9. The sexual response cycle Phase Male response Female response Example of dysfunction Desire mental/physical stimulation Hypoactive sexual desire disorder Sexual aversion disorder Excitement Increasing sexual pleasure with pre-orgasm plateau Penile erection Retraction of testes Cowper’s gland secretion Clitoral enlargement Vaginal lubrication Breast engorgement Male erectile disorder Female sexual arousal disorder Orgasm Peaking of sexual pleasure Ejaculatory spurt Rhythmic contractions of seminal system Skin flushing Rhythmic vaginal and uterine contraction Skin flushing Delayed ejaculation Premature ejaculation Female preorgasmia Resolutions Relaxation, reversal of physiologic changes Refractory to orgasm for a period of time which increases with age No refractory period Postcoital dysphoria Postcoital headache
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13. Female Male erectile disorder Persistent/recurrent/complete failure to attain/maintain lubrication-swelling response Recurrent and persistent partial/complete failure to attain/maintain an erection Must rule out medications (antihypertensives, antihistamine), medical conditions (vascular, neurological, endocrine) Causes marked distress/interpersonal difficulty
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28. BIO PSYCHOSOCIAL Sildenafil (viagra ) for sexual dysfunction Prostaglandin injections Lubricating creams Anti-androgen medication (tamoxifen) Sexual reassignment surgery for transsexualism Psychotherapy for individual, couple Sex education Behaviour modification
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