HUMAN SEXUALITY

What is Normal Sexuality?

… perception of being male or
female and all those thoughts,
feelings, behaviours, connected
with sexual gratification and
reproduction, including the
attraction of one person to
another

involves feelings of desire,

behavior that brings pleasure
to oneself and one’s partner….
Devoid of guilt or anxiety…
and not compulsive
 Human Sexuality
• Expression of sexual sensation and
intimacy between persons
• Expression of identity through sex
• Comprises a broad range of behavior and
processes
 Human Sexuality
• Determined by anatomy, physiology,
psychology, culture, relationship with others,
and developmental experiences

SEXUALITY PERSONALITY

PSYCHOSEXUAL
Physiological Aspects of Human
Sexuality
• Influenced by hormonal changes during
pregnancy/ genetic predisposition
• Sexual Dysfunction:
– libido diminution
– erectile dysfunction
 Social Aspects of Human
Sexuality
• Governed by rules of behavior and status
quo
• Influenced by social norms and vice
versa
– Example: gender identity
 Psychological Aspects of Human
Sexuality
Sexual Identity
• Gender Identity
• Orientation
• Intention
Sexual Function
• Sexual Desire
• Sexual Arousal
• Orgasm
Sexual Satisfaction
 Gender Identity
• Sense of self as
masculine or feminine
• Gender in which a
person identifies
• Gender that other
people attribute to the
individual on the
basis of gender role
• Is affected by a variety
of social structures
 Gender Identity and Sexual
Identity
• Majority it is
congruent
• Human
beings are
cisgendere
d based
on their
biological
sex
• Gender is social and
sex is biological
 Gender Role
• Usually related to and derived from gender
identity
• Includes all disclosures of a person as
having the status of a man or a woman
 Sexual Orientation
• Describes the direction of an individual’s
sexuality
• AKA: sexual preference
• Markers:
– Self-labelling
– Actual sexual behavior
– Sexual fantasy
– Erotic arousal pattern
 Sexual Orientation
• “dynamic and multi-variable process”
Klein, 1985 “The Bisexual Option”
 Sexual Orientation and Mental
Illness
• Psychiatric disorders were more prevalent
among homosexually active people
– Depression/ anxiety
– Suicide
– Substance abuse (alcohol/ smoking)
• Sense of alienation predisposes them to
mental illness
 Sexual Intention
• What a person wants to do to his/ her partner
during the sexual behavior and what is done to
him or her

Sexual Desire
• Interest that a person experiences
– Drive – biological aspects
– Motive – psychological aspects
– Wish – social aspects
 Sexual Arousal
• The emotion of sexual excitement based on
pelvic vasocongestion and autonomic arousal

Orgasm
• Stimulated by high levels of arousal that
results to brief, intense pleasure and
release of pelvic congestion
 Sexual Satisfaction
• Private judgment that sexual behavior is
pleasurable
 Factors Affecting Sexuality
A. Developmental Considerations
-sexuality is the only distinguishing trait
present at conception
-gender, or sex, influences behavior
throughout life
Stages: Birth – 12 yrs = gender related
By 3 yrs. = gender identity
- obtain pleasure from
touching/fondling genitals
- toys are gender related
- able to identify own gender
Preschooler = increased awareness of body parts
- sexuality has been internalized and
preference for sexual partners determined
- enjoys exploring body parts of self and
playmates
- engages in masturbation

