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human sexuality


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birth control pills
oral contraceptive containing synthetic estrogen and progesterone (progestin) or progestin only. Prevents conception by inhibiting ovulation. Complications are rare. 99% efficiency.
usually emitted for matting purposes. There are studies showing a woman can pick a family member from scent of sweat on clothing. Some of it though may be learned phenomena cause of incest taboo. Biologically, people will have sex w/ anyone.
gential pain or discomfort during intercourse. More common in women. Cannot by caused exclusively by vaginismus, lack of lubrication, another axis I disorder, substance or general medical condition (tipped/retroverted uterus, endometriosis, infections, lack of estrogen, vulvogynia, drug side effects, physical problems (scar tissue or cysts), pelvic floor maylgia, and emotional issues
a rare sexual difficulty in which a woman experiences involuntary spasmodic contractions of the muscles (outer third of the vagina) during intercourse. Causes distress and pain or interpersonal difficulty. Not better accounted for by another axis I disorder, substance or general med. cond. Individuals w/ this can become aroused, lubricated and achieve orgasm w/ alternative stimulation
prolonged, painful erection that lasts for several hours up to a few days. Considered a medical emergency. not associated w/ sexual thoughts or activity. blood cannot drain out of the penis once it looses oxygen. If not treated, priapism can scar the penis and lead to impotence. Usually treated by inserting a needle in the side of the penis.
premature ejaculation
when a man ejaculates so quickly that it impairs his pleasure or his partner's pleasure. A clinician must look at the age, duration of the excitement phase, novelty of the sexual partner or situation and/or recent frequency of sexual activity. Not due exclusively to substance abuse. Causes distress or interpersonal difficulty. Techniques: sensate focus, stop-start and quiet vagina technique
female sexual arousal disorder
Female organ not enlarged sufficiently so decreased pleasure w/ stimulation. inability to attain or maintain an adequate lubrication-swelling response of sexual excitement until completion of sexual activity. Causes marked distress or interpersonal difficulty and not better accounted for by another axis I disorder, substance or general med. cond. Effects 25% of women (3/4 are postmenopausal). Treatments include erotic materials, sensual massage, lubricants, therapy, and kegal exercises
hypoactive sexual desire disorder (HSD)
lack of interest in sex. More psychologically based. Some people do not have a high sex drive and are not easily aroused. This is the most frequent problem seen in sex therapy and is experienced by both men and women. SDM-IV defines HSD as deficinet sexual fantasies and desire for sexual activity. A clinican must consider the factors affecting sexual functioning such as age and the context off the person's life. The disturbance causes distress or interpersonal difficulty and is not better accountd for by another axis I disorder, substance or med. cond.
Acquired/lifelong sexual dysfunction
lifelong- sexual dysfunction has been present since the onset of sexual functioning.
Acquired- sexual dysfunction develops only after a period of normal functioning. Physiological conditions can be primary causes of sexual problems or can combine w/ psychological factors to result in dysfunction. Rule out other causes of sexual problmes through medical examinations.
Erectile Dysfunction
inability to attain or maintain an erection until the completion of sexual activity. The disturbance causes distress or interpersonal dissiculty and is not better accounted for by another axis I disorder, substance or medical condition. May be caused by medical trauma, pelvic surgery, diabetes, vascular problems, neurological disorders, medication, alcoholism, hormone imbalance, depression, etc. Treated by medication, penile implants, urethral suppositories, injection therapy, vacuum erection devices, vascular surgery and/or sex surgery.
male orgasmic disorder
delay or absence of orgasm following a normal sexual excitement phase during sexual activity. The clinician must take into account the age, focus, intensity and duration. The disorder causes distress or interpersonal difficulty and is not better accounted for by another axis I disorder, substance or med. cond.
Female Orgasmic Disorder
delay or absence of orgasm following a normal excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The clinician must take into account the age, sexual experience, intensity of stimulation and duration of sexual activity. The disorder causes distress or interpersonal difficulty and is not better accounted for by another Axis I disorder, substance, or med. cond.
