Ebook ABC of sexual heath (3E): Part 2
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Ebook ABC of sexual heath (3E): Part 2
CHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2emic Medical Centre. University of Amsterdam. Amsterdam. The NetherlandsOVERVIEW. Problems with sexual des 'e and sexual arousal are no longer considered to be separate sexiwl problems. Sexual desire/arousal results from an interplay of a sensitive sexual response system and effectne stimuli that ac Ebook ABC of sexual heath (3E): Part 2tivate this system• In the context of a sexual relationship, problems that are presented as a lack, or loss, of sexual desire can usually be reframedEbook ABC of sexual heath (3E): Part 2
as differences in sexual desire and in differences in what kmd of sex is desired. A biopsychosocial sexual history from a longitudina' perspectne IS mCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2needs to be involved in assessment and treatment. Enhancing sexual pleasure of both partners IS a cruoal factor in bog-lasting improvement of the sexual relationshipIntroductionA distressing lack of interest in sexual activity that persists is the most common reason why women seek sex therapy. Early Ebook ABC of sexual heath (3E): Part 2 studies show that at least one-third of women younger than 59 reported low sexual desire over the past year. Because less than 28% of sexual difficulEbook ABC of sexual heath (3E): Part 2
ties (defined as being present for 1 month) persist for 6 months or more, only enduring and distressing symptoms should be considered representative oCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2ps to approximately 8-12%. Multinational studies have found higher rates of low sexual interest in Middle East and Southeast Asian countries.emphasizing the importance of cultural sensitivity when assessing sexual interest and arousal (see Table 15.1). There is considerable research interest in wome Ebook ABC of sexual heath (3E): Part 2ns low sexual desire and this is amplified by the fact that, to date, there are no Federal Drug Administration (FDA)-approved pharmaceutical treatmentEbook ABC of sexual heath (3E): Part 2
s available contributing to an aggressive (and expensive) race to find the panacea unlocking womens lost sexual desire.ABC «)StXMl Health. Third EditiCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2t as an intrinsic part of the human experience, emerging from internal drive states much like hunger or thirst. This view contributed to a linear, tri-phasic model of sexual response in which it was believed that sexual desire was the initiator of a sequence of phases leading to arousal and subseque Ebook ABC of sexual heath (3E): Part 2ntly orgasm. More recent conceptualizations, however, frame sexual desire as emerging from the experience of sexual arousal. The Incentive MotivationEbook ABC of sexual heath (3E): Part 2
Model proposes that sexual desire directly emerges from, and is difficult to separate from, sexual arousal. In this view, feelings of sexual arousal aCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2esent the awareness of genital changes resulting from sexual stimulation, perhaps combined with a conscious evaluation that the situation is indeed ’sexual', whereas feelings of desire may represent the experience of a willingness to behave in a sexual way.To date, problems with sexual desire and se Ebook ABC of sexual heath (3E): Part 2xual arousal arc no longer considered to be separate sexual problems. In the fifth edition of the Diagnostic and Statistical Manual of Mental DisorderEbook ABC of sexual heath (3E): Part 2
s (DSM-5, 2013), such problems arc classified as 'Sexual Interest/Arousal Disorder' (SIAD). Unlike previous definitions of hypoactivc sexual desire diCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2omen.AetiologySexual desire/arousal is inherently a biopsychosocial experience. Therefore, in cases of low or absent desirc/arousal. the clinician should consider the biological, psychological, sexual and sociocultural influences associated with the change in desire/arousal, and the ongoing factors Ebook ABC of sexual heath (3E): Part 2sustaining the difficulty. A longitudinal perspective in which the clinician considers the predisposing factors (i.e. the events predating the sexualEbook ABC of sexual heath (3E): Part 2
difficulty that may have made a woman vulnerable to developing low desire/arousal). the precipitating factors (ic. those occurring in temporal proximiCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2omprehensive view of the chronology of the problem. It is also important for the clinician to consider the 'protective' factors (ix. those aspects of the womans self or relationship or context that mitigate some of the negative influences on her desire).5960ABC of Sexual HealthTable 15.1 prevalence Ebook ABC of sexual heath (3E): Part 2of low sexual desire in womenStudySample characteristicsPrevalencelaumann er al (1999)1.749 partnered. American women aged 18-5927-32% low desire (disEbook ABC of sexual heath (3E): Part 2
tress not assessed)Fugl-Meyer and Sjogren1.335 Swedish women aged 18-7434% had lew desire (defined as cften/neariy all the tmafall theFugFMeyer(1999)tCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 2d low desire for at least 6 monthsBancroft er al (2003)987 American wcrnen aged 20-657.2% prevalence of low desireOberg efaf. (2004)1.056 Swedish women aged 19-6560% mid tow desxe. 29% manifest lew desirelaumaim er al 12035)9,003 sexually active multinational women aged 40-8026-43%terbium era'. (203 Ebook ABC of sexual heath (3E): Part 26)952 sexually active Amer can surgcally or naturally postmenopausal women aged 20-7024-36% had low desire. Rates of RSDD ranged from 9% to 26%OennersEbook ABC of sexual heath (3E): Part 2
tern et al. (2006)2.467 sexually active European women aged 20-7016-46%. Rates of HSDO ranged from 7% to 16%Wilting eta' (2008)5.463 Finnish women ageCHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 Acade Ebook ABC of sexual heath (3E): Part 21 American women aged 18-10234% had low desire, overall 10% had tow desre and distressMitchel efaf (2009)6.942 British women aged 16-4410.7% reported lack of desire for 6 months or more. 27 9% of those sought help Ebook ABC of sexual heath (3E): Part 2CHAPTER 15Problems of Sexual Desire and Arousal in WomenLori A. Brotto1 and Ellen T.M. Laan21 University of British Columbia. Vancouver, Canada1 AcadeGọi ngay
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