School Aged = gender role behaviors

- tendency toward having same-sex
friends
- increasing self-awareness
Adolescence = need information regarding
changes; information obtained based on myths
- develop opposite-sex relationships
- masturbation is common
- girls concerned w/reputations and
self-image
- become “hippy” and w/small waist
- boys preoccupied w/competitiveness
of sexual activity
- increase in testes size and they drop
further into place
- increased perspirations and vaginal
secretions
Young / Middle Adulthood = premarital sex
is common
-may experiment w/various sexual
expressions
-develop own value system and respects
values of others
-women are in “childbearing” mode and
searching for a mate; become
menopausal w/an increased sex drive
-men begin graying, having decreased
ejaculations and sex drive
Older Adulthood = orgasms may
become shorter and less intense
in both sexes
-vaginal secretions decrease and period of
resolution in men lengthens
- fear loss of sexual abilities
B. Culture
- every culture has its own norms dictating duration
of sexual intercourse, methods of sexual
stimulation and sexual positions
- some cultures promote childhood sexual play,
polygamy/monogamy, and puberty rites including
male circumcision
- religious beliefs promote beliefs on premarital /
extramarital coitus, homosexuality, and decisions on
circumcision (male and female)
C. Religion
- some view organized religion as having a generally
negative effect on expression of sexuality
- sexual expression other than male-female coitus
are considered unnatural by some
- concept of virginity came to be synonymous with
purity, and sex became synonymous with sin
- double standards and rigid regulations exists in
many religions
- sexual dysfunctions can be related to anguish over
negative connotation of sex dictated by religion
- many have recognized the importance of sold sex
education w/in the realm of church
- new interest in spirituality of marriage, supporting
the intimate/sexual relationship of married couples
- provides guidelines
D. Ethics
- healthy sexuality depends on freedom from
guilt and anxiety
- what one views bizarre, perverted or wrong
may be natural and right to another
- if sexual expression is performed by
consenting adults, is not harmful to them and
is practiced in privacy, it is not considered a
deviant behavior
- many accept sexual expression of various
forms
E. Lifestyle
-both men and women are exposed to stress, and
many are under considerable strain to perform and
function in workplace as well as at home
-stressors may be external (job, financial demands)
or internal (competitive)
-although some couples view sexual activity as a
release from stressors of everyday life, most place
sex far from the top of the list of things to do
-crucial for relationships to set aside priority time - -
if not for lovemaking, then for intimate,quiet contact
-sexual expressions from heterosexual,
homosexual, bisexual, and transsexual
F. Health State
1. Chronic Pain
2. diabetes
3. cardiovascul
ar diseases
4. Diseases of
Joints and
Mobility
5. Surgery and
7. Mental Illness
8. Sexually Transmitted Disease

