Human Sexuality 3rd Edition by Roger R. Hock – Test Bank A+

Description

CHAPTER 5:

Contraception: Planning and Preventing Pregnancy

Total Assessment Guide (T.A.G.)

Topic	Question Type	Factual	Conceptual	Application
Introduction to Chapter	Multiple Choice	1	2
	True/False	1-2
	Short Answer	1
	Essay
Historical Perspectives	Multiple Choice	3-4
	True/False	3-4
	Short Answer
	Essay	1
Choosing a Method of Contraception	Multiple Choice	5	6
	True/False	7	5, 6
	Short Answer
	Essay		2
Methods for Preventing Pregnancy and STIs	Multiple Choice	9, 11, 14, 15, 19	10, 12, 16, 18	7, 8, 13, 17
	True/False	8, 9, 11	10, 12
	Short Answer	4, 5, 6	3
	Essay		3
Methods for Preventing Pregnancy (But Not STIs)	Multiple Choice	21, 23. 24, 27, 30, 31, 32, 33, 42, 45, 46, 53, 54, 55, 59, 61	20, 22, 29 , 34, 38, 39, 40, 44, 51, 56, 58, 60	25, 26, 28, 35, 36, 37, 41, 43, 47, 48, 49, 50, 52, 57
	True/False	13, 14, 15, 18, 19, 20, 22, 23, 24	16, 17, 21, 25
	Short Answer	7, 8, 9, 10, 11, 12
	Essay		4
Abortion Is Not Contraception	Multiple Choice		62
	True/False	26
	Short Answer
	Essay
Experimental and Future Methods of Contraception	Multiple Choice True/False Short Answer Essay	66 27 13, 14, 15 5	67	64, 65

Major Headings:

1. 146-147 Introduction to Chapter
2. 147-148 Historical Perspectives
3. 148-151 Choosing a Method of Contraception
4. 151-162 Methods for Preventing Pregnancy and STIs
5. 162-181 Methods for Preventing Pregnancy (But Not STIs)
6. 181-182 Abortion Is Not Contraception
7. 182-183 Experimental and Future Methods of Birth Control

MULTIPLE CHOICE

1. About _____ percent of all pregnancies in the United States are unplanned.
2. 33
3. 25
4. 50
5. 80

Answer: C
Difficulty: 2
Page ref: 146
Topic: Introduction
Skill: Factual

Rationale: Most heterosexual couples want to engage in sexual intercourse and most of the time they do, they want to prevent pregnancy. However, about half of all pregnancies in the United States are unplanned, which does not necessarily mean that they are unwanted.

1. What is the name of the process that is used to prevent conception?
2. contraception
3. abortion
4. sexual supplements
5. adoption

Answer: A
Difficulty: 1
Page ref: 146

Topic: Introduction
Skill: Factual

1. The Comstock Act was a bill that stated _____.
2. it was illegal to sell or distribute any birth control information or devices
3. sodomy was legal
4. abortion was illegal
5. homosexual marriages was illegal

Answer: A
Difficulty: 2
Page ref: 147
Topic: Historical Perspectives
Skill: Factual

Rationale: Anthony Comstock was an “anti-obscenity,” right-wing radical who considered all contraceptive information and devices obscene and indecent. His act, the Comstock Act, made it illegal to sell or distribute contraceptive information or devices in any form.

1. Margaret Sanger was a widely recognized leader in the _____ movement in the United States.
2. Comstock
3. contraceptive
4. abstinence
5. abortion

Answer: B
Difficulty: 2
Page ref: 147-148
Topic: Historical Perspectives
Skill: Factual

Rationale: Margaret Sanger opened the first birth control clinic, located in Brooklyn, New York. She became a celebrated and widely recognized leader of the contraceptive movement in the United States, and in many countries throughout the world.

1. Research has shown that _____ percent of unplanned pregnancies occur in couples that are using contraceptives.
2. 23
3. 40
4. 53
5. 60

Answer: C
Difficulty: 2
Page ref: 148
Topic: Choosing a Method of Contraception
Skill: Factual

Rationale: Research has shown that 53 percent of unplanned pregnancies occur in couples that are using contraceptives. Most of these contraceptive failures are due either to incorrect use of the contraceptive method or to reliance on false information about pregnancy and contraception.

1. Why is douching ineffective in preventing pregnancy?
2. because seminal fluid sticks to the vaginal walls preventing sperm from being killed
3. the water or other solution used to wash out the vagina can actually push the remaining sperm through the cervix even faster
4. because semen is an acid-like substance which counteracts the effects of douching
5. because douching kills bacteria that helps sperm swim to the fallopian tubes

Answer: B

Difficulty: 2

Page ref: 151

Topic: Choosing a Method of Contraception

Skill: Conceptual

Rationale: Many people still believe in certain myths about contraception; one such myth is that douching is an effective way to prevent pregnancy. The truth is that the stream of water or other solution used to wash out the vagina can actually push the remaining sperm through the cervix even faster. Not only is douching not recommended for contraception, but it could force bacteria higher into a woman’s reproductive system and increase the risk of infections.

1. Danielle would like to use a method of contraception that protects against sexually transmitted infections and prevents pregnancy. Which of the following would be the best choice for her?
2. cervical cap
3. birth control pills
4. diaphragm
5. selective abstinence

Answer: D

Difficulty: 2

Page ref: 155-156

Topic: Methods for Preventing Pregnancy and STIs

Skill: Application

Rationale: The only 100-percent effective way to prevent pregnancy and prevent contracting or transmitting STIs is avoiding all sexual behaviors that can result in pregnancy or spread infection; this strategy is called selective abstinence.

