female sexual dysfunction - sexual pain disorders

8/18/2019 Female Sexual Dysfunction - Sexual Pain Disorders

1/44

Female SexualFemale Sexual

DysfunctionDysfunctionKevin GilliganKevin Gilligan

Raquel GrimesRaquel Grimes

Cornelia GroseCornelia Grose

Nicholas HahnNicholas Hahn


2/44

Sexual problems in femalesSexual problems in females

are very prevalent anare very prevalent an

commonly associate !ithcommonly associate !ith

physiological concerns anphysiological concerns an

the quality of life"the quality of life"


3/44

Female sexual isorers inclue#Female sexual isorers inclue#

Sexual esire isorers#Sexual esire isorers# Hypoactive sexual esire isorer Hypoactive sexual esire isorer

Sexual aversion isorer Sexual aversion isorer

Sexual arousal isorer Sexual arousal isorer

$rgasmic isorer $rgasmic isorer Sexual pain isorers#Sexual pain isorers#

DyspareuniaDyspareunia

%aginismus%aginismus


4/44

& !!!"behavenet"com' ())*+& !!!"behavenet"com' ())*+

Sexual Desire Disorers#Sexual Desire Disorers#

Hypoactive sexual esire isorer Hypoactive sexual esire isorer ,ersistently or recurrently eficient &or absent+ sexual,ersistently or recurrently eficient &or absent+ sexual

fantasies an esire for sexual activity" -he .ugment offantasies an esire for sexual activity" -he .ugment ofeficiency or absence is mae by the clinician' ta/ingeficiency or absence is mae by the clinician' ta/inginto account factors that affect sexual functioning' suchinto account factors that affect sexual functioning' such

as age an the context of the person0s life"as age an the context of the person0s life" -he isturbance causes mar/e istress or interpersonal-he isturbance causes mar/e istress or interpersonal

ifficulty"ifficulty" -he sexual ysfunction is not better accounte for by-he sexual ysfunction is not better accounte for by

another 1xis 2 isorer &except another Sexualanother 1xis 2 isorer &except another SexualDysfunction+ an is not ue exclusively to the irectDysfunction+ an is not ue exclusively to the irectphysiological effects of a substance &e"g"' a rug ofphysiological effects of a substance &e"g"' a rug ofabuse' a meication+ or a general meical conition"abuse' a meication+ or a general meical conition"


5/44

&!!!"behavenet"com' ())*+&!!!"behavenet"com' ())*+

Sexual Desire Disorers#Sexual Desire Disorers#

Sexual aversion isorerSexual aversion isorer ,ersistent or recurrent extreme aversion,ersistent or recurrent extreme aversion

to' an avoiance of' all &or almost all+to' an avoiance of' all &or almost all+genital sexual contact !ith a sexualgenital sexual contact !ith a sexual

partner"partner" -he isturbance causes mar/e istress-he isturbance causes mar/e istress

or interpersonal ifficulty"or interpersonal ifficulty"

-he sexual ysfunction is not better-he sexual ysfunction is not betteraccounte for by another 1xis 2 isoreraccounte for by another 1xis 2 isorer&except another Sexual Dysfunction+"&except another Sexual Dysfunction+"


6/44


Sexual 1rousal Disorer Sexual 1rousal Disorer

,ersistent or recurrent inability to attain' or to,ersistent or recurrent inability to attain' or tomaintain until completion of the sexual activity'maintain until completion of the sexual activity'an aequate lubrication3s!elling response ofan aequate lubrication3s!elling response ofsexual excitement"sexual excitement"

-he isturbance causes mar/e istress or-he isturbance causes mar/e istress orinterpersonal ifficulty"interpersonal ifficulty"

-he sexual ysfunction is not better accounte-he sexual ysfunction is not better accountefor by another 1xis 2 isorer &except anotherfor by another 1xis 2 isorer &except another

Sexual Dysfunction+ an is not ue exclusivelySexual Dysfunction+ an is not ue exclusivelyto the irect physiological effects of a substanceto the irect physiological effects of a substance&e"g"' a rug of abuse' a meication+ or a&e"g"' a rug of abuse' a meication+ or ageneral meical conition"general meical conition"