G. Medications
- some meds have side effects that affect sexual
functioning
- some people use illegal drugs because of their
reputed ability to heighten sexual experience,
but can have serious and even deadly side
effects
 Sexual Dysfunction
Men – erectile failure (impotence) = history of
diabetes, spinal cord trauma, cardiovascular disease,
surgical procedure, alcoholism
- use of antihypertensions, antidepressants, or
illicit drugs
- mental depression that may be present
premature ejaculation = pt defines dysfunction and
ability to control
- causative relationship factors like anxiety,
guilt, lack of time, new partner
retarded ejaculation = history of
neurologic disorders, Parkinson’s disease,
certain meds
Women – inhibited sexual desire = use of
oral contraceptives or hormonal therapy,
alcohol or certain meds
- history of sexual abuse, rape or incest,
depression, or other sexual dysfunctions
orgasmic dysfunction =
communication pattern between pt and
partner
- usual sexual pattern and behavior
• dyspareunia = history of diabetes,
hormonal imbalance, vaginal infection,
endometriosis, urethritis, cervisitis or rectal
lesions
- use of antihistamines, alcohol,
tranquilizers, or illicit drugs
- ability for vaginal lubrication
during sex
- use of coital positions
- use of cosmetic or chemical irritants to
genitals
• vaginismus = pattern of sexual activity
(how often, level of arousal, orgasm)
- presence of other sexual
dysfunctions
- history of sexual abuse,
trauma or rape
- feelings regarding
partner
- causative factors (fear of
pregnancy, anxiety, guilt)
The Sexual
Response
Cycle
 The sexual response cycle refers to
the sequence of physical and emotional
changes that occur as a person
becomes sexually aroused and
participates in sexually stimulating
activities, including intercourse and
masturbation. Knowing how your body
responds during each phase of the
cycle can enhance your relationship
and help you pinpoint the cause of
sexual dysfunction.
The Phases of the Sexual
Response Cycle
• Phase 1: Excitement
• Phase 2: Plateau
• Phase 3: Orgasmic
• Phase 4: Resolution
Human sexual response cycle
 Normal Sexual Behavior
• Sexual response is a true psychophysiological
experience
• There is….
– Arousal
– Experience of tension
– Orgasm
• Four phase response cycle in relation to
stimulation
– Phase 1: Desire
– Phase 2: Excitement
– Phase 3: Orgasm
– Phase 4: Resolution
 Physiologic Changes
Associated with the Sexual
Response Cycle
 Phase 1: Excitement
The excitement phase (also known as the
arousal phase or initial excitement phase) is
the first stage of the human sexual response
cycle. It occurs as the result of any erotic
physical or mental stimulation, such as kissing,
petting, or viewing erotic images, that lead to
sexual arousal. During the excitement stage, the
body prepares for coitus, or sexual intercourse.
 Four Phase Response Cycle
• Phase 1: Desire
– Motivation, drives, and personality towards
the love object
– Sexual fantasies and desire to have sexual
activity
 Phase 1: Excitement
Signs Present in Both Signs Present In Males Signs Present In
Sexes Only Females Only
 Increased muscle  Penile erection  Enlargement of the
tension  Tensing, thickening, clitoral glands
 Moderate increase in and elevation of  Vaginal lubrication
heart rate, the scrotum  Widening and
respiration, and blood  Partial elevation and lengthening of the
pressure increase in size of vaginal barrel
 Sex flush (less testicles  Separation and
prevalent in men than flattening of the labia
in women; present in majora
75% of women)  Reddening of the
 Nipple erection ( 60% labia minora and
of men and most of vaginal wall
women)  Breast enlargement
and enlarge
areolae
 Phase 2: Plateau
The period during which sexual
tension increases to levels nearing
orgasm, may last from 30 seconds to
3 minutes
 Four Phase Response Cycle
•Phase 2: Excitement
–Subjective sense of pleasure from
•Psychological stimulation (fantasy, presence of the love object)
•Physiological stimulation (Stroking or kissing)
•Combination of both
Male
-Lasts several minutes to several hours
-Penile tumescence (increase in diameter/
length)
-Tightening & lifting of the scrotal sac and
elevation of the testes; 50% increase in the
size of the testes
-2-3 drops of mucoid fluid that contain viable
sperm are secreted at the height of
excitement
-Increase in heartbeat and respiration rates
-Heightened excitement lasts 30 secs to
several minutes
Female
-Lasts several minutes to several hours
-Vaginal lubrication, nipple erection
-Clitoral enlargement, thickening of the labia
minora
-Increase in breast size (25%)
-Vaginal color change to dark purple; vaginal
transudate appears 10-30 secs after arousal
-Labia minora changes color to bright and
deep red
-Increase in the heartbeat and respiration
rates
-Heightened excitement lasts 30 secs to
several hours
 Phase 2: Plateau
Signs Present in Both Signs Present In Males Only
Sexes
 Increased voluntary and  Increased in penile
involuntary myotonia circumference, at
 Abdominal, intercostal, the coronal ridge,
anal, and facial and deepening in
muscle contraction color
 Accelerated heart rate  50% increase in testicular
and respiratory rate size, and elevation close
and blood pressure to the perineum
 Sex flush ( appearance in  Appearance of a few
some men late in the drops of mucoid
phase; spread over the secretions from the
entire body in women) bulbourethral glands at
tip of penis; may contain
sperm
Signs Present In Females
Only
 Retraction of the
clitoris under the hood
 Appearance of the
orgasmic platform,
increased in the size of
the outer one-third of
the vagina and the labia
minora
 Slight increase in width
and depth of the inner
two-thirds of the vagina
 Farther reddening of
the labia minora
 Appearance of few drops
of mucoid secretion
from the Bartholin’s
glands to lubricate the
inner labia
 Farther increase in
breast size and areolar
enlargement
 Phase 3: Orgasmic
This phase is the climax of the sexual
response cycle. It is the shortest of
the phases and generally lasts only a
few seconds.
 Four Phase Response Cycle
•Phase 3: Orgasm
–Peaking of sexual pleasure with subsequent release of sexual
tension and rhythmic contraction of the perineal muscles and the
pelvic organs