1. Ethan has chosen celibacy as his method of contraception. What does this mean?
2. Ethan cannot have intercourse but can masturbate.
3. Ethan can engage in deep kissing and mutual masturbation.
4. Ethan must avoid any activity where seminal fluids are secreted.
5. Ethan must avoid all sexual expression and activity.

Answer: D

Difficulty: 2

Page ref: 155

Topic: Methods for Preventing Pregnancy and STs

Skill: Application

Rationale: An individual who is celibate engages in so sexual activity whatsoever, and avoids all sexual expression and activity.

1. Outercourse is a form of _____.
2. abstinence were a couple avoids risky sexual behaviors such as intercourse
3. contraception where a couple avoids all sexual expression and activity
4. contraception where the man withdraws his penis prior to ejaculation
5. abstinence where a couple only engages in anal intercourse

Answer: A

Difficulty: 1

Page ref: 155

Topic: Methods for Preventing Pregnancy and STIs

Skill: Factual

Rationale: Outercourse (sometimes called selective abstinence) means engaging only in sexual behaviors that are “safe” and avoiding those that are risky, such as vaginal or anal intercourse and oral sex.

1. Behaviors available to a couple practicing outercourse include _____.
2. vaginal intercourse
3. anal intercourse
4. oral sex
5. intimate touching

Answer: D

Difficulty: 2

Page ref: 156

Topic: Methods for Preventing Pregnancy and STIs

Skill: Conceptual

Rationale: Behaviors that are available to a couple practicing outercourse include holding hands, kissing, intimate touching, and exploring each other’s bodies.

1. How do condoms work to prevent pregnancy?

1. They release a chemical that kills sperm.
2. They contain chemicals that combine with a woman’s natural lubrication to stop sperm from leaving the vagina.
3. They release a chemical that prevents eggs from being fertilized .
4. They provide a barrier to prevent semen from entering the vagina.

Answer: D
Difficulty: 1
Page ref: 158

Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

Rationale: Condoms function as contraceptives by providing a barrier to prevent semen from entering the vagina.

1. Why is it recommended that only polyurethane or latex condoms be used to protect against pregnancy and STIs?
2. Disease-causing viruses can pass through the pores in lambskin condoms.
3. Lambskin condoms are lubricated with Vaseline which causes them to break.
4. Latex and polyurethane condoms never expire.
5. Latex and polyurethane condoms always have a reservoir tip which limits breakage.

Answer: A
Difficulty: 2
Page ref: 158
Topic: Methods for Preventing Pregnancy and STIs
Skill: Conceptual

Rationale: Only latex or polyurethane condoms should be used; natural membrane (lambskin) condoms have small pores that may allow disease-causing viruses to pass through.

1. Baron and Nettie are about to engage in intercourse together for the first time. They can best increase their confidence in their use of the male condom by using _____.
2. condoms with nonoxynol-9
3. condoms with a reservoir tip
4. lambskin condoms
5. natural membrane condoms

Answer: B
Difficulty: 2
Page ref: 158
Topic: Methods for Preventing Pregnancy and STIs
Skill: Application

1. Condoms have a _____ failure rate when used correctly and consistently.
2. 3%
3. 10%
4. 30%
5. 50%

Answer: A
Difficulty: 3
Page ref: 158
Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

Rationale: The 3% failure rate means that if 100 couples have intercourse an average of twice each week for a year and use condoms correctly each time, only three of the couples will become pregnant. The 3% failure rate is based on the couples using them, not the condom failure itself.

1. One reason for condom failure is _____.
2. using old condoms
3. manufacturing defects
4. wrong size
5. allergic reactions

Answer: A
Difficulty: 2
Page ref: 159
Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

Rationale: Failures are not generally due to product failure, but are usually because of incorrect use. One of the common mistakes that people make when using condoms is using old or damaged condoms.

1. When used correctly, the male condom is placed over _____.
2. the penis right before ejaculation
3. the penis prior to erection
4. an erect penis prior to intercourse
5. an erect penis sometime during intercourse

Answer: C
Difficulty: 2
Page ref: 160
Topic: Methods for Preventing Pregnancy and STIs
Skill: Conceptual

Rationale: The condom should be placed on the erect penis before any contact between the penis and the partner’s genital area.

1. Harrison’s sexuality class is learning to use male condoms correctly. His professor probably told the class to _____.
2. unroll the condom prior to placing it on the penis
3. withdraw the penis when the erection is lost after ejaculation
4. always use water-based lubricants
5. fill the condom with water prior to using to test for leakage

Answer: C
Difficulty: 2
Page ref: 160
Topic: Methods for Preventing Pregnancy and STIs
Skill: Application

If a couple decides to add lubrication, they should not use an oil-based product, as those can cause latex to break. Only water-based lubricants should be used, such as K-Y Jelly, spermicidal creams, or other lubricants made especially for sexual activity.

1. The female condom works by _____.
2. releasing a spermicide into the vagina
3. preventing an exchange of sexual fluids
4. changing the chemical balance within the vagina
5. creating a barrier between the cervix and fallopian tubes

Answer: B
Difficulty: 2
Page ref: 160-161
Topic: Methods for Preventing Pregnancy and STIs
Skill: Conceptual

Rationale: The female condom creates a lining on the inside of the vagina to prevent genital contact or the exchange of sexual fluids.

19.. An advantage of the female condom is it _____.