7/44


$rgasmic Disorer $rgasmic Disorer

,ersistent or recurrent elay in' or absence of' orgasm follo!ing a,ersistent or recurrent elay in' or absence of' orgasm follo!ing anormal sexual excitement phase" 4omen exhibit !ie variability innormal sexual excitement phase" 4omen exhibit !ie variability inthe type or intensity of stimulation that triggers orgasm" -hethe type or intensity of stimulation that triggers orgasm" -heiagnosis of Female $rgasmic Disorer shoul be base on theiagnosis of Female $rgasmic Disorer shoul be base on theclinician0s .ugment that the !oman0s orgasmic capacity is less thanclinician0s .ugment that the !oman0s orgasmic capacity is less than!oul be reasonable for her age' sexual experience' an the!oul be reasonable for her age' sexual experience' an theaequacy of sexual stimulation she receives"aequacy of sexual stimulation she receives"

-he isturbance causes mar/e istress or interpersonal ifficulty"-he isturbance causes mar/e istress or interpersonal ifficulty"

-he orgasmic ysfunction is not better accounte for by another-he orgasmic ysfunction is not better accounte for by another

1xis 2 isorer &except another Sexual Dysfunction+ an is not ue 1xis 2 isorer &except another Sexual Dysfunction+ an is not ueexclusively to the irect physiological effects of a substance &e"g"' aexclusively to the irect physiological effects of a substance &e"g"' arug of abuse' a meication+ or a general meical conition"rug of abuse' a meication+ or a general meical conition"


8/44


Sexual ,ain Disorers#Sexual ,ain Disorers#

DyspareuniaDyspareunia Recurrent or persistent genital pain associate !ithRecurrent or persistent genital pain associate !ith

sexual intercourse in either a male or a female"sexual intercourse in either a male or a female" -he isturbance causes mar/e istress or interpersonal-he isturbance causes mar/e istress or interpersonal

ifficulty"ifficulty"

-he isturbance is not cause exclusively by %aginismus-he isturbance is not cause exclusively by %aginismusor lac/ of lubrication' is not better accounte for byor lac/ of lubrication' is not better accounte for byanother 1xis 2 isorer &except another Sexualanother 1xis 2 isorer &except another SexualDysfunction+' an is not ue exclusively to the irectDysfunction+' an is not ue exclusively to the irectphysiological effects of a substance &e"g"' a rug ofphysiological effects of a substance &e"g"' a rug ofabuse' a meication+ or a general meical conition"abuse' a meication+ or a general meical conition"Due to Combine FactorsDue to Combine Factors


9/44


Sexual ,ain Disorers#Sexual ,ain Disorers#

%aginimus%aginimus Recurrent or persistent involuntary spasm of theRecurrent or persistent involuntary spasm of the

musculature of the outer thir of the vagina thatmusculature of the outer thir of the vagina thatinterferes !ith sexual intercourse"interferes !ith sexual intercourse"

-he isturbance causes mar/e istress or-he isturbance causes mar/e istress orinterpersonal ifficulty"interpersonal ifficulty" -he isturbance is not better accounte for by-he isturbance is not better accounte for by

another 1xis 2 isorer &e"g"' Somati5ationanother 1xis 2 isorer &e"g"' Somati5ation

Disorer+ an is not ue exclusively to the irectDisorer+ an is not ue exclusively to the irectphysiological effects of a general meicalphysiological effects of a general meicalconition"conition"


10/44

&6erman et" al' 7888+&6erman et" al' 7888+

Female Sexual Response CycleFemale Sexual Response Cycle

9asters an :ohnson characteri5e cycle !ith four phases#9asters an :ohnson characteri5e cycle !ith four phases# ;xcitement;xcitement ,lateau,lateau $rgasmic$rgasmic

ResolutionResolution

Kaplan propose iea ofKaplan propose iea of


11/44


;valuation;valuation

Female sexual arousal results in a combinationFemale sexual arousal results in a combination

of vasocongestive an nueromuscular events'of vasocongestive an nueromuscular events'

incluing increase clitoral' labial' an vaginalincluing increase clitoral' labial' an vaginal

!all engorgement an increase vaginal luminal!all engorgement an increase vaginal luminaliameter an lubrication"iameter an lubrication"

9uscle tension' respiratory rate' heart rate' an9uscle tension' respiratory rate' heart rate' an

bloo pressure rise steaily uring arousal'bloo pressure rise steaily uring arousal'

finally pea/ing uring orgasm"finally pea/ing uring orgasm"


12/44

;valuation &cont"+;valuation &cont"+

;valuations may iffer from person to;valuations may iffer from person to

person "person "

