that falls at either extreme of
the continuum, however can signal problems.
27. Mr. Vincent Ejakait 27
SEXUAL ADDICTION
• Is a disorder in which the central focus of life is sex
• People with these addictions spend 50% or more of all
waking hours dealing with sex, from fantasy to acting out
behavior.
• Acting out behavior is often victimless, e.g., overindulging
in masturbation, fetishism, pornography use, or commercial
telephone sex; or visiting prostitutes
• Victimizing behaviors (those with a non-consenting
partner) are less frequent and include obscene phone calls,
frotteurism, voyeurism, exhibitionism, child sexual abuse
and rape
28. Mr. Vincent Ejakait 28
SEXUAL ADDICTION
• Sexual addiction is not simply the frequent
enjoyment of sexual behaviors; rather, it is a
progressive disease in which sex is used to numb
pain.
• The pay off is the same as in any other addiction,
i.e., an intensely pleasurable, short-lived release
from pain, and an escape from the problems of
daily life.
• The consequences are the same in the addict’s life
and eventually becomes unmanageable
29. Mr. Vincent Ejakait 29
SEXUAL ADDICTION
• Many sexual addicts grew up in homes where
they were emotionally, physically, or sexually
abused
• Most of them suffer from low self-esteem
and believe themselves unlovable.
• They have desperate need for love and they
equate sex with proof of love.
30. Mr. Vincent Ejakait 30
SEXUAL ADDICTION
• The components have the hallmarks of
obsessive-compulsive behavior:
– Preoccupation
• Spends hours thinking or obsessing about
sex and is so time consuming that the person
cannot fulfill work, school, or family
responsibilities
31. Mr. Vincent Ejakait 31
SEXUAL ADDICTION
• The components have the hallmarks of
obsessive-compulsive behavior:
– Ritualization
• The individual engages in specific behaviors
done just the “right” way and in the same
sequence at the right time. The ritual seems to
control anxiety; once addicts begin a ritual, they
cannot stop until the cycle is completed
32. Mr. Vincent Ejakait 32
SEXUAL ADDICTION
• The components have the hallmarks of
obsessive-compulsive behavior:
– Compulsivity
• The individual cannot control sexual behavior
and this behavior becomes the most
important aspect of life
33. Mr. Vincent Ejakait 33
SEXUAL ADDICTION
• The components have the hallmarks of
obsessive-compulsive behavior:
– Shame and Despair
• At the end of the cycle, the person experiences
guilt and shame at the loss of control. The pain
of despair creates the need to begin the cycle
all over again. Like other addicts, these
individuals want to stop their behavior, promise
to stop, try to stop and are unable to stop
without treatment.
34. Mr. Vincent Ejakait 34
SEXUAL DYSFUNCTIONS
• These are problems or difficulties with sexual
expression classified according to the phase of
the sexual response cycle that is affected
• This does not include dissatisfaction problems
• Contributory factors actually implicate past and
current factors:
– Lack of sex education
– Internalization of the teaching that sex is dirty
or sinful
– Parental punishment for normal exploration of
one’s genitals
– Severe trauma such as rape or child sexual
abuse
35. Mr. Vincent Ejakait 35
SEXUAL DYSFUNCTIONS
• Contributory factors actually implicate
past and current factors:
– Negative feelings like guilt anxiety,
anger which interfere with the ability to
experience pleasure and joy
36. Mr. Vincent Ejakait 36
SEXUAL DYSFUNCTION
• Fear of failure in sexual performance often
becomes a vicious cycle, i.e., fear of failure
creates actual failure, which in turn, produces
more fear.
37. Mr. Vincent Ejakait 37
CLASSIFICATIONS OF SEXUAL
DYSFUNCTION
Disorders of Sexual Desire
Arousal Disorders
Orgasm Disorders
38. Mr. Vincent Ejakait 38
DISORDERS OF SEXUAL DESIRE
• Inhibited Sexual Desire
– Persistently low interest or a total lack of
interest in sexual activity
• Sexual Aversion Disorder
– Severe distaste for sexual activity or the
thought of the sexual activity, which then leads
to a phobic avoidance of sex
– The most common cause of sexual aversion
disorder is childhood sexual abuse or adult rape
• Increased Sexual Interest
– Symptomatic of the manic phase of a bipolar
disorder
39. Mr. Vincent Ejakait 39
AROUSAL DISORDERS
• Physiologic responses and subjective sense of
excitement experienced during sexual activity
– Female Sexual Arousal Disorder
• Lack of vaginal lubrication
– Male Sexual Arousal Disorder
• Occurs when the man has erection problems
during 25% or more of sexual interactions;
cannot attain a full erection or loses erection
prior to orgasm (impotence / erectile inhibition)
40. Mr. Vincent Ejakait 40
ORGASM DISORDERS
• Inhibited Female Orgasm / Frigid
– Woman is totally incapable of responding sexually
– Sexual response stops before orgasm occurs
• Pre-orgasmic
– Women who have never experienced an orgasm
• Secondarily Non-Orgasmic
– They have had orgasm in the past but are not
currently experiencing them
• Situationally Non-orgasmic
– Have orgasms in some situations but not in others
41. Mr. Vincent Ejakait 41
ORGASM DISORDERS
• Inhibited Male Orgasm
– Male can maintain an erection for long periods
(e.g., an hour or more) but has extreme
difficulty ejaculating
– Could be organic, e.g., spinal cord injuries,
multiple sclerosis, due to drugs or may be
psychogenic (fear of pregnancy, performance
pressure, fear of losing control, anxiety and
guilt about engaging in sexual activity)
42. Mr. Vincent Ejakait 42
ORGASM DISORDERS
• Rapid Ejaculation
– One of the most common dysfunction among
men
– Refers to the absence of voluntary control of
ejaculation
– Probably due to:
• Inability to perceive his arousal level accurately
• Lowered sensory threshold due to infrequent sexual
activity
• Early conditioning as a result of hurried masturbation
or hurried sexual intercourse
• Extreme anxiety during sexual interaction, resulting
in ejaculation triggered by the SNS
43. Mr. Vincent Ejakait 43
SEXUAL PAIN DISORDERS
• Vaginismus
– Involuntary spasms of the outer one third
of the vaginal muscles making penetration
of the vagina painful and sometimes
impossible.