1. has a significantly higher success rate than the male condom
2. is cheaper than male condoms
3. allows women to be more in control of contraception
4. is not lubricated therefore eliminating allergic reactions

Answer: C
Difficulty: 2
Page ref: 162
Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

Rationale: The female condom has the advantage of allowing the woman to be in more control of contraception and preventing sexually transmitted infections. It also allows for greater spontaneity than the male condom because the female condom may be inserted up to eight hours before intercourse.

1. One thing all female hormonal contraceptives have in common is that they _____.
2. alter certain aspects of a woman’s ovulation cycle or reproductive tract
3. form a barrier between egg and sperm
4. prevent entry of the sperm into the fallopian tubes
5. kill and weaken sperm

Answer: A
Difficulty: 3
Page ref: 163
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: Female hormonal methods of contraception prevent pregnancy by altering certain characteristics of a woman’s ovulation cycle or reproductive tract. Hormonal contraception prevents ovulation, thickens the cervical mucus to create a barrier against sperm, or changes the lining of the uterus so that even if an egg is fertilized, it will not implant and create a pregnancy.

1. Oral contraceptives are also referred to as _____.
2. birth control pills
3. barrier methods
4. fertility awareness
5. sterilization

Answer: A
Difficulty: 1
Page ref: 163
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: In general, oral contraceptives, also referred to as birth control pills, are among the most popular reversible contraception methods used by women in the United States.

1. Oral contraceptives_____.
2. offer protection against sexually transmitted infections
3. are an effective method of preventing pregnancy
4. should be used with a spermicide
5. contain the hormone testosterone

Answer: B
Difficulty: 2
Page ref: 163
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: When used correctly, oral contraceptives provide a convenient and extremely effective method of preventing pregnancy, but they provide no protection against STIs.

1. Which two hormones are used in the combination pill?
2. estrogen and testosterone
3. nonoxynol-9 and estrogen
4. progestin and estrogen
5. nonoxynol-9 and progestin

Answer: C
Difficulty: 3
Page ref: 163
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: Combination oral contraceptives contain both estrogen and progestin.

1. The minipill is a hormonal method that contains _____.
2. estrogen
3. progestin
4. progesterone
5. testosterone

Answer: B
Difficulty: 2
Page ref: 164

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The progestin-only “minipill” has approximately the same low failure rate as the combination (progestin and estrogen) pill. The main advantage of the progestin-only oral contraceptive pill is that it avoids some of the potential negative side effects associated with estrogen in the combination pill.

1. Arianna is using a new oral contraceptive called Seasonale. How many days does she take the pills with hormones?
2. 28 days
3. 21 days
4. 78 days
5. 84 days

Answer: D
Difficulty: 2
Page ref: 164
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: Instead of the traditional 21-day regimen, Seasonale provides a daily dose or hormones for 84 consecutive days, after which she takes the usual placebo pills for 7 days.

1. Natalia is interested in using extended oral contraception such as Seasonale and Seasonique. What should she know about this method?
2. It must be taken for 50 consecutive days.
3. She may have bleeding or spotting between menstrual periods.
4. It provides protection from sexually transmitted infections.
5. She may never have a period again.

Answer: B
Difficulty: 2
Page ref: 165
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: In studies of extended oral contraceptives, the most serious side effect was an increase in bleeding or spotting between periods.

1. The most common incorrect use of oral contraceptives is _____.
2. taking them at different times each day
3. taking more than one per day
4. taking the wrong pill
5. forgetting to take them every day

Answer: D
Difficulty: 1
Page ref: 165
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The most common incorrect use of oral contraceptives is forgetting to take them every day. Women using oral contraceptives must take one pill every day of the 21-day course, and should try to take a pill at approximately the same time each day.

1. Mary takes her progestin-only contraceptive pill at 8:00 every morning, but today she didn’t remember to take it until 3:00 in the afternoon. What should she do?
2. throw away the rest of the pack and avoid intercourse for ten days
3. take two pills every morning for the rest of the month
4. take a pill as soon as she remembers, take the next pill at the usual time, and use a backup method for 48 hours after taking the late pill
5. ask her physician to prescribe a different oral contraceptive

Answer: C
Difficulty: 2
Page ref: 166
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: A woman could become pregnant if she forgets to take her progestin-only pill more than three hours past the regular time. If she does forget, she should take the missed pill as soon as she remembers. She should take the next one at the usual time.

1. Hormonal implants differ from traditional oral contraceptives (birth control pills) because hormonal implants _____.
2. have no negative side effects
3. have a much higher effectiveness rate than birth control pills
4. use a different method to release contraceptive hormones into a woman’s body
5. have to be replaced every six months

Answer: C
Difficulty: 2
Page ref: 167
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rational : The hormonal implant is a small tube containing a progestin-family hormone that is implanted under the skin of a woman’s upper arm. It releases a hormone similar to that found in many oral contraceptives. The contraceptive action of a contraceptive implant involves the slow release of hormones into the woman’s body, so that protection is provided without any action at all on the woman’s part.

1. An advantages of the hormonal implant is that it _____.
2. has near perfect effectiveness
3. offers protection from STIs
4. may reduce the length of a period
5. has no possible side effects

Answer: A
Difficulty: 2
Page ref: 167
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The advantages of the hormonal implant are its ease of use and near-perfect effectiveness.

1. An advantage of using oral contraception is that it _____.
2. is impossible to miss a dose
3. offers protection from STIs
4. may reduce the length of a period
5. has no possible side effects

Answer: C

Difficulty: 2

Page ref: 168

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

Rationale: An advantage of using oral contraceptives is that they may reduce the length of menstrual periods; they may also reduce the amount of menstrual bleeding.