-he !ay of iagnosing is through-he !ay of iagnosing is through

physiological response !hich coul resultphysiological response !hich coul result

in problems !ith not consieringin problems !ith not consiering

psychological evaluations"psychological evaluations"


13/44

&6rassil et" al' ())(+&6rassil et" al' ())(+

,opulations !ho may experience,opulations !ho may experience

female sexual ysfunction &FSD+#female sexual ysfunction &FSD+# 1buse 1buse ,erimenopausal,erimenopausal ,regnancy,regnancy

9ultiple sclerosis9ultiple sclerosis Chilhoo sex abuseChilhoo sex abuse ChemotherapyChemotherapy

Genital mutationGenital mutation ,ost menopausal,ost menopausal >ac/ of sensitivity>ac/ of sensitivity

Gynecological cancer Gynecological cancer RaiationRaiation 6attere6attere

Nuerogenic iseaseNuerogenic isease Sexual traumaSexual trauma Spinal cor in.urySpinal cor in.ury

%ascualr isease%ascualr isease ,ost3hysterectomy,ost3hysterectomy ,ost3partum,ost3partum


14/44


StatisticsStatistics

ife

survey of 7@*8 !omen' *A B experiencesurvey of 7@*8 !omen' *A B experience

sexual ysfunction"=sexual ysfunction"=

A) B of men report sexual problemsA) B of men report sexual problems S population ata reveale that 8"@ millionS population ata reveale that 8"@ million

1merican !omen age )3@* years self3report 1merican !omen age )3@* years self3report

complaints of iminishe vaginal lubrication'complaints of iminishe vaginal lubrication'

pain an iscomfort !ith intercourse' ecreasepain an iscomfort !ith intercourse' ecrease

arousal' an ifficulty achieving orgasm"arousal' an ifficulty achieving orgasm"


15/44

&6rassil et" al' ())(+&6rassil et" al' ())(+

;tiology;tiology


16/44

,sychological Causes,sychological Causes

1s !ith most 1s !ith most

isorers' femaleisorers' female

sexual ysfunctionsexual ysfunction

can be cause ancan be cause anaggravate byaggravate by

psychological causes"psychological causes"


17/44

& 6rassil ? Keller' ())(+& 6rassil ? Keller' ())(+

-here are five main ,sychological-here are five main ,sychological

Causes to FSD"Causes to FSD" Sexual or ;motional 1buseSexual or ;motional 1buse

DepressionDepression

Relationship 2ssuesRelationship 2ssues StressStress

Self ;steemSelf ;steem


18/44

&Sar!e ? Durla/' 788E+&Sar!e ? Durla/' 788E+

Sexual or ;motional 1buseSexual or ;motional 1buse

-his can inclue chil abuse' omestic violence'-his can inclue chil abuse' omestic violence'

rape' an sexual exploitation"rape' an sexual exploitation"

-hese can lea to long term sexual ysfunction-hese can lea to long term sexual ysfunction

!ith !omen ue to problems such as overall!ith !omen ue to problems such as overalltrust issues to esensiti5ation"trust issues to esensiti5ation"

6et!een @B to 8*B of !omen !ith a sexual6et!een @B to 8*B of !omen !ith a sexual

ysfunction coul be accurately ientifie on theysfunction coul be accurately ientifie on the

basis of prior abuse' but many nonysfunctionalbasis of prior abuse' but many nonysfunctional

!omen !ere misclassifie"!omen !ere misclassifie"


19/44

DepressionDepression

Depression is a prevalent cause of sexualDepression is a prevalent cause of sexual

ysfunction in both men an !omen"ysfunction in both men an !omen"

9ost !omen' !hen grieving' experience a9ost !omen' !hen grieving' experience a

loss of sexual esire"loss of sexual esire"

Depression can be a ouble ege s!orDepression can be a ouble ege s!or

for some' ue to the increase of sexualfor some' ue to the increase of sexual

ysfunction cause by anti3epressants"ysfunction cause by anti3epressants"


20/44

& >aumann et al"' 7888+& >aumann et al"' 7888+

RelationshipRelationship

1 healthy relationship is base on trust' 1 healthy relationship is base on trust'

intimacy' an communication"intimacy' an communication"

1 stuy in the last five years foun that 1 stuy in the last five years foun that

sexual ysfunction is highly associatesexual ysfunction is highly associate

!ith negative experiences in sexual!ith negative experiences in sexual

relationships an overall !ell3being"relationships an overall !ell3being"


