Treatment for Sexual Disorders and Dysfunctions.

Essay by char26 October 2005

download word file, 5 pages 3.3

Downloaded 100 times

The topic selected for the presentation is sexual disorders

and dysfunctions. This paper will focus on the treatment of

these problems. The audience will benefit from this subject

matter by learning how to cope with and treat the problems at

hand. The organization of this project was divided up into

disorder, causes, treatments, and effects on relationships.

Disorders of Sexual Desire.

Hypoactive sexual desire disorder (HSDD) is the lack of

desire for sexual activity, which can cause distress on an

individual (Strong, DeVault, Sayad, & Yarber, 2005). There are

several treatments for this disorder. Ceasing medications which

cause a decreased libido such as Prozac, Zoloft, and Paxil assist

in the process of correcting HSDD (Deglin & Vallerand, 1999).

Also, due to decreased testosterone levels, hormone replacement

may be salutary for the couple (Phillips, 2000). In addition,

there is the clitoral therapy device, also known as EROS-CTD.

This device is placed on the clitoris and via gentle suction,

causes increased blood flow and sensation to the clitoris

(Strong, et.

al., 2005).

Sexual aversion disorder is the actual avoidance of contact

with the partner's genitals (Strong, et. al., 2005). Most of the

treatments coincide with the treatments for HSDD. Another

approach is psychosexual therapy. This allows the individual to

address anxieties due to a previous traumatic event, such as rape

or childhood molestation (Strong). During therapy the individual

is guided by the therapist to explore the underlying problem and

are shown that they are in control (Strong).

Sexual Arousal Disorders.

Female sexual arousal disorder is the, "...inability to

attain or maintain the level of vaginal lubrication and swelling

associated with sexual excitement...," (Strong, et. al., 2005).

There are a variety of lubricants available to assist the female,

such as K-Y jelly (Strong). Other suggestions are vitamin E or

mineral oil (Phillips, 2000). In addition, stimulation of the

clitoris can assist in arousal of the female. As aging occurs,

more stimulation is required in order for the female to be

aroused (Phillips). This can be done by increase in foreplay,

use of vibrators, and masturbation (Phillips). Also, a warm bath

prior to intercourse can be helpful (Strong).

Male erectile disorder is the failure to attain or maintain

an adequate erection until completion of sexual activity (Strong,

et. al., 2005). There are several oral therapies available for

this male disorder. They are known as PDF-5 inhibitors

(Sildenafil, Vardenafil, Taladafil)(Van Kampen, DeNeerdt, Claes,

Feys, DeMaeyer, & Van Poppel, 2003). These medications enable the

penis to relax and dilates the penial arteries, therefore allowing

blood flow to the penis causing an erection (Strong, et. al.,

2005). There are alternative treatments available. Some may

elect for vascular surgery or microneurosurgery (Van Kampen, et.

al., 2003). While others may find that a prosthetic implant or

use of a suction device assists them better in maintaining an

erection (Van Kampen). The physical therapy efforts include the

pelvic floor muscle exercises that have proven to be effective

(Van Kampen).

Orgasmic Disorders.

Female orgasmic disorder is the absence of or delay of an

orgasm following typical sexual excitement (Strong, et. al.,

2005). In some cases inhibition can promote difficulty in

orgasmic ability. In order to create a pleasurable orgasmic

experience for a woman there are steps that can be taken in order

to attain it. Maximizing the stimulation and minimizing the

inhibitions will aid the female (Phillips, 2000). Stimulation can

be performed by masturbation either digitally or with a vibrator

(Phillips). Kegel exercises are also helpful in acheiving

stimulation (Phillips). When inhibition comes into play, a

distraction can serve as a deterrent. These distractions can take

the form of fantasy or music playing in the background (Phillips).

