Dec. 1 Life @ MCO Report

Didactic Materials

• Female Sexual Interest/Arousal Disorder
  • Lack of, or significantly reduced, sexual interest, as manifested by at least three of the following:
    • Absent/reduced interest in sexual activity 
    • Absent/reduced sexual/erotic thoughts or fantasies
    • Absent/reduced sexual excitement/pleasure during sexual activity
    • No/reduced initiation of sexual activity
    • Absent/reduced sexual interest in response to any internal or external sexual/erotic cues (written, verbal, or visual)
    • Absent/reduced genital or non–genital sensations during sexual activity
  • Symptoms have persisted for at least 6 months
  • Symptoms cause clinically significant distress in the individual
  • Sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other stressors or substance/medication or other medical issues.
  • Specify whether:
    • Lifelong
    • Acquired
  • Specify whether:
    • Generalized
    • Situational
  • Specify current severity
    • Mild
    • Moderate
    • Severe
• Male Hypoactive Sexual desire disorder
  • Persistently or recurrently deficient sexual/erotic thoughts or fantasies and desire for sexual activity. 
  • Symptoms have persisted for at least 6 months
  • Symptoms cause clinically significant distress in the individual
  • Sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other stressors or substance/medication or other medical issues.
  • Specify whether:
    • Lifelong
    • Acquired
  • Specify whether:
    • Generalized
    • Situational
  • Specify current severity
    • Mild
    • Moderate
    • Severe

• If I never had sex again I’d be fine
• Why can’t we just connect emotionally
• Sex is just for men
• It’s my job/ my wifely duty
• I’m not a sexual person 
• My husband is a pervert
• I’m grossed out by his arousal or sex 
• Sex is messy 
• It takes too much effort 
• I don’t have sexual thoughts/I don’t ever think about it 
• I feel normal- that no wife they know wants sex 
• My body just doesn’t work 

• The underlying stress in the relationship must be resolved before anticipation of sexual activity with husband can be elicited – Penner’s 

• When women experience conflict about being sexual, it may be because rigid anti-sexual teaching, pass sexual trauma, or ambivalence about being out of control and vulnerable with a man- Penner’s 
• – Rigid Anti-Sexual Teaching: most often associated with religion, where women aren’t given permission to enjoy and express their sexuality or receive sexual pleasure (purity culture, extreme modesty teaching, abstinence curriculum, scare tactics, loud silences around sexuality, etc.)
• – Sexual trauma: Many adult women have had at least one sexual experience that left them confused, guilty or traumatized. They usually blame themselves for these events, and thus feel badly about themselves sexually -Penner’s (Molestation, Incest, assault, early exposure to sexually explicit content, guilt about masturbating or fantasizing, etc.) 
• – Sexual ambivalence: this is a persistent avoidance of sex, these women often come from chaotic, dysfunctional homes. Their bodies may respond sexually, however, pre and post times of sexual intimacy anything sexual is aggressively avoided or can be experienced as dormant. Sexual ambivalence can be challenging for husbands to understand because their wive’s bodies respond well during intercourse. 

• – Lack of bonding in infancy: Decrease or absence of bonding in infancy can lead to a fear of expressing and receiving intimacy 
• – Sexual trauma: Negative feelings associated with themselves and sexuality, guilt/shame/humiliation for example (effects men in the same way it effects women) 
• – Rigid Anti-Sexual Teaching: most often associated with religion, where men aren’t given permission to enjoy and express their sexuality or receive sexual pleasure (purity culture, extreme modesty teaching, abstinence curriculum, scare tactics, loud silences around sexuality, etc.)
• – Controlling, male deprecating mother: “If a boy grew up in a home with a mother that totally usurped any of his sense of power and independence as he was developing, he will be very hesitant to allow himself to be open and vulnerable with a woman. Having sex with his wife may elicit an overwhelming sense of panic at being swallowed up or being controlled.” -Penner’s
• – Homosexually Oriented Male: if a man is attracted to men, even if never expressed, will make it difficult for him to respond positively to sex with a women or his wife (this is not our area of expertise and would likely need to refer)

• It takes too long to get there
• My mind is always distracted
• I don’t know what feels good 
• It’s embarrassing to say what feels good 
• My desire/excitement build with no orgasm 
• My orgasms are weak (if at all)
• I used to be able to orgasm, why can’t I now 

• Something in the past has made it difficult to make a positive association with sexuality and themselves. They must learn how to give themselves permission to be sexual, connect sexual feelings to somatic experience, remove pressure to please, and learn to respond to their bodies and pursue sexual pleasure so that arousal can be achieved. 

•  – Lack of understanding of how to properly stimulate her body to arousal by herself and her husband. Unfortunately female arousal is more complicated than male arousal and is not often pursued as a priority. And when properly stimulated is discovered, her body will respond. 

• – Causes of Erectile Dysfunction:
  • – Anxiety: performance fear due to a past experience and preoccupation with recurrence, or another new negative experience. Anxiety increases with each failure. 
    • Negative experiences– premature or delay ejaculation, fear of rejection, etc. 
  • – Physical Factors: erection is a vascular response, so any type of blood flow issues can cause ED, hormonal imbalances, diabetes, medication side effects, addiction, smoking.