21/44

Relationship &cont"+Relationship &cont"+

$ther factors that can$ther factors that canaffect the sexual health ofaffect the sexual health ofa relationship area relationship areconflicts about cultural'conflicts about cultural'

social or religious beliefs"social or religious beliefs" -hese can invo/e-hese can invo/e

feelings of guilt uringfeelings of guilt uringsexual activity an affectsexual activity an affectthe ability of a !omen tothe ability of a !omen to

be arouse' obtain anbe arouse' obtain anorgasm' or have anyorgasm' or have anyesire to have sex"esire to have sex"


22/44

StressStress

-oay most people are so busy an are-oay most people are so busy an are

often too stresse or too exhauste tooften too stresse or too exhauste to

have sex"have sex"

4hen some !omen have ecrease4hen some !omen have ecrease

esire to have sex' it !ill become moreesire to have sex' it !ill become more

ifficult to become arouse an to orgasmifficult to become arouse an to orgasm

High stress factors inclue !or/placeHigh stress factors inclue !or/place

stress' social or financial crisesstress' social or financial crises


23/44

&6rassil ? Keller' ())(+&6rassil ? Keller' ())(+

Stress &cont+Stress &cont+

Couples !ho areCouples !ho are

infertile an !ho areinfertile an !ho are

participating in invitroparticipating in invitro

fertili5ation !ill oftenfertili5ation !ill oftenexperience aexperience a

ecrease in esireecrease in esire

associate !ith theassociate !ith the

stress of having tostress of having toperform"perform"


24/44

Self ;steemSelf ;steem

-o have a healthy response to sex' a-o have a healthy response to sex' a

!oman must have a goo boy image an!oman must have a goo boy image an

self esteem"self esteem"

2f a !oman oes not feel comfortable in2f a !oman oes not feel comfortable in

her o!n boy' she !ill not feel comfortableher o!n boy' she !ill not feel comfortable

experiencing sex"experiencing sex"


25/44

&6rassil ? Keller' ())(+&6rassil ? Keller' ())(+

Diagnosis an -reatmentDiagnosis an -reatment

-he chance of a female expressing sexual-he chance of a female expressing sexual

concerns is influence by her perception of theconcerns is influence by her perception of the

health care professionalhealth care professionals level of comfort ins level of comfort in

iscussing the sub.ect"iscussing the sub.ect" 4hen iagnosing sexual ysfunction' a sexual4hen iagnosing sexual ysfunction' a sexual

function questionnaire is to be complete by thefunction questionnaire is to be complete by the

patient' then they !ill be intervie!e by apatient' then they !ill be intervie!e by a

psychologist to etermine any history of abusepsychologist to etermine any history of abuseor relationship issues that may be affecting theor relationship issues that may be affecting the

femalefemales sexual response"s sexual response"


26/44

-reatment-reatment

$nce it is etermine that the sexual isorer is$nce it is etermine that the sexual isorer ispsychological in nature the patient !ill then bepsychological in nature the patient !ill then bereferre to a psychologist !ho speciali5es inreferre to a psychologist !ho speciali5es insexuality"sexuality"

4hen possible her partner shoul be inclue in4hen possible her partner shoul be inclue inthis therapy"this therapy"

2f you are consiering therapy !ith a specialist in2f you are consiering therapy !ith a specialist in

sexual isorers you can call the 1mericansexual isorers you can call the 1merican 1ssociation of Sex ;ucators' Counselors' an 1ssociation of Sex ;ucators' Counselors' an-herapists at &A7(+ E**3)( or go to their-herapists at &A7(+ E**3)( or go to their!ebsite!ebsite !!!"aasect"org!!!"aasect"org for local referrals"for local referrals"

http://www.aasect.org/http://www.aasect.org/http://www.aasect.org/


27/44

& Segraves' ())(+& Segraves' ())(+

,sychiatric Drugs Role in Female,sychiatric Drugs Role in Female

Sexual DysfunctionSexual Dysfunction Female Sexual Dysfunction is highlyFemale Sexual Dysfunction is highly

prevalent in the general population an isprevalent in the general population an is

highly co morbi !ith many psychiatrichighly co morbi !ith many psychiatric

synromes"synromes" 9any prescribe psychiatric rugs have9any prescribe psychiatric rugs have

sexual sie effects"sexual sie effects"


