This document summarizes a presentation given by Dr. Martha Tara Lee on sexuality in obstetrics and gynecology. It discusses Dr. Lee's background and credentials in human sexuality. The presentation covers topics like what is sexology, common sexological issues, models for addressing sexual concerns, female sexual dysfunctions, myths about sexuality, and cultural influences on sexuality. Treatment suggestions are provided for issues like low sexual desire. The goal is to have an educational yet non-judgmental approach to discussing sexuality issues.
2. Dr. Martha Tara Lee
Clinical Sexologist
• Doctorate in Human Sexuality
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Certificate in Sex Therapy
• Certitificate in Practical Counselling
• Cert in Life Coaching
3. Agenda
1. What is Sexology
2. Sexual Desire
3. Myths/ misconceptions
about sex
4. My observations
5. Yin/ Yang
6. Suggestions of what to
do
4. What is Sexology?
Study of sexual interests, behavior, and function which combines:
Biology Physiology Medicine Psychology Statistics Epidemiology
Criminology Religion Philosophy Zoology Anthropology Sociology
6. Common Sexological Issues
• Body image and sex-negative conditioning
• Sexual desire
• Courtship concerns
• Obstacles to Intimacy
• Sexual development, maturation and aging
• Sexual communication and negotiation
• Medical considerations affecting sexuality
• Atypical sexual behaviours
• Sexual trauma
• Gender identity
• Sexual orientation
• Sexual education for parents
• Women’s concerns
• Men’s concerns
8. PLISSIT Model
Permission to self – Pleasure; to use vibrator, Ask for certain
kinds of touch, caress.
Limited Information – Changes in sexual response with
pregnancy, menopause, aging. Impact of medication(s) on
sexual function.
Specific Suggestions – HRT benefits and risks, use of
lubricants; Positions.
Intensive Therapy – Refer to specialists for couple therapy,
resolution of long-standing problems.
10. Sexual Desire
• Begins in the brain.
• The experience of sexual
fantasies, thoughts, and
wanting to engage in or be
involved in sexual activity.
• Includes being responsive or
receptive to sexual advances
by a partner and of wanting
to continue the activity once
physical contact begins.
15. • Sexual dysfunctions (except substance-/medication-
induced sexual dysfunction) now
o Require a duration of approximately 6 months and
o More exact severity criteria
• Subtypes for all disorders include only
o “Lifelong vs. acquired" and
o “Generalized vs. situational”
• Two subtypes were deleted:
o “Sexual dysfunction due to a general medical
condition" and
o “Due to psychological versus combined
factors"
More on DSM-5
17. Culture Impacts Function
• Sex is not discussed
– Ignorance re: anatomy, function, technique
• Sense of self ≠ societal expectations
– Anxiety, confusion, shame, isolation
– More depression, substance abuse, unprotected sex
• Gender role inequities
– Poor communication re: safer sex, sexual needs
– Sexual inhibition/avoidance after sexual trauma
18. Misconceptions of
Sexual Function & Satisfaction
• Men want sex more than women
• Women care about intimacy more than men
• If you love your partner, sex will be wonderful
• My partner should know what I want
• Good sex is spontaneous
• Movies and TV portray sex as it really is
• Bigger is always better
19. Facts about Sexual Function
• Both women and men enjoy sex / intimacy
• Fulfilling sex often requires planning / effort
• Changes in function occur with life stress, aging,
illness, and many medications
• Lifestyle adaptations preserve sexual satisfaction
in many circumstances
Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United
States: prevalence and predictors. JAMA 1999;281:537-544.
20. Sex and Gender Differences
• Sexiness criticized in women; admired in men:
– ‘Slut’ vs. ‘stud’
• Premarital / extramarital sex unacceptable for women;
condoned in men:
– Intact hymen, chastity belt
• Sexual pleasure valued less / taboo for women:
– ‘My husband’s needs come first’
– Female genital circumcision
• Stigma greater for older women than men:
– ‘All dried up’, ‘withered’ vs. ‘he’s a real Don Juan’
21. • Sex means sexual intercourse
• Talking about sex is not natural, proper, or
necessary
• Sex is for younger people
• Men should initiate sexual activity
• Sex should be spontaneous
• A firm penis is a requirement for satisfying sex
• Quality sex ends with a orgasm
Myths about Sexuality
23. Masculine/ Feminine
1. Projecting
2. Active
3. Solar/ Warming
4. Discharges energy
5. Prefers raw sex
6. Rational/ Logical
7. Needs adventure
8. Gives love to get sex
1. Receptive
2. Passive
3. Lunar/ Cooling
4. Retains energy
5. Prefers cuddly sensuality
6. Intuitive/ Emotional
7. Geared for survival
8. Gives sex to get love
26. My Observations
1. Before Pregnancy
• Female: Fears/ anger/ dismissive – just sperm
• Male: Sexual performance anxiety
2. During Pregnancy
• Female: Mood swings
• Male: May not have any sex
3. After Baby
• Female: Tired
• Male: When are things going to get better?
