Sexuality Over The Life Span

 Infancy and childhood  Adolescence  Early adulthood  Middle adulthood  Late adulthood

Infancy and Childhood

 Psychosexual development begins in infancy (how we should feel)  It begins with loving touch and handling by parents and others (this helps develop the ability to love)

Infancy and Childhood

 Sex play – Mommy & Daddy – Dr. And patient  Infants and young children can have orgasm and be sexually aroused

Masturbation What Should We Teach Children?

 Pleasure from self-stimulation is normal and acceptable (Feitel, 1990)  Something we do in private  Some people are uncomfortable with masturbation  Proper names for genitals  What genitals are for

Sexuality In Adolescence

 Puberty (biological stage) – Ability to reproduce  Adolescence (culturally determined)  Still learning gender roles and social roles  Still learning sexual scripts  Still struggling to understand feelings and sexual orientation

Gay and Lesbian Adolescents

 Some gay men and lesbians report that they began to be aware of their “difference” in middle or late childhood  “Feminine” preferences not predictive for gay men  Non “masculine” preferences is more predictive for gay men

Gay and Lesbian Adolescents

 Gay and lesbian teens are “invisible to society  More suicide attempts than other teens  Bisexual teens are faced with the same problems as gay and lesbian teens  Coming out helps teens with psychological adjustment

Gay and Lesbian Adolescents

 Gay, lesbian and bisexual teens of color face more formidable issues than do white teens  Often a choice is made between what is more important ethnic identification or sexual orientation  May need to choose one identity over the other

Masturbation

 Chances are good it will start in adolescents if it has not started before  Hormonal and physical changes of puberty play a major role  Less common among African Americans and Latinos than whites  More common among males than females

Normal Sequence of Sexual Behaviors

 Hand-holding  Embracing  Kissing  Fondling  Petting  Intercourse – Miller, Christopherson, & King, (1993)

Normal Sequence of Sexual Behaviors (White Teens)

– Smith & Udry, (1985)  Necking  Feeling breasts through clothes  Felling breasts directly  Felling female genitals  Felling penis directly  Intercourse

Normal Sequence of Sexual Behaviors (Black Teens)

 Sequence not predictable  Example: more African American adolescents had experienced intercourse than had engaged in unclothed petting involving either the breasts or the genitals

Commitment to the Relationship

 Commitment is cited as a reason for sexual intimacy more often than love  Emotional involvement is also cited more often than love

Kissing

 One of the first expression of sexual intimacy  Unforgettable experience  Helps teens to become comfortable with physical closeness  Helps teens to become comfortable with giving and receiving sexual pleasure

Oral Sex

 This is not

talking

about sex  Among heterosexual, lesbians, and gay  Has become increasingly frequent in recent years  Gaining acceptability in the culture at large  Cunnilingus most common form of

reported

students sex among junior high school

Junior High School Students

– Newcomer & Udry, (1985)  Cunnilingus most common form of

reported

sex among junior high school students  Girls: more had given or received oral sex than had engaged in intercourse:  Boys: more had engaged in intercourse than had given or received oral sex

Sex Education

 70% of public school children get some sex education before graduation  17 states require sex education  30 states recommend sex education  Most Americans favor sex education  Often discussions about desire, pleasure, or sexual entitlement are missing from classes

Early Adulthood

 Establishing sexual orientation  Integrating love and sex  Forging intimacy and making commitments  Making fertility/childbearing decisions  Practicing safer sex to protect against sexually transmitted diseases  Evolving a sexual philosophy

Sexual Orientation

 Starts in childhood and adolescents with experimentation  Experimentation is not always associated with sexual orientation  In early adulthood one will associate activities with sexual orientation

Integrating Love and Sex

 Men are from Mars Women are from Venus Gender roles call for  Men to be sex oriented  Women to be love oriented  Instead of polarizing love and sex people need to develop ways of uniting them

Forging Intimacy and Making Commitments

 Increased sexual experience  Relationships become more meaningful  Intimacy and interdependence increases  As intimacy increases commitment ability also needs to develop

Fertility and Childbearing Decisions

 Childbearing is increasingly more expected in young adulthood (20’s) especially for married people  Often these issues are left up to chance  Single young adults need to address these issues

Safer Sex

 Will be covered in a special class  Needs to be integrated in to communication, values, and behaviors of all young adults

Sexual Philosophy

 Moral standards now based on personal principles of right and wrong, caring, and responsibility not on authority  Place sexuality within the larger framework of their lives and relationships  Integrate personal, religious, spiritual, and or humanistic values with their sexuality

Older Adults

 Health is the single most significant factor affecting sexuality of older adults

Sexual Enhancement and Therapy

Rik Papagolos, RN

Sexual Enhancement

 THE QUALITY OF OUR SEXUALITY is intimately connected to the quality of our lives and relationships.