28/44

6rief history6rief history

-he first case stuy of antiepressant3inuce orgasm-he first case stuy of antiepressant3inuce orgasmisorer in female patients !as reporte by 4yatt' R":"isorer in female patients !as reporte by 4yatt' R":"in 78@7"in 78@7"

2n 78@@ a case stuy ocumenting antipsychotic inuce2n 78@@ a case stuy ocumenting antipsychotic inuce

sexual ysfunction in both sexes !as reporte"sexual ysfunction in both sexes !as reporte" 2n 788* the DS9 2% inclue a category for rug inuce2n 788* the DS9 2% inclue a category for rug inuce

sexual ysfunctions"sexual ysfunctions" -he success of silenafil as a treatment for male erectile-he success of silenafil as a treatment for male erectile

isorer leas to the increase interest in FSD' moreisorer leas to the increase interest in FSD' morespecifically# clinical trials' evelopment of ne!specifically# clinical trials' evelopment of ne!assessment tools' increase interest in biologicalassessment tools' increase interest in biologicalcontributions to FSD' an refinement of iagnosticcontributions to FSD' an refinement of iagnosticunerstaning"unerstaning"


29/44

,revalence,revalence

-he National Health an Social >ife Survey-he National Health an Social >ife Survey

conucte in 788( involving intervie!s !ith aconucte in 788( involving intervie!s !ith a

probability sample of the S population bet!eenprobability sample of the S population bet!een

the ages of 738 foun that#the ages of 738 foun that# *AB of females have ha significant sexual*AB of females have ha significant sexual

complaints in the preceing yearcomplaints in the preceing year

AAB reporte lac/ of sexual interestAAB reporte lac/ of sexual interest

(*B reporte ifficulty reaching orgasm(*B reporte ifficulty reaching orgasm 78B reporte lubrication problems78B reporte lubrication problems


30/44


31/44

;ffects of ,sychiatric Drugs;ffects of ,sychiatric Drugs

1ntiepressants 1ntiepressants Double3blin have inicate that monoamineDouble3blin have inicate that monoamine

oxiase inhibitors &91$oxiase inhibitors &91$s+' ben5oia5epines's+' ben5oia5epines'

an tricyclic antiepressants &-C1s+ elayan tricyclic antiepressants &-C1s+ elayorgasms"orgasms"

nfortunately these sie effects !ere notnfortunately these sie effects !ere notnotice by psychiatrist until after several yearsnotice by psychiatrist until after several years

of clinical useof clinical use such sie effects !ere not note unless irectlysuch sie effects !ere not note unless irectly

as/e by physicians an most common sieas/e by physicians an most common sieeffects !ere elaye orgasm an ecrease libio"effects !ere elaye orgasm an ecrease libio"


32/44

;ffects of ,sychiatric Drugs;ffects of ,sychiatric Drugs

continueIcontinueI

1ntipsychotics 1ntipsychotics 9ost traitional antipsychotics can cause9ost traitional antipsychotics can cause

ifficulties !ith orgasmifficulties !ith orgasm9oo Stabili5ers9oo Stabili5ers

-he relationship !ith these rugs an FSD is-he relationship !ith these rugs an FSD isunclear because it is ifficult to separateunclear because it is ifficult to separate

illness cycle from the rug effect also' sexualillness cycle from the rug effect also' sexualactivity frequently increases uring manicactivity frequently increases uring manicepisoes an ecreases uring epressiveepisoes an ecreases uring epressiveepisoes"episoes"


33/44

,harmacological -reatments of,harmacological -reatments of

Female DisorersFemale Disorers

%asoactive Drugs%asoactive Drugs Silenafil increases the genital vasocongestion an lubricationSilenafil increases the genital vasocongestion an lubrication

but there is no evience that these agents have therapeuticbut there is no evience that these agents have therapeuticbenefits for FSD"benefits for FSD"

-his may not be effective because females !ith FSD often sho!-his may not be effective because females !ith FSD often sho!ob.ective arousal but o not report sub.ective arousal"ob.ective arousal but o not report sub.ective arousal"

$ther treatments in progress$ther treatments in progress 1nrogen an estrogen treatments have been fairly extensively 1nrogen an estrogen treatments have been fairly extensively

researche an suggests that a relationship exists bet!eenresearche an suggests that a relationship exists bet!een

libio an anrogen levels in females"libio an anrogen levels in females" -estosterone treatments are also being researche though-estosterone treatments are also being researche though

chronic osages !oul result in masculini5ation an other siechronic osages !oul result in masculini5ation an other sieeffects"effects"