1. A disadvantage of using oral contraceptives is that they _____.
2. increase the length and severity of menstrual periods
3. are not very effective in preventing pregnancy
4. offer no protection against sexually transmitted infections
5. cause the growth of facial hair

Answer: C

Difficulty: 2

Page ref: 168

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

Rationale: Oral contraceptives provide no protection against sexually transmitted infections.

1. Depo-Provera is a(n) _____.
2. injectable hormonal contraceptive
3. hormonal implant
4. contraceptive patch
5. emergency contraceptive pill

Answer: A
Difficulty: 1
Page ref: 169
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: Depo-Provera is a hormonal contraceptive that is administered through an injection in the arm or in the hip. Each injection gives a minimum of three months of highly effective contraception.

1. How is Depo-Provera administered?
2. It is injected every three months.
3. It is taken in pill form every day.
4. It is implanted under the arm.
5. It is inserted into a woman’s vagina.

Answer: A
Difficulty: 2
Page ref: 169
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: Depo-Provera is a hormonal contraceptive that is administered through an injection (given by a physician or a nurse) in the arm or in the hip.

1. Victoria was told that a common side effect of Depo-Provera is amenorrhea. Which of the following would you use to explain the term amenorrhea to Victoria?
2. cessation of a woman’s period
3. very heavy and long periods
4. a type of depression
5. spotting between periods

Answer: A
Difficulty: 2
Page ref: 169
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: A side effect common to Depo-Provera is amenorrhea, the cessation of a woman’s periods.

1. Yolanda is using a form of birth control called Ortho Evra. What type of contraception is Yolanda using?
2. IUD
3. implants
4. injection
5. patch

Answer: D
Difficulty: 2
Page ref: 169-170
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: The contraceptive patch was introduced into the U.S. market in 2002, under the name Ortho Evra.

1. Arielle is going to use the contraceptive patch. Her physician probably told her that each patch is worn for _____ consecutive weeks, then the _____ week is patch-free.
2. four; fifth
3. three; fourth
4. two; third
5. five; sixth

Answer: B
Difficulty: 2
Page ref: 170
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: Each patch is worn for one week, for three consecutive weeks, and then the fourth week is patch-free.

38.How does the contraceptive ring work?

1. It is inserted into the vagina and is left there for three weeks.
2. It is injected every three months and delivers one hormone.
3. It is attached to the abdomen and delivers two hormones.
4. It is implanted in the underarm and is left for three years.

Answer: A
Difficulty: 2
Page ref: 170
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: The woman inserts the ring into her vagina and leaves it there for three weeks. At the end of the three weeks, she removes it for a week, when she will typically have her period.

39.What are emergency contraceptive pills?

1. pills used to prevent pregnancy after unprotected intercourse has occurred
2. pills taken when one birth control pill is missed
3. pills taken prior to sexual intercourse to prevent pregnancy
4. pills used to terminate an unplanned pregnancy

Answer: A
Difficulty: 2
Page ref: 172
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: ECPs use various combinations of drugs to interrupt a woman’s normal hormonal pattern and prevent pregnancy after unprotected intercourse has already occurred.

40.Which of the following is a barrier method of contraception?

1. calendar
2. sterilization
3. diaphragm
4. ring

Answer: C
Difficulty: 1
Page ref: 173
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: The diaphragm is a thin latex membrane that is attached to a flexible ring, forming a shallow cup. Following ejaculation, sperm are blocked from reaching the cervix by the diaphragm.

1. Ed and Louisa would like to use the diaphragm as their method of contraception. What should they know about effective diaphragm use?
2. There is no need to use a spermicide with the diaphragm.
3. It may be inserted up to 24 hours prior to intercourse.
4. It must be left in place for at least 6 hours after intercourse.
5. Additional spermicide is not needed if intercourse is repeated within 6 hours.

Answer: C

Difficulty: 2

Page ref: 173

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Application

Rationale: The diaphragm must always be used with a spermicide, and may be inserted up to six hours before intercourse. Following intercourse, it must be left in place for at least six hours, but not longer than 24 hours.

1. The cervical cap provides protection for up to _____ without the necessity of additional spermicide.
2. 6 hours
3. 8 hours
4. 24 hours
5. 48 hours

Answer: D

Difficulty: 2

Page ref: 174

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

Rationale: The cervical cap provides continuous protection for up to 48 hours without the necessity of additional spermicide, so it can be placed in the vagina up to two days before intercourse.

1. Jessica is using a new type of contraceptive that is used like a diaphragm but does not need to be fitted by a health professional. What is the name of this contraceptive?
2. IUD
3. cervical cap
4. contraceptive ring
5. Lea’s Shield

Answer: D
Difficulty: 2
Page ref: 173

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: Lea’s Shield is used in much the same way as a traditional diaphragm, but due to its design, it does not need to be fitted by a health professional.

1. How does the contraceptive sponge work?
2. It releases spermicide when inserted into the vagina.
3. It blocks sperm from reaching the cervix.
4. It prevents the passage of the zygote into the uterus.
5. It prevents ovulation by secreting hormones.

Answer: A
Difficulty: 3
Page ref: 175
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: When the sponge is moistened with water and inserted into the vagina, it releases spermicide and sets up a barrier between the vagina and the cervix.

