Question

Summarize and discuss biological as well as psychosocial causes and treatments for sexual dysfunction in males and females. Consider the case of a couple who is seeking help from a therapist specializing in sexual health. The husband reports that he is overweight, has high blood pressure, and has a very stressful career that causes him much anxiety. The wife is in excellent physical health, exercises frequently, but reports lack of desire because her husband "doesn't seem to even notice me and never initiates sex." What biological and psychosocial treatments might a therapist recommend for this couple?

Answer 1

• Female sexual dysfunction causes:-
• Biological-Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm.
• The vaginal lining also becomes thinner and less elastic, particularly if a woman is not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.The body's hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect the desire to have sex.
• Psychosocial-Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.
• Long-standing conflicts with the partner — about sex or other aspects of the relationship — can diminish the sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.
• Treatment:-
• Talking with a counselor or therapist who specializes in sexual and relationship problems. Therapy often includes education about how to optimize your body's sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.
• Effective treatment for sexual dysfunction often requires addressing an underlying medical condition or hormonal change.
• Estrogen therapy-Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
• Androgen therapy-Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower levels of testosterone.
• Flibanserin (Addyi)-Originally developed as an antidepressant, flibanserin is approved by the Food and Drug Administration as a treatment for low sexual desire in premenopausal women.A daily pill, Addyi may boost sex drive in women who experience low sexual desire and find it distressing. Potentially serious side effects include low blood pressure, sleepiness, nausea, fatigue, dizziness and fainting, particularly if the drug is mixed with alcohol.
• Male sexual dysfunction causes:-
• The most common problems related to sexual dysfunction in men include ejaculation disorders, erectile dysfunction, and inhibited sexual desire. These and other sexual dysfunction problems can be corrected by treating the underlying biological or psychological causes.
• Psychological causes might include:
• Concern about sexual performance
• Marital or relationship problems
• Depression, feelings of guilt
• Effects of past sexual trauma
• Work-related stress and anxiety
• Biological causes:- Low testosterone, high prolactin, and abnormal thyroid hormone levels can cause sexual dysfunction. Chronic kidney and liver disease. These diseases affect blood vessels, nerves, and hormone levels
• Treatment-
• Oral medication. Three effective drugs – sildenafil, vardenafil, and talafadil – work by increasing blood flow to the malegenital organ during sexual stimulation
• Penile therapies. Medications injected into the male genital or inserted into the urethra to increase blood flow may work when oral medications do not
• Testosterone replacement therapy. Testosterone can be replaced through injections, skin patches, gels, or tablets placed between the cheek and gums
• If a relationship or an emotional problem is the cause, the individual's doctor may suggest that the couple see a sex therapist
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