Male orgasmic disorder is also the absence or delay of an

orgasm following typical sexual excitement (Strong, et. al.,

2005). The treatment is fairly easy, but it does take patience

and time on both parties' accounts. The partner simply handles

the penis and is directed on what is pleasurable (Strong, et. al.,

2005). The purpose of this exercise is for the male to, "...identify his partner with sexual

pleasure and desire,"

(Strong). After the male has reached an orgasmic state, via

masturbation, the next step is vaginal intercourse (Strong).

Premature ejaculation is ejaculation prior to or not long

after sexual intercourse or manual stimulation (Strong, et. al.,

2005). There are several techniques that can be used to address

this issue. Relationship counseling is often suggested, so that

the couple can discuss the problem together (Epperly & Moore,

2000). Behavioral therapy is another option. This includes the

Seman's Pause Maneuver, Master's and Johnson's squeeze pause

technique, and Kaplan's start-stop method (Epperly, 2000). These

techniques use stimulation of the penis which then causes

ejaculation, but is then ceased as to prevent orgasm from

occurring (Epperly). In addition, medications are available to

alter the ejaculatory response. Sertraline and clomiprimide are

antidepressants that have been found to also increase ejaculatory

response time (Epperly).

Retrograde ejaculation is, " the backward expulsion of semen

into the bladder rather than out of the urethral opening,"

(Strong, et. al., 2005). This condition is not usually harmful

and has few treatments. If it is due to a sphincter problem and

no other condition, then a surgical repair may be indicated

(Strong, 2005). If infertility is an issue for a couple, the male

can then have sperm extracted and invitro fertilization can occur.

Some medications can cause this problem. If ingesting medication

that can induce retrograde ejaculation, the proper treatment would

be to cease the use of that particular medication (Epperly &

Moore, 2000). Another cause is benign prostate

hypertrophy/hyperplasia (BPH) (Strong). This treatment includes

sensitive sex counseling (Strong).

Sexual Pain Disorders.

Dyspareunia is pain of the genitals that occurs with

intercourse (Strong, et. al, 2005). Due to the different areas of

pain, there are different treatments. If the patient is

experiencing superficial pain, topical lidocaine (anesthetic) can

be applied to the labia (Phillips, 2000). Also, a warm bath prior

to intercourse is helpful (Phillips). If the patient is

experiencing vaginal pain one could use the same treatments as for

superficial pain, but also include lubricants (Phillips). If the

patient is experiencing deep pain, then a change in the position

often decreases or relieves the pain (Phillips). Medications can

assist in pain relief, such as NSAIDs (non-steroidal anti-

inflammatory drugs) (Phillips). Aspirin and ibuprofen are a few

NSAIDs available over the counter (Deglin & Vallerand, 1999).

Vaginismus is a condition in which the vagina experiences

involuntary muscle spasms (Strong, et. al., 2005). Progressive

muscle relaxation and vaginal dilation is a method used to assist

the patient in becoming accustomed to penetration (Phillips).

This is done by using rod-like object that is inserted into the

vagina, usually at nighttime (Phillips). During treatment the

rod-like object is used and increases in size over time until the

spasms have ceased and intercourse is allowable (Phillips). If

this method is unsuccessful then sex therapy may be another option



Epperly, T. D. & Moore, K. E. (2000). Health issues in men: Part 1 Common genitourinary disorders. American Family Physician, 61(12), 3657-3658.

Deglin, J. H. & Vallerand, A. H. (1999). Davis's Drug Guide for Nurses. (6th ed.). Philadelphia: F. A. Davis Company.

Phillips, N. A. (2000). Female sexual dysfunction: Evaluation and treatment. American Family Physician, 62(1), 127.

Strong, B., DeVault, C., Sayad, B. W., & Yarber, W. L. (2005). Human Sexuality: Diversity in contemporary America. (5th ed.). New York: McGraw-Hill.

Van Kampen, M., De Weerdt, W., Claes, H., Feys, H., De Maeyer, M., & Van Poppel, H. (2003). Treatment of erectile dysfunction by perineal exercise, electromyographic feedback & electrical stimualtion. Physical Therapy, 83(6), 536-538.