1. A disadvantage of the contraceptive sponge is it _____.
2. typically prevents ovulation
3. is less effective in preventing pregnancy than some other methods
4. reduces the length of a period
5. interferes with future fertility

Answer: B
Difficulty: 2
Page ref: 175

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: A main disadvantage is that the contraceptive sponges are not quite as effective in preventing pregnancy as some other methods.

1. Spermicides should be applied within _____ before intercourse.
2. 1 hour
3. 3 hours
4. 4 hours
5. 8 hours

Answer: A

Difficulty: 2

Page ref: 175

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

Rationale: A spermicide should be applied to the inside of the vagina within an hour before intercourse and must be deep enough in the vagina to reach the cervix.

1. Josh and Rashida are considering using spermicides as their form of contraception. What should they know about spermicides prior to using them?
2. They offer protection from sexually transmitted infections.
3. They have a very low failure rate.
4. They should be applied inside the vagina within two hours of intercourse.
5. A new application of spermicide must be used for each act of intercourse.

Answer: D

Difficulty: 2

Page ref: 175

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Application

Rationale: A new application of spermicide must be used for each act of intercourse, and following intercourse it must be left in place for at least six hours.

1. Lloyd and Luna are using a method of birth control that is based on ovulation prediction. This couple is using a(n) _____ method.
2. barrier
3. hormonal
4. intrauterine
5. fertility awareness

Answer: D
Difficulty: 1
Page ref: 175

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: Fertility awareness methods of contraception are based on the knowledge that a couple’s ability to become pregnant varies during the woman’s menstrual cycle. If a woman knows exactly when she ovulates, and she and her partner abstain from intercourse for about seven days prior and one day after ovulation, she would be at a low risk of pregnancy.

1. Caresa has a somewhat irregular menstrual cycle ranging from 21 to 35 days. Are Caresa and her partner good candidates for the Standard Days method of birth control?
2. No, because it is very difficult to accurately predict when she ovulates and therefore which days are “safe” from pregnancy.
3. No, because she may end up having intercourse near the beginning of her period, thereby increasing the likelihood of conception.
4. Yes, because not having to use any artificial means of birth control will greatly enhance their sexual satisfaction.
5. Yes, because an irregular menstrual cycle indicates that she is probably not fertile anyway.

Answer: A
Difficulty: 3
Page ref: 176

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: This method of ovulation prediction is based on the fact that most (80 percent) of women’s fertility cycles are between 26 and 32 days long; this means that 80 percent of women ovulate between days 11 and 18 of their fertility cycles. To be safe, a woman should assume that her window of fertility is from five days before ovulation to a day after. Caresa’s cycle is too irregular to use this method with any degree of reliability.

1. Max and Mimi are using a method of birth control that requires Mimi to carefully observe changes in the secretions from her cervix to predict ovulation. This couple is using the _____ method.
2. standard days
3. Two-Day
4. symptothermal
5. basal body temperature

Answer: B
Difficulty: 2
Page ref: 177

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: The Two-Day Method of fertility awareness allows a woman to tell when she is ovulating by carefully observing changes in the mucus that is secreted from the cervix into the vagina.

1. According to the Two-Day method of birth control _____.
2. a woman should check for changes in her vaginal walls every week
3. it is okay to use hormonal contraceptives while learning to use this method
4. it is safe to have unprotected sex during a woman’s period
5. unprotected intercourse should be avoided when mucus is present for two days

Answer: D
Difficulty: 2
Page ref: 177

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: If a woman notices the presence of clear, slick mucus for two days, she should abstain from unprotected intercourse because she is likely to be ovulating, or will soon.

1. Rena is using the basal body temperature method. She needs to check her temperature _____.
2. every day
3. every other day
4. only when she thinks she is ovulating
5. the week after ovulation has ended

Answer: A
Difficulty: 2
Page ref: 177
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: Basal body temperature refers to the internal temperature immediately upon awakening the morning. If a woman takes her temperature every morning, she will usually notice a slight drop the day before she ovulates.

53.For increased accuracy when using fertility awareness, it is recommended to _____.

1. also use an IUD
2. only check cervical mucus
3. monitor changes in cervical mucus and changes in basal body temperature
4. also take birth control pills

Answer: C
Difficulty: 2
Page ref: 177

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The combination of these two methods, called the symptothermal method of fertility awareness, is best used to determine when ovulation has ended, at which time unprotected intercourse will most likely be free of the risk of pregnancy.

1. An advantage of fertility awareness is that these methods_____.
2. protect against sexually transmitted infections
3. do not require cooperation from both partners
4. have a low failure rate if used incorrectly
5. have no negative side effects

Answer: D
Difficulty: 2
Page ref: 178

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: Fertility awareness methods involve no hormones, chemicals, or devices, so there are not negative side effects to worry about.

55.The intrauterine device is inserted into the _____.

1. fallopian tubes
2. ovaries
3. uterus
4. labia

Answer: C
Difficulty: 1
Page ref: 178

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The IUD is a small plastic device in the shape of a T that a doctor inserts into the uterus through the cervix via the vagina.

1. What is one way in which the IUD works?
2. It releases spermicide when inserted into the vagina.
3. It prevents the ovum from reaching the fallopian tube.
4. It prevents the passage of the zygote into the uterus.
5. It contains a progesterone-like hormone that thickens the cervical mucus so sperm cannot pass through.

Answer: D

Difficulty: 2

Page ref: 179

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Conceptual

Rationale: One type of IUD, Mirena, contains a small amount of progesterone-like hormone (levonorgestrel) that is released into the uterus and contributes to pregnancy prevention by thickening the cervical mucus so that sperm cells cannot pass through from the vagina.