Androgen Insensitivity syndrome
genetic defect that causes chromosomally normal males to be insensitive to the action of testosterone and other androgens. These individuals develop female external genitals of normal appearance. Pseudohemophrodite. In utero, males who don't respond to androgen w/ secondary female characteristics, female core ender identity & sterile
performance anxiety
Primary issue in sex therapy. can block natural sexual arouseal and release by dimiinishing the pleasurable sensations that would produce them, creating greater anxiety. Arbitrary definitions of sexuality that impose external standards of success and failure reduce the opportunities for individuals and couples to determine what is satisfactory based on their own findings.
insufficient stimulation
Freud believed that clitoral orgasms were inferior to vaginal orgasms, but most sex therapists believe that women who enjoy intercourse and experience in orgasm in some way other than during intercourse do not have a sexual problem. It's common for women to need manual clitoral stimulation.
sexual aversion disorder
absence of sexual fantasies and desire for sexual activity. Clinicians must consider additional causes for lack of desire. The disturbance causes distress or interpersonal difficulty and is not better accounted for by another axis I disorder, substance or med. cond.
sexual compulsivity and addiction
accoring to carnes, people who engage in atypical sexual behaviors are manifesting outward symptoms of a process of psychological addiction in which feelings of depression, anxiety, loneliness, & worthlessness are temporarily relieved through a sexual high (unlike alcohol & drugs). 4 stage process of addiction: preoccupation, ritualistic behaviors, sexual act and despair.
exposing one's genitals to unsuspecting strangers. The person has acted on these sexual urges and/or the urges have caused marked distress or interpersonal difficulty. Lasts over a period of at least 6 months
fantasies, urges, or behaviors involving the use of nonliving objects (female undergarments). cuases distress or impairment in social, occupational, or other imp. areas of fucntioning. The fetish is not limited to articles of female clothing used in cross-dressing or devices dsigned for the purpose of tactile gential stimulation (vibrator). Lasts over a period of at least 6 months.
fantasies, uges, or behaviors involving sexual activity w/ a prepubescent child or children (13 & under). The person has acted on these sexual urges & the urges cause distress & interpersonal difficulty. The person is at least 16 y.o. & at least 5 years older than the child or children. Does not include an individual in late adolescence involved in an ongoing sexual rel. w/ a 12 or 13 y.o.
fantasies, urges, or beh's involving the act of observing an unsuspecting person who is naked, in the process of disrobing or engaging in sexual acitivity. The person has acted on these sexual urges or the urges have cause marked distress or interpersonal difficulty. Lasts over a period of at least 6 months.
sexual masochism
fantasies, urges or beh's involving the act of being humiliated, beaten, bound or otherwise made to suffer. The urges have caused distress or interpersonal difficulty. Lasts over a period of at least 6 months. Asphyxia as well
sexual sadism
fantasies, urges or beh's involving acts in which the psychological or physical of a victim is exciting to the person. The person has acted on the urges w/ a non-consenting person & the urges cause distress or interpersonal difficulty. Lasts over a period of at least 6 months.
sadomasochism-the association of sexual expression w/ pain. S and M is either sadomasochism or slave master.
diseased transmitted by sexual contact, but can be spread non-sexually as well. Term includes, but is not limited to diseased traditionally called veneral disease (VD).
Acquired immunodeficiency syndrome. A catastrophic illness in which a virus invades and destroys the ability of the immune system to fight disease. The AIDS viruse appears to be passed primarily through sexual contact, sharing needles and less commonly through administration of contaminated blood products. AIDS results from infection from the human immunodeficiency virus (HIV).
Pelvic Infammatory Disease (PID)
Specific inflammation in pelvis. Usually secondary to chlamydia or gonorrhea. A genital infection of the upper reporductive tract, caused by either clamydia trachomatis or clamydia salpingitis. PID resulting from chlamydia trachomatis may lead to disrupted menstrual periods, chronic pelvic pain, fever, nausea, vomiting, and headache. PID resulting from chlamydia salpingitis is the primary preventable cause of female infertility and ectopic pregnancy
Oldest disease, treated reliably w/ penicillin. Only one! Due to specific microorganims (bacteria). Sore, disappear, rush...than secondary symptoms. An STD caused by a thin, corkscrew-like bacterium (spirochete)called treponema pallidu. If untreated, the STD progresses fro chancres at site where the organsim entered (typically on the genitals) to skin rashes on the body, to latency stage (possibly several years), & eventually leads to severe conditions such as heart failure, blindness, paralysis, liver damage, and ultimately death. Treated w/ an antibiotic.