– Cause is mainly psychophysiologic: as
protection against real or imagined pain;
history of sexual trauma; emotional conflict
44. Mr. Vincent Ejakait 44
SEXUAL PAIN DISORDERS
• Dyspareunia
– Pain during or immediately after
intercourse
– Could be due to skin irritations, vaginal
infection, estrogen deficiency, or drugs;
pelvic disorders, such as endometriosis,
scar tissue, tumors
45. Mr. Vincent Ejakait 45
PROBLEMS WITH SEXUAL SATISFACTION
• These are more related to the emotional tone
of the relationship than the physiologic
response
• May be situational, due to lack of extragenital
satisfaction, related to the relationship
difficulties, due to lack of intimacy
46. Mr. Vincent Ejakait 46
NURSING CARE FOR SEXUAL DYSFUNCTIONS
• Reduce anxiety and fear
– Accurate identification of feelings is the first
step
– Help the client identify one anxiety-producing
situation within their sexual interactions
– The nurse and client may analyze the situation
to discover negative anticipatory thoughts that
may be the source of the anxiety.
– Review how the client has handled anxiety in
the past and evaluate the range and
effectiveness of this past coping behavior,
then explore alternative coping behaviors
47. Mr. Vincent Ejakait 47
NURSING CARE FOR SEXUAL DYSFUNCTIONS
• Decrease spiritual distress
– Because the origin of spiritual distress is
the lack of intimacy or connection within a
sexual relationship, the goal of nursing care
is to help clients achieve and maintain a
level of intimacy each partner finds
comfortable
48. Mr. Vincent Ejakait 48
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Promote more effective family coping
– Apart from setting specific times to share feelings,
and belief, some couples need training in more
effective communication skills.
• Teach couples to avoid the “you” language, which evokes
a defensive response and results in arguments, and
encourage use of the “I” language, which expresses
personal thoughts, feelings and needs.
– Example of “You” language
• “You only have sex on your mind. You are a pervert”
– Example of “I” language
• “I am concerned because we seem to have different
expectations of how often we would like to make love.”
49. Mr. Vincent Ejakait 49
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Promote comfort with personal identity
– A multidisciplinary approach is most
effective in helping transsexuals adjust to
their situation
– Family and friends need support and
counseling to reintegrate this person into
their lives as a person of the other sex
50. Mr. Vincent Ejakait 50
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Promote effective role performance
– Refer sexual addicts to self-help groups
and specialized professional therapy
– Recovery is a long-term process facilitated
by individual, group, couple, family, and
family-of-origin therapy
51. Mr. Vincent Ejakait 51
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Promote non-coercive sexuality patterns
– If practiced with an adult consenting
partner requires no nursing intervention
except for client and partner education and
possible couple negotiation about the
behavior
52. Mr. Vincent Ejakait 52
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Decrease violence against the self and others
– The most important nursing education
regarding autoerotic asphyxia is community
education
– Therapy for sex offenders is a specialized
area that should not be taken lightly
– Behavior modification techniques, group
therapy, hypnosis could be used
53. Mr. Vincent Ejakait 53
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Decrease pain
– Thorough physical examination is necessary
to find and treat the organic cause of the
pain
– Vaginismus is treated with education,
dilators and supportive psychotherapy
54. Mr. Vincent Ejakait 54
NURSING CARE FOR SEXUAL
DYSFUNCTIONS
• Increase knowledge
– Teach clients sexual anatomy and the
sexual response cycle
– Encourage couples to talk with one another
about their individual responses
55. Mr. Vincent Ejakait 55
SEX THERAPY
• Common components
– Information and education about sexual
functions
– Experiential and Sensory Awareness
• Therapist helps clients to recognize feelings of
anxiety, anger and pleasure by tuning into bodily
cues
– Insight
• Therapist attempts to learn and understand
what is causing and perpetuating the sexual
problem
56. Mr. Vincent Ejakait 56
SEX THERAPY
• Common components
– Cognitive Restructuring
• Clients identify and re-evaluate their non-sexual
fears about sexual interaction
– Behavioral Interventions
• Focus is on changing the non-sexual behavior
that contributes to sexual problems
• Assertiveness training, communication training,
stress-reduction exercises and problem-solving
techniques