1. Lena is interested in using the intrauterine device (IUD) as her form of contraception. What should she know about it?
2. Spermicides must be used with an IUD
3. There are many negative side effects
4. It has a low effectiveness rate
5. It is an effective method of contraception that does not require the user to remember to take a pill every day.

Answer: D
Difficulty: 3
Page ref: 179

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Application

Rationale: A main advantage of the IUD is that it is a hassle-free, effective method of contraception that does not require the user to remember to take a daily pill or have a method of contraception readily available prior to intercourse.

1. Sterilization procedures for both men and women involve _____.
2. surgery
3. abstaining
4. oral contraception
5. insertion of a vaginal ring

Answer: A
Difficulty: 1
Page ref: 179

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: Sterilization is defined as any surgical alteration that prevents the emission of sperm or eggs; it is also referred to as voluntary surgical contraception.

1. Laparoscopy is a form of female sterilization that involves _____ incisions.
2. two
3. three
4. four
5. five

Answer: A

Difficulty: 2

Page ref: 180

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

Rationale: Surgical sterilization is typically done by means of labaroscopy or minilaparascopy; both of these procedures require two very small incisions in the abdomen, through which a viewing scope and a surgical instrument are inserted.

1. A _____ involves cutting and tying off the vas deferens so that sperm produced by the testicles can no longer mix with semen in the ejaculate.
2. vasectomy
3. tubal ligation
4. Essure PBC
5. laparoscopy

Answer: A
Difficulty: 2
Page ref: 180

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

Rationale: A vasectomy involves making a small incision with a scalpel on each side of the scrotum to remove a small section of the vas deferens and closing the ends either by tying or cauterizing them. This makes it impossible for sperm to travel into the man’s body from the testicles.

1. After a vasectomy, a man is not considered to be infertile until he has submitted two semen samples after three months. This is to make sure that _____.
2. no sperm cells are left over in his reproductive tract following surgery
3. his scars have healed
4. he is ejaculating properly
5. a sufficient cut was made in his urethra

Answer: A
Difficulty: 2
Page ref: 181

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

Rationale: The small failure rate of vasectomies could be due to several factors, one of which is because sperm cells are left over in the male reproductive tract following surgery. To avoid this, a man is not considered to be infertile until he has submitted two semen samples after three months.

1. Abortion is _____.
2. a method used to prevent pregnancy
3. the termination of a pregnancy
4. an easy decision for most people
5. a fertility awareness method

Answer: B
Difficulty: 2
Page ref: 182

Topic: Abortion Is Not Contraception
Skill: Conceptual

Rationale: Abortion is the termination of a pregnancy, not the prevention of fertilization of an ovum by a sperm.

1. How many types of contraceptive methods are available for men?
2. one
3. three
4. five
5. seven

Answer: B
Difficulty: 1
Page ref: 182

Topic: Experimental and Future Methods of Contraception
Skill: Factual

Rationale: For men, there are three methods of contraception: abstinence, condoms, and vasectomy.

1. Larry is a participant in a research study that is exploring a male hormonal contraceptive. How does this type of contraception work?
2. It changes the electrical charge of sperm cells, making them incapable of fertilization.
3. It plugs the vasa deferenita.
4. It deforms the heads of the sperm, making it difficult to penetrate the ovum.
5. It alters male hormones so that sperm production decreases to the point of infertility.

Answer: D

Difficulty: 2

Page ref: 182

Topic: Experimental and Future Methods of Contraception

Skill: Application

Rationale: In 2008, a pharmaceutical company in China developed at type of injectable testosterone that suppresses the production of sperm to infertile levels within 6 months.

1. Chuck is a participant in a research study that is exploring a contraceptive technique for men called RISUG. How does RISUG work?
2. It changes the acidity and electrical charge of sperm cells, making them incapable of fertilization.
3. It plugs the vasa deferenita.
4. It interferes with the calcium in the heads of sperm, making it difficult to dissolve the outside of the ovum.
5. It alters male hormones so that sperm production decreases to the point of infertility.

Answer: A
Difficulty: 3
Page ref: 183

Topic: Experimental and Future Methods of Contraception

Skill: Application

Rationale: In the technique called RISUG, a plastic-like compound is injected into each vas deferens using a very tiny needle and a local anesthetic. As sperm pass through the material, it changes the acidity and electrical charge of the sperm cells, rendering them incapable of fertilization.

1. What are immunocontraceptives?
2. a hormonal contraceptive for men
3. a gel that kills sperm cells
4. a method to plug the vas deferentia
5. a injection that vaccinates men against fertility

Answer: D
Difficulty: 2
Page ref: 183

Topic: Experimental and Future Methods of Contraception

Skill: Factual

Rationale: Immunocontraceptives are vaccines that may cause a man’s immune system to develop antibodies against specific hormones necessary for sperm cells to mature, or to effect genetic changes in sperm to render them unable to fertilize an ovum.

1. Antimicrobial and spermicidal gels that are applied vaginally, like BufferGel, are designed to kill _____.
2. sperm cells and increase sexual pleasure
3. only viruses, but not bacteria

c bacteria and prevent a fertilized egg from reaching the uterus

1. sperm cells and block most of the pathogens that cause many STIs

Answer: D
Difficulty: 3
Page ref: 183
Topic: Experimental and Future Methods of Birth Control
Skill: Conceptual

Rationale: Antimicrobial, spermicidal gels applied vaginally are designed to stop sperm dead in their tracks and block most of the pathogens that cause sexually-transmitted infections such as HIV, genital herpes, genital warts, gonorrhea, and syphilis. The leading candidates in this line of research are known by the brand names BufferGel and Pro 2000.