Non-specific inflammation of vagina. General term applied to a variety of vaginal infections characterized by a white discharge. Symptoms include irritation, itching of gential tissue, burning during urination & pain around the vaginal opening during intercourse. Vaginitis is one of the most common reasons women consult a physician.
Itching, burning, discharge. spread by sexual contact or sometimes by fingers from one body site to another. See PID for symptoms in women. In men, the infection of the urethra may cause burning and discharge during urination. Chlamydia caused epidiymitis may produce a sense of heaviness in affected testicle, scrotal inflammation & painful swelling at the bottom of the testicle. Treated w/ Flagyl for both men and women
gential herpes
HSV1=lips. transmitted by vaginal, anal, or oral-genital intercourse. Symptoms include small, painful red bumps on genital area, which become painful blisters that eventually rupture to form wet, open sores. No known cure, but variety of treatments to reduce symptoms. This is a virus, but not isolated like the HIV virus or the one causing syphilis.
genital warts
spread through vaginal, anal, or oral-genital contact. Warts are hard and yellow-gray on dry skin areas, pinkish-red and cauliflower-like on moist areas. Can be removed by freezing, acid, cauterization, surgical or laser removal. Can be anywhere.
gonorrhea (clap)
spread through genital, oral-genital or genital-anal contact. symptoms in men include cloudy discharge and burning during urination. If untreated, leads to inflammation of scrotal skin and swelling at the base of testicle. Symptoms in women include green or yellowish discharge, and if untreated, PID. Treated w/ antibiotics
Viral. Blood, seman, vaginal secretions and saliva transmit Hepatitis B. Manual, oral, or penile stimulation of the anus are strongly assoc. w/ the spread of the virus. Hep. A is transmitted primarily by the oral-fecal route and is assoc. w/ oral-anal sexual contact. Symptoms vary from mild flu-like symptoms to high fever, vomiting & severe abdominal pain. Treated w/ bed rest & fluid intake
Kinsey report
Pub. a study on male sexuality in 1948 & female sexuality in 1953. The volumes documented the actual sexual beh. of americans & demonstrated the discrepancy between public standard & actual sexual beh. The Kinsey scale (0-6 sexuality scale) demonstrated the continuum of other-sex & same-sex beh, which previously had been viewed as completely heterosexual or homosexual idenitty. 0 represents exclusively other sex beh. and 6 represents exclusively same sex beh. Everyone masturbates. How often do women masturbate.
Masters and Johnson report
Looked more at the physiology of sex. They developed the human sexual response cycle. The Human sexual response was pub. and used direct observations & measurement in a lab. setting to study physiological changes during sexual arousal. The study demonstrated that male & female sexual responses are very similar & that women achieve orgasm primarily by clitoral stimulation, discrediting Freud's distinction between vaginal & clitoral orgasm, & legitimizing female masturbation. The Human Sexual Response Cycle has 4 phases: Excitement, Plateau, Orgasm, & Resolution. Male model includes a refractory period in the resolution phase.
Hite Report
Follow up to Kinsey. Behavioral end. Report taken in 1976 that asked women if they routinely experienced orgasm during coitus w/out simultaneous manual stimulation of the clitoral area. Only 30% responded that they did.
Kaplan Approach
Kaplan's model of sexual response contains three stages: desire, excitement, and orgasm. Distinguished by identification of desire as prelude to sexual response. Had 3 stages and a follow up. She had sex therapy techniques.
A combination of vasodilation & vasoconstriction. Blood vessels going in dilate & the ones going out constrict. Manifestations include erection of the penis, lubrication of the vagina, engorgement of the labia, testicles, clitoris, and nipples.
the increase muscle tension that occurs throughout the body during sexual arousal. Includes both voluntary flexing and involuntary contractions such as facial grimaces, spasmodic contractions of the hands and feet and the muscular spasms that occur during orgasm.
Excitement Phase
First stage characterized by myotonia, increased heart rate and blood pressure, engorgement and deepening of color of several areas of sexual anatomy and sex flush (more common in women). Foreplay, vasocongestion. In males, it includes erection of penis, thickening & tensing of scrotal skin, & elevation & engorgement of testes. In women, it includes engorgement fo the clitoral shaft, vestibular bulbs & lavia minora, & separation of labia majora from the vagina opening. Also nipples engorge.
