Care of Male and Female Clients with General and Specific Conditions

• Sexual dysfunction


  Difficulty experienced by individual or couple during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm
• Sexual desire disorders


  Lack or absence, for some period of time, of sexual desire or libido for sexual activity
• Sexual arousal disorders


  Previously known as frigidity in women and impotence in men, though these have now been replaced with less judgmental terms
• Erectile dysfunction (ED)


  Sexual dysfunction characterized by the inability to develop or maintain an erection of the penis
• The introduction of the first pharmacologically effective remedy for impotence, Sildenafil (Viagra), in the 1990s caused a wave of public attention, propelled in part by the news-worthiness of stories and heavy advertising
• Premature ejaculation


  Ejaculation occurs before the partner achieves orgasm (<2 minutes from the time of the insertion of the penis), or a mutually satisfactory length of time has passed during intercourse
• Orgasm disorders


  Persistent delays or absence of orgasm following a normal sexual excitement phase in sexual encounters
• Dyspareunia


  Painful intercourse, may be caused by insufficient lubrication in women
• Vaginismus


  Involuntary spasm of the vaginal wall muscles
• Vulvodynia or Vulvar Vestibulitis


  Burning pain during sexual intercourse related to problems with the skin in the vulvar and vaginal areas
• Post-Coital Tristesse (PCT)


  Feeling of melancholy and anxiety after sexual intercourse that lasts for up to two hours
• Sexual Headaches


  Occur in skull & neck during sexual activity, including masturbation, arousal, or orgasm
• Post-orgasmic Illness Syndrome (POIS)


  In men, it causes severe muscle pain throughout the body and other symptoms immediately following ejaculation
• Dhat Syndrome


  In men, it causes anxious and dysphoric mood after sex, but is distinct from the low-mood and concentration problems (acute aphasia)
• There is no known cure or treatment for Dhat Syndrome
• Pelvic floor dysfunction


  The underlying cause of sexual dysfunction in both women and men, treatable by physical therapy
• Infertility


  Inability to conceive & maintain a pregnancy after 12 months (6 months for woman older than 35 years old age) of unprotected sexual intercourse
• Primary infertility


  Infertility in a couple who have never had a child, the absence of live birth for women who desire a child and have been in a union for at least 12 months, during which they have not used any contraceptives
• Secondary infertility


  The failure to conceive following a previous pregnancy, the absence of live birth for women who desire a child and have been in a union for at least 12 months since their last live birth, during which they did not use any contraceptives
• Male causative factors for infertility

  • Endocrine: Pituitary diseases, Pituitary tumors, Hypothalamic diseases, Low levels of luteinizing hormone (LH), Low Follicle-Stimulating Hormone (FSH), Low testosterone
  • Spermatogenesis: Drugs, Infections, Varicocele, Radiation, Chemotherapy, Testicular trauma, Testicular torsion, Cryptorchidism, Genetic disorders
• Infertility may be caused by an infection in the man or woman, but often there is no obvious underlying cause
• Couples where infertility lies with the man

  • In many cultures, the inability to conceive bears a stigma
  • In closed social groups, a degree of rejection (or a sense of being rejected by the couple) may cause considerable anxiety and disappointment
• Causes of infertility


  • One third - are related to female factors alone
  • One third - to male factors alone
  • One third - to a combination of male and female factors
• Categories of male causative factors

  • Endocrine
  • Spermatogenesis
  • Sperm antibodies
  • Sperm transport factor
  • Disorders of intercourse
• Endocrine


  • Pituitary diseases
  • Pituitary tumors
  • Hypothalamic diseases
  • Low levels of luteinizing hormone (LH)
  • Low Follicle-Stimulating Hormone (FSH)
  • Low testosterone can decrease sperm production
• Spermatogenesis


  • The process in which mature functional sperm are formed
  • Several factors that can affect the development of mature sperm - also referred to as gonadotoxins
• Gonadotoxins


  • Drugs (e.g., chemotherapeutics, calcium channel blockers, heroin, alcohol, and nicotine)
  • Infections (e.g., prostatitis, sexually transmitted illnesses, and contracting mumps after puberty)
  • Systemic illness
  • Heat exposure: Prolonged heat exposure of testicles (e.g., use of hot tubs, wearing tight underwear, frequent bicycle riding)
  • Pesticides
  • Radiation to the pelvic region
• Sperm antibodies


  • An immunological reaction against the sperm that causes a decrease in sperm motility (movement of sperm)
  • Common after vasectomy reversal or testicular trauma
  • Antisperm Antibody (ASA) has been considered as an infertility cause in around 10–30% of infertile couples
  • In both men and women, ASA production is directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence on the implantation process, and impaired growth and development of the embryo
• Sperm transport factor


  Related to anatomy that might be missing or blocked, thus interfering with the transportation of sperm
• Causes of sperm transport factor

  • Vasectomy
  • Prostatectomy
  • Inguinal hernia
  • Congenital absence of the vas deferens
• Disorders of intercourse


  • Erectile dysfunction
  • Ejaculatory dysfunctions
  • Anatomical abnormalities
  • Psychosocial factors
• Erectile dysfunction


  Inability to achieve and/or maintain an erection
• Ejaculatory dysfunctions


  Retrograde ejaculation
• Psychosocial factors


  That can interfere with fertility
• Categories of female causative factors

  • Ovulatory dysfunction
  • Tubal and pelvic pathology
  • Cervical mucus factors
• Ovulatory dysfunction

  • Includes an ovulation or inconsistent ovulation
  • Affect 15%–25% of couples experiencing infertility and have a very high success rate with appropriate treatment
• Tubal and pelvic pathology

  • Damage to the fallopian tubes - related to previous (PID) pelvic inflammatory disease or endometriosis
  • Uterine fibroids - benign growths of the muscular wall of the uterus, which can cause a narrowing of the uterine cavity & interfere with embryonic & fetal development, causing a spontaneous abortion
• Cervical mucus factors


  • Cervical surgeries such as cryotherapy a medical intervention used to treat cervical dysplasia
  • Infection
• Risk factors for women infertility

  • Autoimmune disorders
  • Diabetes
  • Eating disorders or poor nutrition
  • Excessive alcohol drinking
  • Excessive exercising
  • Obesity
  • Older age
  • Sexually transmitted infections
• Risk factors for men infertility

  • Environmental pollutants
  • Heavy use of alcohol, marijuana, or cocaine
  • Impotence
  • Older age
  • Sexually Transmitted Infections
  • Smoking