TRUE-FALSE

1. Research shows that college students who are using contraception tend to use it inconsistently.

Answer: True
Difficulty: 1
Page ref: 146

Topic: Introduction
Skill: Factual

1. Research shows that most male and female college students are using reliable contraception.

Answer: False
Difficulty: 1
Page ref: 146
Topic: Introduction
Skill: Factual

1. In the late 1800s, the only form of birth control available to most people was the rhythm method.

Answer: True
Difficulty: 1
Page Ref: 147
Topic: Historical Perspectives
Skill: Factual

1. Margaret Sanger’s later work for contraceptive research funding resulted in the development of the first hormonal birth control pill.

Answer: True
Difficulty: 2
Page ref: 148
Topic: Historical Perspectives
Skill: Factual

1. Couples who are able to communicate effectively about contraception are more likely to use it consistently.

Answer: True
Difficulty: 2
Page ref: 149

Topic: Choosing a Method of Contraception
Skill: Conceptual

1. Douching is an effective means of contraception.

Answer: False
Difficulty: 2
Page ref: 151
Topic: Choosing a Method of Contraception
Skill: Conceptual

1. Having sexual intercourse standing up will prevent conception.

Answer: False
Difficulty: 2
Page ref: 151
Topic: Choosing a Method of Contraception
Skill: Factual

1. The only 100-percent effective way to prevent pregnancy and contracting STIs is selective abstinence.

Answer: True
Difficulty: 1
Page ref: 155
Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

1. Recent research reveals that the use of condoms lubricated with nonoxynol-9 may decrease the possibility of HIV transmission.

Answer: False

Difficulty: 3

Page ref: 158

Topic: Methods for Preventing Pregnancy and STIs

Skill: Factual

1. Inadequate lubrication during intercourse may cause a condom to break.

Answer: True

Difficulty: 3

Page ref: 159

Topic: Methods for Preventing Pregnancy and STIs

Skill: Conceptual

1. Removal of male condoms should occur after the loss of erection.

Answer: False
Difficulty: 2
Page ref: 160

Topic: Methods for Preventing Pregnancy and STIs
Skill: Factual

1. The female condom should be used at the same time as a male condom.

Answer: False
Difficulty: 1
Page ref: 162

Topic: Methods for Preventing Pregnancy and STIs
Skill: Conceptual

1. Withdrawal prior to ejaculation provides protection from sexually-transmitted infections.

Answer: False

Difficulty: 2

Page ref: 162-163

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. Oral contraceptives should be taken at approximately the same time each day.

Answer: True
Difficulty: 1
Page ref: 165-166
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. Amenorrhea is a common side effect of Depo-Provera.

Answer: True
Difficulty: 3
Page ref: 169

Topic: Methods for Preventing Pregnancy (But Not STIs))
Skill: Factual

1. The contraceptive patch may expose women to much lower levels of hormones than are found in most oral contraceptives

Answer: False
Difficulty: 3

Page ref: 170
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

1. The vaginal ring is left in the vagina for three weeks.

Answer: True
Difficulty: 2
Page ref: 170
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

1. Emergency contraception should be taken as soon as possible after unprotected intercourse.

Answer: True
Difficulty: 2
Page ref: 172
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. The diaphragm can be placed in the vagina up to two days before intercourse.

Answer: False
Difficulty: 2
Page ref: 173
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. With proper care and storage, barrier devices like the diaphragm and the cervical cap can last from six months to two years.

Answer: True
Difficulty: 2
Page ref: 173
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. The contraceptive sponge cannot be used with male or female condoms.

Answer: False
Difficulty: 2
Page ref: 175
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

1. Fertility awareness provides protection from sexually-transmitted infections.

Answer: False
Difficulty: 1
Page ref: 176

Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. The Standard Days Method requires a woman to predict the time period in which she ovulates.

Answer: True
Difficulty: 1
Page ref: 176
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. One of the main advantages of the IUD is that it does not require the user to remember to take a pill each day.

Answer: True
Difficulty: 2
Page ref: 179
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Factual

1. A vasectomy is a sterilization procedure in which a section of a man’s urethra is removed.

Answer: True
Difficulty: 2
Page ref: 180
Topic: Methods for Preventing Pregnancy (But Not STIs)
Skill: Conceptual

1. Abortion is the prevention of fertilization of an ovum by a sperm.

Answer: False
Difficulty: 2
Page ref: 182
Topic: Abortion Is Not Contraception

Skill: Factual

1. Research on immunocontraceptives for men focuses on developing vaccines that may cause a man’s immune system to develop antibodies against specific hormones necessary for sperm cells to mature.

Answer: True
Difficulty: 2
Page ref: 183

Topic: Experimental and Future Methods of Contraception

Skill: Factual

SHORT ANSWER

1. _____ is any process or means of preventing sperm cells from fertilizing an ovum.

Answer: Contraception
Difficulty: 1
Page ref: 146

Topic: Introduction

Skill: Factual

1. _____ opened the first birth control clinic in Brooklyn, New York.

