ORIGINS OF SEXUAL DIFFICULTIES

• Complex & difficult process
• hard to isolate
• causal factors vary
• Organic factors
• vascular, endocrine and neurological
• illnesses & disabilities
• diabetes, arthritis, cancer
• spinal-cord injuries
• coping: accept limitations
• medications
• psychiatric drugs
• antihypertensive drugs
• anticancer, antihistamine, gastrointestinal
• some prescription drugs
• Cultural Influences
• negative childhood learning
• sexual double standard
• narrowly defined sexuality
• rigid goals
• Individual factors
• sexual knowledge
• self-concept
• sexual abuse & assault
• Relationship factors
• unresolved problems

• ineffective communication

• fears about pregnancy or STDs
• concealment of true sexual orientation

• Hypoactive sexual desire disorder (HSD)
• lack of interest
• usually temporary
• often due to relationship problems

• Dissatisfaction with frequency of sexual activity
• inability to compromise

• polarization

• Sexual aversion disorder (SAD)
• extreme, irrational fear of sexual activity

• often due to sexual abuse or assault

• Female sexual arousal disorder
• inhibited lubrication

• often due to apathy, fear

• noncoital activities may increase lubrication

• use of water-soluble jelly helps

• Male erectile disorder
• persistent lack of an erection

• brief episodes are common in men

• long-term difficulty often due to an organic factor

• Female orgasmic disorder
• anorgasmia = absence of orgasm
• many cases are situational
• influenced by culture

• Male orgasmic disorder
• inability to ejaculate

• Premature ejaculation
• definition varies with each couple

• based on subjective satisfaction

• many men experience this

• 25% of men experience this a lot

• physiological predisposition

• Faking orgasm
• often due to performance pressure, caretaking of a partner, lack of hope or ability to achieve orgasm
• negative consequences
• creates emotional distance

• increases guilt

• becomes a vicious cycle

• can be stopped with effort
• learning about what works

• communicating

• may need therapist’s help

• Painful intercourse in men
• phimosis
• infected or irritated foreskin

• Peyronie’s disease

• other pelvic or genital infections

• Painful intercourse in women
• decreased lubrication

• infections

• smegma

• deep pelvis pain

• STD infections

• Fear or negative attitudes

• Vaginismus
• strong, involuntary contractions of the outer third of vagina
• due to fear of ambivalence as a result of assault, hostility