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Chapter 14
Sexuality Difficulties and Solutions
Defining Sexual Difficulties
• Sexual satisfaction is subjective
• The way people are surveyed can skew results
• A sexual problem which occurs throughout life
among all situations is generalized
• A problem which only occurs intermittently is
Desire Phase Difficulties
• Hypoactive sexual desire disorder (HSD)
– Lack of interest in sexual activity
– Usually temporary
– Often due to relationship problems, or
internalized negative attitudes about sex
– Very common
• Sexual aversion disorder (SAD)
– Extreme, irrational fear of sexual activity
– Often due to sexual abuse or assault
Excitement Phase Difficulties:
Male Erectile Dysfunction
• Lack of an erection for at least 3 months
• ED occurs in one in five men older than 20 years
• Most often caused by combination of biological,
psychological, and social factors
Orgasm Phase Difficulties:
Male Orgasm Disorder
• Premature ejaculation (PE)
– Inability to control orgasm to either partners’
– 20-30% men worldwide (ages 18-59)
repeatedly experience PE
Faking Orgasm
• Common among women and men but usually discussed
in reference to women
• Reasons
– Avoid disappointing or hurting partner
– To get sex over with
– Poor communication
– Limited knowledge of sexual techniques
– Overemphasized coitus, may contribute to inadequate
stimulation for women.
– Attempt to hide deteriorating relationship
Origins of Sexual Difficulties:
Physiological Factors
• Hormonal, vascular, neurological
• Good health habits = good sexual functioning
• Chronic illnesses & disabilities
– blindness and/or deafness
Chapter 15
Sexually Transmitted Diseases
STDs & College-Age Population
• Two thirds of STDs diagnosed occur among individuals
under age 25
• 1 in 4 experienced adolescents are infected with one or
more STDs each year
• More than half of all reported cases of chlamydia and
gonorrhea occur among 15 to 25 year olds
• Half of new HIV infections occur among people younger
than 25 years
• Brainstorming…
Incidence of STDs:
Why So High?
• Engaging in risky behavior
– Multiple partners
– Unprotected (condomless) sex
– Highest in adolescence & early adulthood, when
incidence of STDs is highest
• Oral contraceptives
• Lack of public health measures and limited access STD
prevention and treatment
Preventing STDs:
Guidelines for Lowering Risk
• Get to know partners before sex
• Obtain prior medical examinations
– Multiple partners= every three months
• Always use condoms & spermicide
• Avoid multiple sexual partners
• Inspect and wash genitals
– Yours and your partner’s
• Disclose your STD status
Chapter 16
Atypical Sexual Behavior
What Constitutes Atypical Sexual Behavior?
Paraphilia: uncommon sexual expression
Classified as noncoercive vs. coercive paraphilias
Behaviors represent extremes on a continuum
More males reported & prosecuted
Clustering of paraphilias
Unconventional behavior may alienate others leading to
difficulty in establishing relationships
Non-Coercive Paraphilias:
• Sexual arousal primarily from body part or
inanimate object
• Symbolic transformation
• Rarely harmful to others
Coercive Paraphilias:
• Exposing genitals to unwilling other
• Some offenders commit more serious crimes
• Suggested response
– Calmly ignore it
– Leave immediately
– Report to authorities ASAP
Non-Coercive Paraphilias:
Sexual Sadism & Sexual Masochism
• Sadism: sexual arousal from giving physical or
psychological pain
• Masochism: sexual arousal from receiving pain /
• Difficult to label because some behaviors common
Coercive Paraphilias:
Obscene Phone Calls
• Sexual arousal from response to call
• Usually a shy, insecure male
• Suggested response
– Gently hang up, ignore re-call
– Screen calls; call tracing
– Report & ask for new number
Coercive Paraphilias:
• Sexual arousal from observing others undressing or
engaging in sexual activity, without their consent
• Offenders often feel inadequate & lack sociosexual skills;
tend to be young men in 20s
• More likely to observe strangers than acquaintances