Plateau Phase
Second phase in which sexual tension continues to mount unitl it reaches the peak that leads to orgasm. Leveling off a bit, quiet before the storm. Several signs from excitement phase become more pronounced. Prolonging sexual tensions at this high level produces greater arousal & more intense orgasms for many people
Orgasmic Phase
In men, ejaculation occurs in two phases: emission & expulsion. In the emission phase, seminal fluid is gathered in the urethral bulb w/ feelings of inevitable orgasm. In the expulsion phase, semen is expelled out from the penis by muscular contractions. Femae orgasms often last slightly longer than male orgasms, although the subjective descriptions of orgasm are relatively indistinguishable for both sexes. 1-2 sec. experience. BP zooms, heart problems poss.
Resolution phase
Final stage in which the sexual systems return to their non-excited state.
Refractory period
after orgasm, the male typically enters a refractory period in which no amount of additional stimulation will result in orgasm. Women generally do not experience a refractory period.
Point of Ejaculatory Inevitability
The point of stimulation beyond which ejaculation cannot be stopped even if stimulation is stopped. Sometimes the excitement defeats the actual orgasm.
Sex therapy exercises
increased self-knowledge is often an important step in modifying negative perconceptions and feelings around sex. Basics include self-awareness, communication, sensate focus, and masturbation w/ partner present
Sensate focus
Can do w/ or w/out partner. touching exercise aimed at reducing anxiety caused by goal orientation & in increasing communication, pleasure & closeness. Parners can take turns touching each other while following some essential guidelines. Toucher explores his/her own interest & pleasure, not the partner's. Intercourse & genital touching is excluded from early stages of sensate focus exercises.
Squeeze Technique
A tx for premature ejaculation in which the partner applies strong pressure w/ her thumb on the frenum & her second and third fingers on the topside of the penis (one above and one below the corona) until the man loses the urge to ejaculate.
Stop-Start technique
Teach control. A tx technique for premature ejaculation, consisting of stimulating the penis to the point of impending orgasm & then stopping until the pre-ejaculatory sensations subside
Quiet vagina exercise
a tx technique for males w/ erectile dysfunction (ED) & premature ejaculation syndrome (PES). The male gets erect by manual or self-stimulation & female lowers on him & stays still. Goal when used w/ ED is for the male to be inside the vagina w/out losing erection. Goal when used for PES if for the male to be inside the vagina w/out ejaculation
Here and now approach
Be in the moment instead of worrying about performance. Explore here and now feelings instead of history.
stimulus-response connection
Response to arousal of things that weren't previously desired. Usually we have an automatic response to a particular stimulus-classical or operant conditioning.
PLISSIT Method *on test*
We go from a more cog/beh. approach to an insight oriented approach if needed after cog/beh. exercises. Approach to sex therapy apecifies 4 levels of therapy, each providing tx at an increasingly deeper level. PLISSIT is an acronym for permission (for clients to appreciate their own unique patterns & desires, w/out comparison to others), limited information (factual information about client's sexual concerns), specific suggestions (homework exercises such as masturbation techniques or sensate focus exercises), and intesive therapy (therapist uses insight-oriented therapy to help client gain awareness of unconscious thoughts & feelings that lead to sexual difficuty.
Countering Strict or Rigid Religious Beliefs
Countering via cognitive methods & education. severe religious orthodox equaling sex w/ sin is common to the background of many troubled people. More rigidly orthodox married members of Jewish, Catholic & Protestant churches are found to have less sexual interest, repsone, frequency & pleasure. These members also report more sexual inhibitions, guilt, shame, and disgust. Countering these religious beliefs often involves education, as one study found that incidence of sexual problems decreases as sexual level increases.
Countering deep-seated communication problems
communicating sexual needs is often the first step in ensuring that they are met. W/out effective verbal communication couples must base their sexual encounters on assumptions, past experiences and wishful thinking. Exercises to enhance partner verbal communication and listening skills are often helpful in providing tools for getting sexual needs met.