 The widespread variability in our sexual functioning suggests how "normal" at least occasional sexual difficulties are.

Sexual Enhancement

 Improving the quality of one's sexual relationship is referred to as

sexual enhancement.

 Zilbergeld (1992) suggests that there are six requirements for what he calls "great sex." They form the basis sexual-enhancement programs: of many

Six Requirements for "Great Sex."

 1. Accurate information about sexuality, especially your own and your partner's  2. An orientation toward sex based on pleasure, such as arousal, fun, love, and lust, rather than performance and orgasm  3. Being involved in a relationship that allows each person's sexuality to flourish  4. An ability to communicate verbally and nonverbally about sex, feelings, and relationships

Six Requirements for "Great Sex."

 5. Being equally assertive and sensitive about your own sexual needs and those of your partner  6. Accepting, understanding, and appreciating differences between partners

Self-Awareness

 Being aware of your own sexual needs is often critical to enhancing your sexuality. 

What is good sex

?

 "Sexually in charge" man.

 "Sexual, but not too sexual" woman.  We follow the scripts and stereotypes we have been socialized to accept. . .

What Is Good Sex

 Ellison (1985) writes that you will know you are having good sex if you feel good about yourself, your partner, your relationship, and what you're doing. It's good sex if, after a while, you still feel good about yourself, your partner, your relationship, and what you did. Good sex does not necessarily include orgasm or intercourse. It can be kissing, holding, masturbating, oral sex, anal sex, and so on. It can be heterosexual, gay, lesbian, or bisexual.

Discovering Your Conditions for Good Sex

 Feeling intimate with your partner.

– Intimacy is often important for both men and women, despite stereotypes of men wanting only sex.

 Feeling sexually capable.

– An absence of anxieties about sexual performance.

Discovering Your Conditions for Good Sex

 Feeling trust.

– Emotionally safe with their partner.

 Feeling aroused.

– Simply because your partner wants to be sexual does not mean that you have to be.

 Feeling physically and mentally alert.

– Not be excessively under the influence of alcohol or drugs.

Discovering Your Conditions for Good Sex

 Feeling positive about the environment and situation.

– Each needs to feel that the other is sexually interested and wants to be sexually involved.

Intensifying Erotic Pleasure



Sexual Arousal

sexual arousal refers to the physiological responses, fantasies, and desires associated with sexual anticipation and sexual activity.

 The first element in increasing sexual arousal is having your conditions for good sex met.

Alternatives to Intercourse

 Waiting, delays, and obstacles may intensify arousal.

– Absence makes the heart grow fonder.

Alternatives to Intercourse

 Barbach (1982), JoAnn Loulan (1984), and Zilbergeld (1992) suggest the following activities, among others:  Sit or lie down close to each other . . .  Bathe or shower with your partner . . .  Give and receive a sensual, erotic massage . . .  Use your lips, tongue, and mouth to explore your partner's body . . .  "Dirty dance" together . . .

Sexual Disorders And Dysfunctions

 Sexual disorders and dysfunctions refer to difficulties individuals experience in their sexual functioning.  Heterosexuals, gay men, and lesbians experience similar kinds of sexual problems.

Sexual Dysfunctions



Sexual dysfunctions

are generally defined as impaired physiological responses that prevent individuals from functioning sexually, such as.

 Erectile difficulties or absence of orgasm.

Sexual Dysfunctions

 Include: –

Erectile dysfunction

, the inability to have or maintain erection; (Impotence).

–

Premature ejaculation

, the inability to delay ejaculation; –

Inhibited ejaculation

, the inability to ejaculate; And.

–

Delayed ejaculation

, prolonged delay in ejaculating.

Sexual Dysfunctions

 Common dysfunctions among women include: –

Anorgasmia

, the absence of orgasm; (Orgasmic dysfunction).

–

Vaginismus

, the tightening of the vaginal muscles, prohibiting penetration; And.

–

Dyspareunia

, painful intercourse.

Sexual Disorders

 Include such problems as.

 Hypoactive sexual desire (HSD).