27. 1. Guilt – much to be grateful for
2. Dismissed – I’d just go away/ withdraw
3. Rationalized - she’s a good person/ wife/
mother
4. Frustrated – why am I always last on the
list?
5. Anger – towards wife/ child
For Men - Persistent lack of sex
28. 6. Rejected – no longer a priority
7. Self-esteem - No longer attractive to their
partner – own self-perceived lack of
attractiveness
8. Used – to procreate only
9. Internalize things – must have done
something wrong
For Men - Persistent lack of sex
29. Relationship Problems
• Anger
• Poor Communication
• Criticism
• Neurotic Interactions
• Incompatible Sexual
fantasies
• Alcoholism & Sexual Abuse
• Phobic Avoidance of Sexual
Intercourse
• Unconscious Conflict about
Sex, Commitment, Pregnancy
• Sexual Abuse Issues
30. Psychosocial Issues
• Lifelong or acquired
• Symptom or situational
• Unresolved history of sexual abuse or trauma
• Body image/ Self-esteem issues
• Psychiatric history
• Stress, anxiety, sadness
• Relationship conflict
• Partner’s sexual dysfunction
31. Treatment for Low Sexual Desire
1.Physical possibility
2.Tired
3.Stressed
4.Scared
5.Unfit
6.No Time
32. The Low Down on Low Libido
• Increase sea vegetables
• Increase beans
• Increase root vegetables
• Increase water
• Increase spicy foods
• Increase chocolate
• Reduce alcohol
Source: Vitti, A. (2013) Woman Code,
HarperOne, p. 298
33. The Orgasmic Diet
1. Take supplements (especially fish oil); a multivitamin; calcium,
magnesium, and zinc; and extra iron and vitamin C.
2. Balance of 40 percent carbs, 30 percent protein, and 30 percent
fats at every meal.
• Avoid trans fats and polyunsaturated fats, including
vegetable oils such as corn oil, soybean oil, and safflower
oil, that counteract the benefits of the omega-3 fatty acids
• Eat monounsaturated fats like olive or canola oil or
moderate amounts
• Eat a half-ounce of quality dark chocolate every day.
3. Avoid things that interfere with sexual function, including caffeine,
cigarettes and other stimulants; hormonal birth control; and
drinking alcohol to excess.
4. Exercise the PC muscles
Lindberg, M (2008) The Orgasmic Diet: A Revolutionary Plan to Lift Your Libido and Bring You to Orgasm, Harmony
35. Lack of Sexual Drive
1.Communicate
2.Get Tested
3.Arms on Deck
4.Schedule Sex
5.Prepare for sex
6.Self care
a. Exercise
b. Quit smoking
c. Food
36. 7. Expand your ways of having sex
a. Masturbation witnessing
b. Mutual masturbation
c. One-way sex
d. Sex toys
8. Recruit a Taskforce
9. Give it some time
Lack of Sexual Drive
41. We Don’t Ask Because Of…
• Personal embarrassment
• Lack of knowledge re: clinical relevance
• Ignorance re: who, when, how, or what to
ask
• Concern re: not knowing how to answer
questions
• Concern re: becoming
aroused/uncomfortable
• Concern re: appearing seductive/intrusive
• Uncertainty about legal issues
• Time constraints
44. 1. A couple comes in and say the wife has low sex
drive. A sexologist would…
a) Find out what their definition of low sex drive is
b) Ask if they have gone for medical check ups
c) Check what they tried
d) Explore the sexual attitude of the woman
e) All of the above
What Would You Do? - Quiz
45. 2. A lady comes in and attribute her low sex drive to
being sexually violated when she was 5 - 15. A
sexologist would…
a) Encourage her to get over it – it’s all in her head
b) Insist she must tell her husband about it
c) Tell her to go to the police so justice is served
d) Teach her to do kegels
e) Explore what her goals are
What Would You Do? - Quiz
46. 3. A couple comes in and say the wife has low sex
drive. The lady is very negative about everything that is
discussed. She gets angry and defensive. A sexologist
would…
a) Ask if she has gone for a medical check up
b) Tell her she has an attitude problem
c) Sit back and let her talk – It’s her money
d) Admit she is beyond hope
e) Check if she has depression
What Would You Do? - Quiz
47. 4. Your patient starts crying in consultation. She admits
she is feeling depressed. Do you…
a) Pass her tissue, and tell her to stop crying
b) Just do your job and give her the drugs she came for
c) Refer her to staff nurse
d) Send her to a mental health professional
e) Ask if she has suicidal thoughts
What Would You Do? - Quiz
48. What is Your Approach?
• Sex-positive
• Non-judgemental
• Educational
• Client-centered
• Do no harm
49. Dr. Martha Tara Lee
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email: drmarthalee@eroscoaching.com