Kleinfelter syndrome
Pseudohemaphrodite. XXY male. Secondary female characteristics. chromosome abnormality in which men are born w/ at least one extra X chromosome. Sx include: small penis, small firm testicles, diminished pubic, axillaries & facial hair, sexual dysfunction, enlarged breast tissue, late puberty.
congenital abnormality in which internal sexual organs are of one sex, external ones the other or characteristics of both. Can be either male pseudohermaphrodistism (gonads are recognizable as testes, external genitalia feminized), or female pseudohermaphroditism (internal genitalia female, external genitalia masculine)
Sildenafil (viagra)
prescription drug used to treat male erectile difficulties. Works by increasing blood flow to the penis through vasodilation and stay still.
gender identity disorder
Male feels trapped in the female body. a strong & persistent cross-gender identification (not merely a desire for any preceived cultural advantages of being the other sex). Persistent discomfort w/ his/her sex or sense of inappropriateness in the gender role of that sex. The disturbance is not concurrent w/ a physical inter-sex condition. Causes distress or impairment in social, occupational or other areas of functioning. Not considered a mental illness even though it is defined in the DSM-IV.
Gender Dysphoria
They don't feel like their assigned gender. A condition in which a person's gender identity (how that psychologically perceive themselves as male or female) is opposite of his/her biological sex.
Cross-gender behavior
behavior that is culturally considered inappropriate for a person of that gender, but appropriate for the other gender. Examples: tomboy beh. for a girl or cross-dressing. Most cross-dressers are heterosexual men who experience sexual arousal through cross-dressing.
sexual orientation
sexual attraction to one's own sex(homosexual) or other sex (heterosexual). Gay clients feel more comfy w/ gay therapists. A study found 2/3 of clients prefer matched gender & sexual orientation of therapist.
internalized homophobia
homophobia defined as irrational fears of homosexuality in others, the fear of homosexual feelings w/in oneself, or self-loathing because of one's homosexuality. Many psychologists believe that aggression toward homosexuality is an attempt to deny or suppress homosexual feelings in oneself
true hermaphrodites
Complete set of both genetalia. extremely rare state in which a person has both ovarian & testicular tissue. Either a testicle on one side & an ovary on the other or "ovotestes". The dev. of the internal & external genitalia varies over a continuum between the typical male & female. Most have a uterus w/ other ductile structures being more variable. The phallus varies from a small penis to a large clitoris & the scrotum may appear as an enlarged labia
transsexual men and women
a person whose gender identity is opposite to his/her biological sex. Transsexual man & women usually seek sex reassignment surgery. See DSM-IV criteria for gender identity disorder above.
pre & post operatives
HBIGDA (Harry Benjamin International Gender Dysphoria Association). Standards of care require eligibility & readiness standards to be met before sex reassignment surgery. In addition, extensive screening interviews, therapy, & a period of real-life experience living as other sex & hormone therapy are required before surgery. Pre-iperatives are transsexuals who have not yet had reassignment surgery & post-operatives have had the surgery.
global vs. situational factors
global factors exist at all times, while situational factors are based on the situation
interdisciplinary approach
includes addressing biological etiologies (refer to an M.D. if needed), psychological, cultural, & social factors, doing dyadic work w/ patient & partner, increasing education, increasing partner communication, & using sensate focus & erotic communication in tx for sexual difficulties.
Intersex (people born w/ ambiguous genitalia)
abnormal prenatal development can lead to ambiguous sex characteristics. Some ex's include male w/ androgen insensitivity syndrome, fetally androgenized females who are born w/ ambiguous or mostly male external genitals, and DHT deficient males who have ambiguous or female genitals at birth that become masculine-like at puberty.
mechanistic model
Sex is mechanical. model used by DSM-IV views sexual dysfunction/disorder as a clinically sig. disturbance in the process that characterizeds the sexual response cycle. Subtypes: lifelong vs. acquired; generalized vs. situational.
Atypical sexual interests
sexual interests not typically shared by most people in our society. Includes paraphilias defined above & other interests such as cross-dressing, obscene phone calls, zoophilia, necrophilia, klismaphilia (enemas).
sexual scripts
Get in the way, you have a preconceived idea of how sex will have. Your script is written. contemporary sexual scripts are evolving in the following areas: female sexuality, male relationship centered, sexual expression seen as positive, mutual exchange of erotic pleasure, both partner as equally resp.,not limited to intercourse, initiated by either partner, both have the right to or not to experience orgasm, sex outside of marriage is OK
incest taboo
prohibition of incest due to societal customs or protective measures. Incest includes sexual interaction between close relatives other than husband and wife.
retrograde ejaculation
ejaculates into the bladder incorrectly, can be infectous

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