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1

Estrogen

Makes the brain and the body receptive for the influence of testosterone

a reduction iof estrigen leads to vaginal dryness=> painful

2

tetsosterone

Testosterone makes the brain and genitals ready for sex

testosterone is more. important teh strogen in influencing female sexual arousability , sex drive and activity

3

Biopsychosocial model

• Sex = interplay between body, mind and context

4

Sexual response cycle Masters Johnsons

1) Arousal
2) Plateau: high arousal that may be maintained for some time, from several minutes to several hours
3) Orgasm: subjective experience of intense pleasure and release at sexual climax, as well as the accompanying physiological processes
4) Recovery: physiological signs of arousal reverse themselves

5

kaplan

Desire  Arousal/excitement  OrgasmRecovery

6

critique of sexual resspinse cycles

• Sometimes arousal goes down and up and down again  not linear
• Ignore major components of women’s sexual satisfaction: trust, intimacy, the ability to be vulnerable, respect, communication, affection, and pleasure from sensual touching

7

Coolidge effect

animal males who have just mated will mate again more promptly if presented with a novel female

8

sexual arousability

the capacity of the sexual system to react at sexual stimuli
=> Depends on an intact sexual response system and is mediated by hormones (testosteron) and neurotransmitters (dopamine, serotonine)

9

sex hormones

Sex hormones do not influence the sexual response in itself, but determine how responsive the sexual system is, at the central as well as pheripheral level

10

estrogen

Have an effect on mood
=> Have an effect on external features of a?ractiveness
Have no direct effect on the sexual system
=> Makes the brain and the body receptive for the influence of testosteron

11

role of androgens: Testosterone

Facilitates sexual responsitivity, arousability
Facilitates sexual thoughts and fantasies

Facilitates nightly genital responses

Influences genital sensitivity
=> Testosterone makes the brain and genitals ready for sex

12

sexual responses in c hildren

Sexual sensations are present from birth, but need to further develop
=> explore their own body and feelings, relational and sexual meaning comes later

Genital responses in children are elicited by: – Direct genital stimulation
– Emotions

From 2years: repetitive behavior to elicit pleasant sensations =auto-erotic behavior

Do NOT forbid or punish

do not disapprove but set rules for time and place

13

Preconditions for healthy sexual development

affection: love, security, emotional closeness

Positive examples of relational behavior: parents are examples

Positive messages about sexuality

Opportunities to practice with sexuality: age-specific consensual sexually exploratory play

Intact development of genitals, hormones, and genderidentity

love-map ( 6-8) years - map of sexual ideas , wishes , expectations

14

talking with a child about sex and relationships: What can you gain?

Learning a child to talk about sexuality increases the chance that (s)he will seek help in case of sexual problems

By treating the child as an equal conversation partner, you can increase their self-worth

U You stay informed about the sexual knowledge and development of your child

U Facilitates a warm family context => preventive against sexual problems and sexually unhealthy behavior during puberty

=> Decreased risk on sexual problems, more sexual satissfaction, more self-confidence, start with intercourse at later age, more safe sex, less coercive sex, more open and positve attitudes regarding sexuality

15

sexual behavior in preubal children

Gradually (progressive) => step by step: boys 73%, girls 76%
=> higher chance of safe sex behavior

‘Jump style’ (non-linear): more frequently in adolescents with lower educational level or immigrants
=> lack of opportunites and skills to plan or postpone early sexual experiences => higher chance of sexual incompetence

16

emotional motivational framework dewitte)

differentiales between men and woman

men have high concordance between subjective & genital arousal

women have low

17

sexual desire

Mental proces: external (visual) or internal (fantasie) Active (spontaneous) sexual desire

Feeling desire by doing it Responsive sexual desire

Men and women differ
The sexual response starts automatically and occurs at the moment the sexual memory labels a stimulus as sexual

Subjective sexual desire results from a positive cognitive elaboration on the awareness of physical, genital responding (= arousability)

18

sexual desire

sexual responsivity (arousability) + sexual motivation ( incentive motivation leading to ongoing sexual responses)

19

recovery

takes longer in men
increases with age

20

Basson (2002):

Women have a lower biological urge => role of testosterone?
– Other motives to have seks?
– Women are less aware of their genital arousal responses => dissociation between subjective and genital arousal
– Orgasm varies across women

21

islam culture

Encourage sex during marriage => enjoying sex

Sex is part of marital obligation

sexual problems caused by lack of knowledge & experience ( women don't mastruvbate)

22

feedback loop of female hormones

brain => pituitary gland=> ovaries

1. hypthalamus releases gonadotropin-releasing hormone (GnRH) to pituitary gland
2. in oituitary gland GnRH activates scretion of FSH & LH
3. the enter the blood and target ovaries. Fh stimulates the developemnt of ovarian follicels & LH ovulation itself
4. ovarian hormones go to hypothalamus and pituitary glands and start the whole process again

this feedback loop ius inhibitory at low estrogen levels but switches to stimulation at high levels( when ovulation is supposed to happen)

23

effects of hormonal contraceptives on sexual function

have been inadequately studied remain controversial

hormonal contraception have been found to have a reducing effect on lubrication
also increasing evidence suggest HC to influence female perception of partner attractiveness with weaker preference for genetic fitness

24

asexuality

still experience romantic attraction but no desire to express with physical sex

25

sexual arousal

acute psychological state of excitement , also marked by changes in geneitalia (psychological & physiological usesually go together but not alsways)

sexual arousal might be triggered by external event but asl o might stem completely from within ( sponatanous)

anetrior cingulate cortex involde=> happy states

26

sexual attraction in women is more fluid

women are mostly equally aroused by man & woman

27

sexual ideation & behaviour ...

increses testosteron levels


buut testosterone levels do influence aroudability in adult men ( testosterone replacement therapy to restore diminished sexual desire)

but in healthy men testosterone levels don't make a difference in sexual behaviour

28

orgasm men

men = midline of brian (thalamus & nearby strcuture)
contains many dopaminergic neurosn
cereberal cortex activity decreses

oxytocin release

men experience a refarctory period 30-90 minutes

29

orgasm women

cc activity decreses
nucleus accumbens=> reward& pleasure

oxytocin release

30

critique masters & Johnson

teh. odel primarily dwscribes physiological processes , effecst one can obserev or measure ( Like an erection or changes in blood presuure)


BUT DO PHYSIOLOGIACL RWSPONSES ALWAYS MATCH psychological / subjective arousal

in men tehy seem to be tied togetehr
but woem do not always seem sexually excited when tehir genitals are showing sognals of arousal ( potential disconnect between physicological & psychological )


also sexual desire is not mentioned ( the state that precedes arousal)- we want to engage in sex so we do something that makes us aroused ( kaplaN)

woemn also engage in sex not only because of sexual desire but maybve becsue wish of intamacy or other bebfits => but once engaged in physical interaction sexual aroual is triggerd & genital sensation might reinforce sexual desire

was based on a subset of women who were willing to be observed in a lab setting and wre orgasmic with intercourse