Friday, August 13, 2010


Sexual problems among women and men aged 40-80years: Prevalence and Correlates identified in the Global Study of Sexual Attitudes and Behaviors • n = 29 countries • (sampled): n=13,882 women; n=13,618 men • (eligible*): n = 9,000 women; n = 11,205 men *based on having at least 1 intercourse in past year • During the last 12 months have you ever experienced any of the following for a period of 2 months or more when you: – Lacked interest in having sex – Were unable to reach climax (experience orgasm) – Reached climax (experienced orgasm) too quickly – Experienced physical pain during sex – Did not find sex pleasurable – Had trouble achieving or maintaining an erection (men) – Had trouble becoming adequately lubricated (women) • Answered yes/no If yes… • Severity assessed with: “for each of these experiences, how often would you say this has occurred during the last 12 months?” – Occasionally / sometimes / frequently – “Occasionally” treated as “no problem” in Correlates (predictors) assessed • Demographics: age, education, financial problems, • Health: general health status, physical activity, vascular condition, depression, prostate disease, hysterectomy, smoking • Relationships: divorce in past 3 years, expected length of current relationship, are you exclusive? • General satisfaction with life • Individual sexual behaviour: sex & foreplay frequency • Sexual practices: frequency of thinking about sex? • Sexual attitudes • Sexual beliefs: do you think aging reduces sexual desire? Does your religion affect your sexuality? • Sexual Desire Disorders  Sexual Aversion Disorder (prevalence unknown) Extreme aversion to and avoidance of all genital sexual contact with a partner “a sexual phobia” characterized by revulsion and disgust Causes of sexual aversion • A classically conditioned response Unconditioned stimulus Conditioned stimulus + Sex Assault Conditioned response Fear, panic, and avoidance  Orgasmic Disorders: Premature ejaculation • Premature Ejaculation – Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity. • Also known as Rapid Ejaculation • Most prevalent sexual dysfunction in men Who defines early? • Henry believed this was not a sexual dysfunction since most of their sample ejaculated within 2 minutes of penetration. • Recently, researchers have attempted to quantify what is “early”. In large studies, the time take to ejaculate varies widely from 7-14 min. cross country differences: • Germany 7 min • US 13.6 min • England, France, Italy 9.6 min Evolving Definitions of Premature Ejaculation – Ejaculation must take place within 1 minute of penetration 11 Orgasmic Disorder: Delayed Ejacuation • Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person’s age, judges to be adequate in focus, intensity, and duration.

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