Ho!ever it has been sho!n that testosterone !ithin normal limitsHo!ever it has been sho!n that testosterone !ithin normal limitsinfluence libio"influence libio"


34/44

& 6asson et al"' ())7+& 6asson et al"' ())7+

Reefining FSDReefining FSD

Development of research has been hinere by lac/ of strongDevelopment of research has been hinere by lac/ of strongefinitions an a multiimensional structure for iagnosis anefinitions an a multiimensional structure for iagnosis anclassification"classification"

Recapping past efinitions#Recapping past efinitions# 4orl Health $rgani5ation 2nternational Classifications of4orl Health $rgani5ation 2nternational Classifications of

Disease37) &2CD37)+ efines FSD asDisease37) &2CD37)+ efines FSD as


35/44


Shortcomings of previousShortcomings of previous

efinitions of FSDefinitions of FSD >arge overlap has been foun among sexual isorers' particularly>arge overlap has been foun among sexual isorers' particularly

in females' inicating a nee to refine the iagnostic systemin females' inicating a nee to refine the iagnostic system

currently being use"currently being use"

Research has focuse primarily on causes an treatment of maleResearch has focuse primarily on causes an treatment of malesexual isorers' leaving female sexual isorer research muchsexual isorers' leaving female sexual isorer research much

less evelope"less evelope"

-he first 2nternational Consensus Development Conference on-he first 2nternational Consensus Development Conference on

Female Sexual Dysfunction !as organi5e to confront the problemsFemale Sexual Dysfunction !as organi5e to confront the problemsassociate !ith past classifications of FSD"associate !ith past classifications of FSD"


36/44


2nternational Consensus Development2nternational Consensus Development

Conference on FSDConference on FSD -he first 2nternational Consensus Development Conference on-he first 2nternational Consensus Development Conference on

Female Sexual Dysfunction met in $ctober ((' 788 in 6oston' anFemale Sexual Dysfunction met in $ctober ((' 788 in 6oston' an

evelope a ne! system to classify FSD incluing altereevelope a ne! system to classify FSD incluing altere

efinitions for the ifferent isorers"efinitions for the ifferent isorers"

-he ma.or categories &esire' arousal' orgasmic' an sexual pain-he ma.or categories &esire' arousal' orgasmic' an sexual pain

isorers+ ra!n from the DS932% an 2CD37) !ere not change"isorers+ ra!n from the DS932% an 2CD37) !ere not change"

4hile the efinitions remaine similar in basic aspects of each4hile the efinitions remaine similar in basic aspects of each

isorer' an important aition !as the emphasis on personalisorer' an important aition !as the emphasis on personalistress of the patient"istress of the patient"


37/44


Ne! efinitions from the ConsensusNe! efinitions from the Consensus

ConferenceConference Sexual Desire DisorersSexual Desire Disorers

Hypoactive sexual esire isorer#Hypoactive sexual esire isorer#


38/44


Ne! efinitions from the ConcensusNe! efinitions from the Concensus

Conference &cont"+Conference &cont"+ Sexual ,ain DisorersSexual ,ain Disorers

Dyspareunia#Dyspareunia#


39/44

& -iefer et al"' ())(+& -iefer et al"' ())(+

1 Feminist ,erspective of FSD 1 Feminist ,erspective of FSD

1 !or/ing group on 1 Ne! %ie! of 4omen 1 !or/ing group on 1 Ne! %ie! of 4omens Sexual ,roblems met in thes Sexual ,roblems met in the

summer of ())( to iscuss the attention brought to female sexuality throughsummer of ())( to iscuss the attention brought to female sexuality through

publicity generate aroun treatment for erectile ysfunction in men"publicity generate aroun treatment for erectile ysfunction in men"

-he DS932% criteria of FSD !as revisite an critique on its relevance-he DS932% criteria of FSD !as revisite an critique on its relevance

!hen applie to females"!hen applie to females"

1ccoring to -iefer' Hall an -ravis &())(+' there is a 1ccoring to -iefer' Hall an -ravis &())(+' there is a