Male Female
-3-15 seconds -3-15 seconds
-Forceful emission of semen (ejaculation) (12- -Breasts may become tremulous
20 inches at age 18, decreasing with age to -Uterine contractions throughout orgasm
seepage at 70) -Contractions of the lower third of the vagina
-4-5 rhythmic spasms of the prostrate, seminal -Loss of voluntary muscle control (carpopedal
vesicles, vas, and urethra spasm; facial grimacing)
-Loss of voluntary muscle control (facial -Hyperventilation and tachycardia
grimacing; carpopedal spasm)
-BP up to 40-100 mm systolic, 20-50 mm
diastolic
-HR up to 180 beats per minute
-Respiration up to 40 respirations a
minute
 Phase 3: Orgasmic
Signs Present in Both Sexes Signs Present In Males Only
 Involuntary spasms of  Rhythmic, expulsive
muscle groups contractions of the penis
throughout the body at 0.8 seconds interval
 Diminished sensory  Emision of seminal fluid
awareness into the prostatic urethra
 Involuntary contraction  Closing of the internal
of the anal sphincter bladder sphincter
 Peak heart rate (110-  Orgasm may occur
180bpm), respiratory without ejaculation
rate (40/min or greater)  Ejaculation of semen
through the penile
urethra and expulsion
from the urethral
meatus.
Signs Present In Females Only
 Approximately 5-12
contractions in the
orgasmic platform at 0.8
seconds interval
 Contractions of the
muscles of the pelvic
floor and uterine
muscles
 Varies pattern of orgasm
including minor surges
and contractions,
multiple orgasms, or a
simple intense orgasms
similar to that of the
male
 Phase 4: Resolution
Occurs after orgasm and allows the
muscles to relax, blood pressure to
drop and the body to slow down from
its excited state.
 Four Phase Response Cycle
• Phase 4: Resolution
– Disgorgement of blood from the genitalia
(detumescence)
– With subjective feelings of well-being, general
relaxation and muscle relaxation
– If it does not occur, may take 2-6 hours
associated with irritability and discomfort
– Women do not have a refractory period
 Phase 4: Resolution
Signs Present in Both Signs Present In Males Signs Present In Females
Sexes Only Only
 Reversal of  A refractory period
vasocongestion in 10-30 during which the body
minutes; disappearance will not respond to
of all signs of myotonia sexual stimulation;
within 5 minutes varies, depending on
 Genital and breast age and other factors,
return to their from a few moments to
preexcitement states hours or days
 Sex flush disappears in
reverse order of
appearance
 Heart rate, respiratory
rate, blood pressure
returns to normal
 Other reactions include
sleepiness, relaxation,
and emotional outbursts
such as crying or
laughing
Masturbation
Masturbation
•Nearly all men and three
fourths of all women
masturbate sometime
during their lives

•Moral taboos have

generated myths that
masturbation
causes mental
illness or a decrease
in sexual potency
 Masturbation
• Form of release from excessive sexual
tension
• is probably a universal and inevitable
aspect of psychosexual development, and
in most cases……..
• ADAPTIVE
• Becomes pathologic if it becomes a
compulsion
 Homosexuality
•What would your reaction
be if you found out that
your best friend is
homosexual?
•Homosexuality is a
disorder…..?
 Homosexuality
•Homosexuality is a
disorder…..?
•Not a disorder
–In 1973, was eliminated
as a diagnostic category by
the APA
–In 1980, was removed
from the DSM
•If not a disorder,
what?
Homosexuality
•An alternative lifestyle
•A variant of human
sexuality
•Definition:
–A person’s overt behavior,
sexual orientation, and a
sense of personal or social
identity.
•Lesbian or gay men
•Same sex or male female
 Homosexuality
• Prevalence
– 1948 10% of men
: 5% of women
37% had a homosexual
experience
– 1988 : 2-3% of men
– 1989 : < 1% of either sex
– 1993 : 1% exclusively
homosexual
Expression of Human
Sexuality
Adolescent age group
REVIEW: ERIK ERIKSON’S STAGES
OF THE LIFE CYCLE
STAGE 5: Identity vs. Role Diffusion
– 11 years through end of adolescence
– Struggle to develop ego identity
– Danger of role confusion, doubts about sexual
and vocational identity
 Some of the expressions of human
sexuality in adolescents are the following:

• Dating Behavior
• Pre-marital Sex
 Definition: Dating Behavior
• DATE- is defined as any activity that
involved going out with someone of the
opposite sex whether in a group or as
a couple
– Group date
– Single date
 Proportions ever Dated
• Most Filipino youth aged 15-24 years have
dated
• 60% or 3 out of 5 have experienced going
out on a date
• 49% of the teenagers claimed to have
gone out on a date
 Proportions ever Dated
• Dating either in groups or alone with
someone of the opposite sex occurs quite
early 10-13 years for only a few youth
• By the age 15 the propensity to date picks
up
• At 16, more than a third of boys and 2 out
of 5 girls date
 GROUP DATES OR SINGLE
DATES
• 3 out of five-group date
• Girls more likely to start with group date
• Boys immediately launched into a single
date
 TIMING OF THE FIRST DATE
• First date can trigger a series of events
that might change the subsequent life of a
person
• During teens, boys date twice as much as
girls
• Age 15, 1/5 of the girls have dated while
only 1/10 in boys have dated
 FIRST SINGLE DATE
PARTNER
• Irrespective of gender, the partner was a
classmate or officemate introduced by a
friend or a neighbor
• At the time of the first date:
• 46% already a boyfriend/girlfriend
• 28% friend
• 16% admirer or crush
• 10% acquaintance
 DATING WITH A STEADY
PARTNER
• Boys revealed that their partners became
their girlfriends after only 3 months
• Girls report the same after 6 months
• Favorite dating places: movie houses,
restaurants, parks and shopping
malls
 CHAPERONES
• Traditional role: ensure that no untoward
incident happens during a date
• Nowadays: chosen to assuage and
persuade the parents or partner to agree
to the date and leaves the couple during
the actual date
 BEHAVIOR DURING first
DATES
• 36% Kissed
• 3% sexual intercourse
• *17 % of the girls confided
intercourse happened without their
consent
IN THE SUBSEQUENT DATES
• the number of those engaging in very
intimate behaviors (petting and
intercourse) increased dramatically from
15-28%
 Dating and related events
• The urban youth have their first crushes at
14
• Admiring the opposite sex at 15
• Group date at 16
• Single dates with BF and GF at 17-18
 Differentials in dating
behavior
• Those who have had exposure to urban
life were prone to date about a quarter
more than those who have always
remained in the rural setting.
• Having lived in a dorm, studied in a private
school and living away from parents
increase tendency to date
 Determinants of dating
behavior
• Live away from parents
• Older age
• Lived in the city
• Attends private school
• Fathers are college graduates
• Less strict parents
• Unstable marriage of parents
Premarital Sex

Committed
Casual
Commercial
 COMMERCIAL PREMARITAL
EXPERIENCE
• one pays for sexual favors usually with a
prostitute
• Prevalence:
• 1 in 14 single men
• 1 in 8 married men
 CASUAL PREMARITAL SEX
• Sexual intercourse with acquaintance or
friend
• Most common first sexual experience of
boys
 COMMITTED PREMARITAL
SEX
• Sexual experience before a union is
formed
• Experienced more equally between males
and females
 INITIAL EXPERIENCE WITH
PREMARITAL SEX
• Occurs at 18 years old
• 18% of today’s youth engage in premarital sex
• Most popular venue for sexual encounters is the
HOME
• Majority of the youth did not use contraception
because they did not expect to have sex at that
time
• In those who practiced contraception, withdrawal
and condom were them most commonly used
• DESPITE THE ACCEPTANCE OF
PREMARITAL SEX, VIRGINITY IS STILL
GENERALLY VALUED.
» ZABLAN, 1995:

• 91.5% CONSIDER VIRGINITY AS AN

IMPORTANT VIRTUE
 Conclusion
• 49% HAVE GONE OUT ON A DATE
DATING OCCURS AS EARLY AS 10 YRS OLD
GIRLS MORE LIKELY TO GROUP DATE FIRST
FIRST DATE CAN TRIGGER EVENTS THAT MAY
CHANGE THE PERSON’S LIFE
• INITIAL EXPERIENCE WITH PREMARITAL SEX
OCCURS AT AGE 18
• MOST COMMON FIRST SEXUAL EXPERIENCE WITH
BOYS IS CASUAL SEX
 Conclusion
• MAJORITY OF THE YOUTH DID NOT USE
CONTRACEPTION BECAUSE THEY DID NOT
EXPECT TO HAVE SEX AND DESPITE
ACCEPTANCE OF SUCH PRACTICES, VIRGINITY IS
STILL A HIGHLY REGARDED VIRTUE

• SEXUALITY is at it’s peak in adolescence

as expressed in dating behavior and
premarital sex
 Types of Sexual orientation
1. Heterosexuality-one who finds sexual
fulfillment w/a member of opposite gender
2. Homosexuality-a person who finds sexual
fulfillment w/ a member of his or her own
sex.
3. Bisexuality-people who achieve sexual
satisfaction from both heterosexual &
homosexual
4. Transexuality -example is sex change
operation .
 Types of sexual expression

