Sexual Disorders A disturbance in the desire excitement or orgasm phases of the sexual response cycle or pain during sexual intercourse Sexual dysfunctions are more common in women than in men Shafer 2008 Types o Sexual desire disorders Hypoactive sexual desire disorder Sexual aversion disorder o Sexual arousal disorders Female sexual arousal disorder Male erectile disorder erectile dysfunction impotence o Orgasm disorders Female orgasmic disorder inhibited female orgasm or anorgasmia Male orgasmic disorder inhibited orgasm or retarded ejaculation o Sexual pain disorders Dyspareunia Vaginismus o Sexual dysfunction due to a general medical condition o Substance induced sexual dysfunction o Sexual dysfunction not otherwise specified Antidepressants and antipsychotics commonly affect 3 phases of normal sexual response cycle o Sexual interest libido o Physiological arousal including lubrication in women and erection in men o Orgasm Other meds that induce sexual dysfunction o Cardiovascular drugs Low libido impotence anorgasmia o GI Low libido impotence o Hormones Low libido impotence o Sedatives alcohol impotence loss of inhibition o Antimanic drugs Low libido impotence o Anticonvulscents Low libido impotence priapism Sexual disorders o EITHER gender dysphoria OR parahillic disorders o Gender Transsexualism a person wishes to change his or her anatomical sexual characteristics to those of the opposite sex Hermaphroditism intersexuality person born with both ovarian and testicular reproductive tissue Uncommon in children Males are more common o Paraphilia Recurrent intense sexually arousing fantasies sexual urges or behaviors that involve Must have symptoms for 6 months Preference for the use of a nonhuman object Sexual activity involving suffering or humiliation of self or others Repetitive sexual activity with children or other nonconsenting adults Exhibitionism intentional display of the genitals in a public place Fetishism requires a material object to be present in order to be sexually satisfied red heels Frotteurism touching rubbing against or fondling another person to obtain sexual excitement crowded elevator Pedophilia sexual activity with a prepubescent child generally 13 years or younger o The perpetrator must be at least 16 old and at least 5 years older than the victim Voyeurism viewing of other people in intimate situations Transvestic fetishism sexual satisfaction achieved by dressing in the clothing of the opposite gender Sexual sadism sexual satisfaction from the physical or psychological suffering or humiliation of the victim Sexual masochism sexual satisfaction by being humiliated beaten bound or otherwise made to suffer Paraphilia not otherwise specified o Telephone video sexting o Necrophilia dead bodies o Partialism specific body part o Zoophilia animals o Urophilia urine o Hypoxyphilia restricting oxygen Assessment o Explain purpose of the interview o Discuss confidentiality o Questions proceed from least intrusive to more intrusive o Use medically correct terminology