40/44


1 Feminist ,erspective of FSD &cont"+ 1 Feminist ,erspective of FSD &cont"+

4ith the interplay of research an rug company funing' as !ell as4ith the interplay of research an rug company funing' as !ell as

publicity of treatments for sexual ysfunction' physiologicalpublicity of treatments for sexual ysfunction' physiological

problems have been overemphasi5e an separate them from theproblems have been overemphasi5e an separate them from the

overall problem encompasse by FSD"overall problem encompasse by FSD"

,roblems' such as those relate to relationship or culturalJmoral,roblems' such as those relate to relationship or culturalJmoral

conflict' are pushe into the vague category of psychological !ithoutconflict' are pushe into the vague category of psychological !ithout

being fully aresse or stuie"being fully aresse or stuie"

2n an effort to bring more sub.ectivity an female perspective to2n an effort to bring more sub.ectivity an female perspective to

researching an unerstaning FSD' the !or/ing group on a Ne!researching an unerstaning FSD' the !or/ing group on a Ne!

%ie! of 4omen%ie! of 4omens Sexual ,roblems evelope a ne! efinition"s Sexual ,roblems evelope a ne! efinition" Female sexual problems !ere efine asFemale sexual problems !ere efine as


41/44


1 Feminist ,erspective of FSD &cont"+ 1 Feminist ,erspective of FSD &cont"+

-he efinition evelope by the group encompasse the four-he efinition evelope by the group encompasse the four

aspects consiere sources of female sexual isorers"aspects consiere sources of female sexual isorers" Sociocultureal' political' or economic factorsSociocultureal' political' or economic factors

,artner an relationship factors,artner an relationship factors

,sychological factors,sychological factors

9eical factors9eical factors

-he Ne! %ie! group convene to iscuss the current /no!lege of-he Ne! %ie! group convene to iscuss the current /no!lege of

FSD an has calle for a change in the efinition of FSD to moreFSD an has calle for a change in the efinition of FSD to more

accurately apply to !omenaccurately apply to !omens sexuality' as !ell as create a eepers sexuality' as !ell as create a eeperunerstaning of the multiimensional nature of FSD"unerstaning of the multiimensional nature of FSD"


42/44

&6asson et al"' ())7+&6asson et al"' ())7+

1reas of Further Research in FSD 1reas of Further Research in FSD

;piemiological research;piemiological research Researchers nee to buil their /no!lege of prevalence'Researchers nee to buil their /no!lege of prevalence'

preictors' an outcomes of FSDpreictors' an outcomes of FSD

1natomical research 1natomical research -he anatomy of normal female sexual function has been-he anatomy of normal female sexual function has been

overloo/e in the light of research concerning male physiology"overloo/e in the light of research concerning male physiology" -he actual biological mechanism of arousal an orgasm in-he actual biological mechanism of arousal an orgasm in

females an normal female sexual response nees to befemales an normal female sexual response nees to beresearche an unerstoo more clearly before FSD can beresearche an unerstoo more clearly before FSD can beresearche an more effectively treate"researche an more effectively treate"

1ffect of aging an menopause !hich are unique to !omen 1ffect of aging an menopause !hich are unique to !omenshoul be loo/e at closer to unerstan the hormonalshoul be loo/e at closer to unerstan the hormonalprocesses involve in FSD"processes involve in FSD"


43/44


1reas of Further Research in FSD 1reas of Further Research in FSD

&cont"+&cont"+ -here is a lac/ of unerstaning concerning the interaction of-here is a lac/ of unerstaning concerning the interaction of

simultaneously occurring physiological an sub.ective aspects ofsimultaneously occurring physiological an sub.ective aspects offemale sexual arousal" -his area is important in unerstaning !hyfemale sexual arousal" -his area is important in unerstaning !hy!omen experience FSD espite the presence of physiological!omen experience FSD espite the presence of physiologicalinicators of sexual arousal"inicators of sexual arousal"

9ethos of measuring arousal nee to be improve to ma/e them9ethos of measuring arousal nee to be improve to ma/e themmore generali5able to the spectrum of iniviual ifferences frommore generali5able to the spectrum of iniviual ifferences from!oman to !oman"!oman to !oman"

1 final area of importance is the effort to ma/e health care proviers 1 final area of importance is the effort to ma/e health care proviersa!are of FSD an encourage more /no!lege an training in thisa!are of FSD an encourage more /no!lege an training in thisarea of !omenarea of !omens health"s health"