1.Celibacy-abstinence from sexual activity

2.Masturbation-self stimulation for erotic pleasure
3.Erotic stimulation -use of visual materials such as
magazine or photographs for sexual arousal
4. Fetishism-sexual arousal by use of certain
objects
or stimulations.
5. Transvestism-individual who dresses to take on the
role of opposite sex.
6. Voyeurism-Sexual arousal by looking at others
body
7. Sadomasochism-involves inflicting
pain(sadism)or receiving
pain(masochism)to achieve sexual
satisfaction.
8. Exhibitionism-reavealing one’s genitals in
public.
9. Phidophiles-interested in sexual encounters
with children
 Disorder of sexual functioning
Primary sex dysfunction(life long condition)
 1.Erectile Dysfunction -inability to produce an erection
enough for vaginal penetration formerly called as
impotence.drug of choice is Sildenafil(Viagra)
 2.Premature Ejaculation -ejaculation before penile
contact.
 3.Failure to achieve orgasm -can be due to poor sexual
technique or concentration.
 4.Vaginismus -involuntary contraction of the muscles at
the outlet of vagina when coitus is attempted,prohibits
penile penetration usually occurs w/ raped trauma
victims
 5.Dyspareunia-pain during coitus
 6.Inhibiting Sexual Desire -lack of desire for sexual
relations.
 Secondary sexual dysfunction

• Chronic disease,such as peptic

ulcer,or chronic pulmonary disease
that cause frequent pain or discomfort
may interfere with a man or woman’s
overall well being.
• Obese men and women may have
difficulty achieving deep penetration
because of bulk in their abdomen
Another classification of
sexual disorders
SEXUAL DISORDER

» These are disorders that are related to

human sexuality due to psychological
causes
» Types:
1. Alteration in gender identity
2. Alteration in sexual orientation
3. Alteration in sexual behavior
4. Alteration in sexual functioning
5. Painful sexual disorders
 ALTERATION IN GENDER
IDENTITY
1. Transexualism
• Persistent discomfort about one’s sex
assignment
• Caused by confused learning about
gender roles
• Feeling of being trapped in the wrong
body
2. Gender Identity Disorder of Childhood
• Persistent and intense distress at one’s
sexual identity
• Client insist that he/she is an opposite
sex
• Assertion that he/she will grow up to
have transsexual surgery
3.Nontranssexual Cross Gender
Disorder
• Persistent discomfort about one’s sex but
with no preoccupation with getting rid
of the genitalia
ALTERATION IN SEXUAL ORIENTATION

1. Ego-Dystonic Homosexuality
• Weak heterosexual arousal with desire to
have heterosexual relationship
• Client experience inappropriate
homosexual arousal pattern
 ALTERATION IN SEXUAL
BEHAVIOR
1. Sexual Acting Out
- Disturbed conduct or poor impulse control
- May create a sexually provocative remarks
- Have extramarital affairs and promiscuous
- Have high sexual drive
- Presence of inadequate coping and
interpersonal skills
2. Paraphilias
- Sexual urges or fantasies that are
directed toward nonhuman objects pain
to self, partner, or children, or other
non- consenting individuals
- This may be asymptomatic
- Behavior often followed by guilt, shame.
low-esteem, or anxiety
- Not due to other mental disorder
 Types of Paraphilias:
1.Fetishism- substitution of an inanimate
object for the genitals
2.Transvestism- wearing clothes of the
opposite sex to achieve sexual pleasure
3.Exhibitionism- sexual pleasure obtained
by exposing the genitals
4.Pedophilia- attraction to children as sex
objects
5.Voyeurism- sexual gratification obtained
by watching the sexual plays of others
6.Frotteurism- sexual obtained by touching
or rubbing against a non-consenting
person
7.Telephone Scatologia- sexual
gratification form during telephone
conversation
8.Dendrophilia – sexual gratification in
woods
ALTERATION IN SEXUAL FUNCTIONING

1.Sexual Dysfunction- individuals is

unsatisfied in his sexual function
2.Hypoactive sexual desire- absence of
sexual fantasies and desires
3.Sexual aversion- avoidance of genital
sexual contact with partner
4.Sexual arousal disorder- failure to attain
and maintain erection in males
• Lack of lubrication
• Persistent or recurrent lack of subjective
sense of sexual excitement and pleasure