– Low or absent sexual desire.

 Depression is one significant cause.

 In addition, stress, traumatic marital separation or divorce, loss of work, and forced retirement are frequently associated with HSD.

 Drugs, hormone deficiency, and illness also decrease desire.

Sexual Disorders

 Sexual aversion.

– A consistently phobic response to sexual activities or the idea of such activities.

 It is often confused with hypoactive desire.

Sexual Disorders

 Because avoidance often manifests itself as a lack of interest in sexual matters.

 Closer examination, however, may show that the lack of desire is a defense against anxiety causing situations, such as intimacy or touch (Ponticas, 1992).  More women than men experience sexual aversion.

Sexual Disorders

 Disorders are similar to sexual dysfunctions insofar as they limit an individual's ability to be sexual.

 But properly speaking, disorders affect the brain's arousal capabilities rather than physiological responses.

Physical Causes Of Sexual Dysfunctions

 Until recently, researchers believed that most sexual dysfunction was psychological in origin.

 Current research challenges this view.

 The subtle influences of hormones. Our vascular, neurological, and endocrine systems are sensitive to changes and disruptions.

 As a result, various illnesses may have an adverse effect on our sexuality.

Physical Causes Of Sexual Dysfunctions

 Some prescription drugs, such as medication for:  Hypertension or for depression.

– May affect sexual responsiveness.

 Chemotherapy and radiation treatment for cancer.

– Affect sexual desire and responsiveness.

Physical Causes Of Sexual Dysfunctions

 Physical causes in men  Diabetes and alcoholism are the two leading causes of erectile dysfunctions – Diabetes:  As many as 1 million men, diabetes damages blood vessels and nerves, including those within the penis – Alcoholism, smoking, and drug use are widely associated with sexual dysfunctions

Priapism

 Prolonged and painful erection, occurring when blood is unable to drain from the penis.

 Lasting from several hours up to a few days.

 This problem is not associated with sexual thoughts or activities.

– Rather, it results from certain medications, including some antidepressants and excessive doses of penile injections. Certain medical conditions, such as sickle-cell disease and leukemia, may also cause priapism.

Physical Causes in Women

 Organic causes of anorgasmia. In women include:  Diabetes.

 Heart disease.

 Hormone deficiencies.

Physical Causes in Women

 Neurological disorders.

 Drug use and alcoholism.

 Spinal cord injuries may affect sexual responsiveness.

 Multiple sclerosis can decrease vaginal lubrication and sexual response.

Physical Causes in Women

 Dyspareunia:  May result from an obstructed or thick hymen.

 Clitoral adhesions.

 A constrictive clitoral hood.

 Weak pubococcygeus, – The pelvic floor muscle surrounding the urethra and, in women, the vagina.

Physical Causes in Women

 Antihistamines used to treat colds and allergies and marijuana, may reduce vaginal lubrication.

 Endometriosis and ovarian and uterine tumors and cysts may affect a woman's sexual response.

 The skin covering the clitoris can become infected.

Physical Causes in Women

 Women who masturbate too vigorously can irritate their clitoris, making intercourse painful.

 Men can stimulate their partners too roughly, causing soreness in the vagina, urethra, or clitoral area.

 Dirty hands may cause a vaginal or urinary tract infection.

Treatment of Physical Problems

 Sexual dysfunctions are often a combination of physical and psychological problems (LoPiccolo, 1991).

 Thus, treatment for organically based dysfunctions may need to include psychological counseling.

 Women.

– Lubricants or hormone replacement therapy.

Treatment of Physical Problems

 Most medical and surgical treatment for men centers on erectile dysfunctions. Often these problems are due to illnesses or injuries that impair the vascular system, affecting penile vasocongestion. Microsurgery may correct the blood flow problem, but it is not always successful

Treatment of Physical Problems

 Suction devices may be used to induce and maintain an erection.

 A vacuum chamber is placed over the flaccid penis and the air suctioned out, causing blood to be drawn into the penis.

Treatment of Physical Problems

 Erections may also be assisted by implanting a penile prosthesis.

– One type consists of a pair of semi rigid rods embedded in the cavernous bodies of the penis.

– The second type is an inflatable implant that permits the penis to be either erect or flaccid.

 Suppositories, injections, and more recently, oral medications have become the treatment of choice for many men with erectile dysfunction.

Psychological Causes Of Sexual Dysfunctions

 Including fatigue, stress, ineffective sexual behavior, and sexual anxieties.