A. CULTURALLY DEFINED

1. U.S.

• HUMAN POTENTIAL MOVEMENT
• GENDER BIAS
• HETEROSEXIST BIAS

2. SOUTHERN CHINA: KORO

B. INDIVIDUAL OR COUPLE FOCUS

C. ONSET/DURATION -

1. LIFELONG

2. ACQUIRED

3. SITUATIONAL

A. DISORDERS OF DESIRE

1. TYPES

a. HYPOACTIVE (HYPO = LOW) SEX DESIRE DISORDERS

• LACK OF FANTASIES
• LACK OF DESIRE
• NO AGREED UPON STANDARD OF TOO LITTLE
• AMONG 18-24 YEAR OLDS, AFFECTS 33% WOMEN; 16% MEN

b. SEXUAL AVERSION

• REVULSION AT IDEA OF SEX OR SEX ACTIVITY
• MAY BE RELATED TO SEXUAL PHOBIA OR PANIC
• INCIDENCE NOT KNOWN

2. DISORDERS OF DESIRE - ORIGINS

• ANTI-SEX VALUES - CULTURE AND RELIGION
• TRADITIONAL SEX ROLE SOCIALIZATION FOR WOMEN
• SEXUAL ABUSE HISTORY OF MANY WOMEN
• PRO-SEX VALUES

3. TREATMENT

• DIFFICULT TO TREAT
• IMPROVE SEXUAL INTERACTIONS - MASTERS AND JOHNSON'S PROGRAM

a. COMMITMENT NOT TO ENGAGE IN INTERCOURSE

b. INTRODUCTION OF SENSATE FOCUS ACTIVITIES

c. NONVERBAL TECHNIQUE - HANDRIDING

d. SENSUAL INTERCOURSE

e. SEXUAL INTERCOURSE

B. DISORDERS OF AROUSAL

1. TYPES

a. WOMEN - AROUSAL DISORDER

INABILITY TO PRODUCE OR MAINTAIN LUBRICATION AND GENITAL SWELLING

ABOUT 19% OF WOMEN EXPERIENCE

B. MEN - ERECTILE DISORDER

INABILITY TO HAVE OR MAINTAIN ERECTION -10% OF MEN

2. ORIGINS

BIOLOGY - USUAL IS FOR 3-5 EPISODES OF AROUSAL PER NIGHT FOR WOMEN, MEN

CULTURE

SEX ROLE SOCIALIZATION

CHILDHOOD SEXUAL ABUSE

OTHER PSYCHOLOGICAL FACTORS, INCLUDING SPECTATORING AND PERFORMANCE ANXIETY

3. TREATMENT - SAME AS LOW SEXUAL DESIRE FOR WOMEN, MEN

• ALSO FOR MEN - VARIOUS IMPLANTS, VIAGRA

C. DISORDERS OF ORGASM

1. WOMEN

a. ANORGASMIA -

• NOT ABLE TO HAVE ORGASM AFTER EXPERIENCING NORMAL EXCITEMENT PHASE
• 24% OF WOMEN REPORT

b. ORIGINS

PARTNER TECHNIQUE

NEGATIVE ATTITUDES ABOUT SEX

HIGH SEX GUILT

NEGATIVE ATTITUDES TOWARD MASTURBATION

DIFFICULTY COMMUNICATING ABOUT SEXUAL MATTERS

MAY NOT BE VIEWED AS PROBLEM BY SOME WOMEN

c. TREATMENT - LEARN TO MASTURBATE

FOR YOURSELF (BARBACH): 9 WEEK PROGRAM DONE DAILY

WEEK 1: EXAMINE SELF WITH MIRROR; DO KEGEL EXERCISES

WEEK 2: TOUCH GENITAL

WEEK 3: FIND SENSITIVE AREAS

WEEK 4: STIMULATE SENSITIVE AREAS

WEEK 5: INCREASE INTENSITY AND DURATION OF SELF-STIMULATION; USE FANTASY

WEEK 6: USE VIBRATOR IF NO ORGASM YET

WEEK 7: MASTURBATE IN PRESENCE OF PARTNER

WEEK 8: PARTNER STIMULATES WOMAN MANUALLY

WEEK 9: FOR HETEROSEXUALS, HAVE INTERCOURSE WITH PARTNER MANUALLY STIMULATING

d. OTHER TREATMENTS - "PRETEND" TO HAVE ORGASM

IV. SEXUAL DYSFUNCTIONS DUE TO PAIN

A. DYSPAREUNIA - MILD TO SHARP PAIN DURING PENETRATIVE SEX

14% WOMEN; 3% MEN

B. VAGINISMUS

INVOLUNTARY SPASMS OF MUSCLES OF VAGINA THAT PREVENTS PENETRATION

PROBLEM OCCURS IN ABOUT 12-17 PERCENT OF WOMEN WHO VISIT SEX CLINICS

ORIGINS INCLUDE:

• PSYCHOLOGICAL - ABUSE HISTORY
• PHYSICAL - PELVIC DISORDERS, INFECTIONS, OR EPISIOTOMY

TREATMENT: USE SET OF VARIOUS SIZE PLASTIC DILATORS

A. GENITAL MALFORMATIONS- ORGAN FAILS TO GROW OR DEVELOP -CLOSURE OF VAGINA; URETHRAL PROBLEMS; AGING

B. OTHER MEDICAL CONDITIONS THAT AFFECT DESIRE, AROUSAL AND ORGASM

ALCOHOLISM; STROKES; ANXIETY; DEPRESSION; DRUG ADDITIONS; MANY OTHERS

VI. THE SEXUALLY SELF-AFFIRMED WOMAN

• CAN ENJOY HER BODY APART FROM OTHERS
• CAN HAVE SEXUAL EXPERIENCES FOR HER OWN REASONS
• CAN EXPERIMENT AND EXPERIENCE
• HAS OWN STANDARDS AND USES SELF AS MEASURE OF OWN EXPERIENCE
• CAN BE CELIBATE, LESBIAN, HETEROSEXUAL OR BISEXUAL

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