44/44

6ibliography6ibliography

6asson' R"' 6erman' :"' 6urnett' 1"' Derogatis' >"' Ferguson' D"' Fourcroy' :"' Golstein' 2"' Gra5iottin' 1"' Heiman'6asson' R"' 6erman' :"' 6urnett' 1"' Derogatis' >"' Ferguson' D"' Fourcroy' :"' Golstein' 2"' Gra5iottin' 1"' Heiman':"' >aan' ;"' >eiblum' S"' ,ama3Nathan' H"' Rosen' R"' Segraves' K"' Segraves' R" -"' Shabsigh' R"' Sips/i' 9"':"' >aan' ;"' >eiblum' S"' ,ama3Nathan' H"' Rosen' R"' Segraves' K"' Segraves' R" -"' Shabsigh' R"' Sips/i' 9"'4agner' G"' ? 4hipple' 6" &())7+" Report of the 2nternational Consensus Development Conference on Female4agner' G"' ? 4hipple' 6" &())7+" Report of the 2nternational Consensus Development Conference on FemaleSexual Dysfunction# Definitions an classifications"Sexual Dysfunction# Definitions an classifications" Journal of Sex & Marital Therapy Journal of Sex & Marital Therapy '' 27 27 ' A38*"' A38*"

6erman' :"R"' 6erman' >"' an Golstein' 2" &7888+" Female Sexual Dysfunction# incience' ,athophysiology'6erman' :"R"' 6erman' >"' an Golstein' 2" &7888+" Female Sexual Dysfunction# incience' ,athophysiology'evaluation' an treatment options"evaluation' an treatment options"Urology Urology ' *' A3A87"' *' A3A87"

6rassil' D"F' Keller' 9" &())(+" Female Sexual Dysfunction# Definitions' Causes' an -reatment"6rassil' D"F' Keller' 9" &())(+" Female Sexual Dysfunction# Definitions' Causes' an -reatment" UrologicUrologic

Nursing Nursing ' ((' (A@3(*("' ((' (A@3(*("

>aumann' ;"$' ,ai/' 1"' Rosen' R"C" &7888+" Sexual Dysfunction in the nite States">aumann' ;"$' ,ai/' 1"' Rosen' R"C" &7888+" Sexual Dysfunction in the nite States" Journal of the AmericanJournal of the AmericanMedical Association,Medical Association, (7' A@3**"(7' A@3**"

Sar!er' D"6' Durla/' :"1" &788E+" Chilhoo Sexual 1buse as a ,reictor of Female Sexual Dysfunction# 1 StuySar!er' D"6' Durla/' :"1" &788E+" Chilhoo Sexual 1buse as a ,reictor of Female Sexual Dysfunction# 1 Stuyof Couples See/ing Sex -herapy"of Couples See/ing Sex -herapy" hild A!use & Neglect hild A!use & Neglect ' ()' 8EA38@("' ()' 8EA38@("

Segraves' R"-" &())(+" Female Sexual Disorers# ,sychiatric 1spects"Segraves' R"-" &())(+" Female Sexual Disorers# ,sychiatric 1spects" anadian Journal of "sychiatry anadian Journal of "sychiatry ' *783*(E"' *783*(E"Retrieve 1pril E' ())* from ;bsco host"Retrieve 1pril E' ())* from ;bsco host"

-iefer' >"' Hall' 9"' ? -ravis' C" &())(+" 6eyon ysfunction# 1 ne! vie! of !omen-iefer' >"' Hall' 9"' ? -ravis' C" &())(+" 6eyon ysfunction# 1 ne! vie! of !omens sexual problems"s sexual problems" Journal ofJournal ofSex & Marital Therapy Sex & Marital Therapy '' 2# 2# ' ((3(A("' ((3(A("

http#JJ!!!"behavenet"comJhttp#JJ!!!"behavenet"comJ &())*+" 6ehavenet Clinical Capsule# DS932%3-R &-ext Revision+"&())*+" 6ehavenet Clinical Capsule# DS932%3-R &-ext Revision+" Reprinte !ithReprinte !ithpermission from thepermission from the $iagnostic and Statistical Manual of Mental $isorders, %ourth dition, Text 'e(ision$iagnostic and Statistical Manual of Mental $isorders, %ourth dition, Text 'e(ision &()))+"&()))+"
http://www.behavenet.com/http://www.behavenet.com/http://www.behavenet.com/

female sexual dysfunction - sexual pain disorders

Documents