Answer: Margaret Sanger
Difficulty: 1
Page ref: 148

Topic: Historical Perspectives

Skill: Factual

1. Couples practicing _____ avoid all sexual expression and activity.

Answer: celibacy
Difficulty: 2
Page ref: 155
Topic: Methods for Preventing Pregnancy and STIs

Skill: Conceptual

1. The _____ is a thin sheath of latex or polyurethane that is placed over an erect penis prior to intercourse.

Answer: male condom
Difficulty: 1
Page ref: 156

Topic: Methods for Preventing Pregnancy and STIs

Skill: Factual

1. The female condom is made of _____.

Answer: polyurethane
Difficulty: 2
Page ref: 160-161

Topic: Methods for Preventing Pregnancy and STIs

Skill: Factual

1. The female condom may be inserted up to _____ hours before intercourse.

Answer: eight
Difficulty: 2
Page ref: 162
Topic: Methods for Preventing Pregnancy and STIs

Skill: Factual

1. Another name for the withdrawal method is _____.

Answer: coitus interruptus

Difficulty: 2

Page ref: 162

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. The _____ is an oral contraceptive containing only progestin.

Answer: minipill
Difficulty: 3
Page ref: 164

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. A pad that delivers a precise dose of two hormones into a woman’s body through the skin is called the _____.

Answer: contraceptive patch
Difficulty: 2
Page ref: 169-170

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. A birth control method in which unprotected sexual intercourse is avoided on the days a woman is assumed to be ovulating is called the _____.

Answer: Standard Days Method

Difficulty: 2
Page ref: 172

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. The _____ is a small plastic device in the shape of a T that a doctor inserts into the uterus.

Answer: intrauterine device

Difficulty: 2
Page ref: 178
Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. Another name for voluntary surgical contraception is _____.

Answer: sterilization

Difficulty: 1
Page ref: 179

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Factual

1. _____ change the acidity and electrical charge of sperm cells, rendering them incapable of fertilization.

Answer: Vas injection techniques

Difficulty: 3
Page ref: 183
Topic: Experimental and Future Methods of Contraception

Skill: Factual

1. Researchers are looking into injectable _____ for men, which could cause a man’s immune system to develop antibodies against specific hormones necessary for sperm cells to mature.

Answer: immunocontraceptives

Difficulty: 3
Page ref: 183
Topic: Experimental and Future Methods of Contraception

Skill: Factual

1. One effect of _____ that are applied vaginally is to block most of the pathogens that cause sexually transmitted infections.

Answer: antimicrobial gels

Difficulty: 3
Page ref: 183

Topic: Experimental and Future Methods of Contraception

Skill: Factual

ESSAY

1. Discuss the politics of contraception during the early twentieth century. Explain the Comstock Act. What was Margaret Sanger’s contribution?

Difficulty: 2
Page ref: 147-148
Topic: Historical Perspectives

Skill: Factual

Responses should consider:

• Prior to 1930, federal laws prohibited nearly everything related to contraception, including providing information about it.
• These laws were contained in a bill referred to as the Comstock Act, named after its primary supporter, Anthony Comstock.
• The act made it illegal to sell or distribute contraceptive information or devices in any form.
• It made it a crime for any mention of sexually transmitted diseases to appear in print.
• Doctors and nurses were prohibited from discussing these issues with their patients.
• The only method available at the time was the rhythm method.
• Margaret was a nurse and mother of three children, and the one given credit for overcoming the Comstock Act and making contraception widely available.
• In 1912, she began to write and publish articles on female sexuality and on a woman’s right to control her own reproductive body.
• After visiting a birth control clinic in the Netherlands where women were given the diaphragm, she returned to the S. and opened the first birth control clinic in Brooklyn, N.Y.
• The clinic was raided by the police, and she spent 30 days in jail.
• She became a celebrity, and by 1916, 100,000 copies of her booklet Family Limitation had been distributed, and birth control clinics had begun to operate. Her later work for contraceptive research funding resulted in the development of the first hormonal contraceptive pill in the late 1950s.
• She is considered one of the founders of Planned Parenthood.

1. Discuss some of the lifestyle issues that need to be taken into consideration when choosing a method of contraception.

Difficulty: 2
Page ref: 148-150

Topic: Choosing a Method of Contraception

Skill: Conceptual

Responses should consider:

• Contraception refers to preventing conception, which occurs at the moment the ovum and sperm cell join in the fallopian tube.
• Contraception is also about choice, allowing individuals to plan, when, or if, to conceive and bear children.
• Not all contraception methods are equally appropriate for all sexual lifestyles and life stages.
• Individuals should ask themselves some of the following questions:
• Am I engaging in sexual activities that involve any risk of pregnancy or the transmission of STIs?
• Am I confident that I am in a one-on-one, exclusive relationship in which both of us are free of diseases that may be sexually transmitted?
• How often do I engage in potentially risky sexual activities?
  Do I have (or am I likely to have) more than one concurrent sexual partner?
• How seriously would an accidental pregnancy disrupt my life?
• Will the method I choose conflict with my religious beliefs?
• Do I need to be in charge of contraception, or can I trust my partner to take care of it?
• Do I feel comfortable with using this method of contraception?
• Answering the above questions will help an individual to determine exactly what features he/she needs in a method of contraception.

1. What are male and female condoms? Discuss how both types of condoms work, how to use them, and their advantages and disadvantages.

Difficulty: 2
Page ref: 156-162

Topic: Methods for Preventing Pregnancy and STIs

Skill: Conceptual

Responses should consider:

• A male condom is a think sheath of latex (rubber) or polyurethane (plastic) that is placed over an erect penis prior to intercourse.
• Male condoms offer protection against pregnancy and STIs.
• They work by acting as a barrier to prevent semen from entering the vagina.
• They also prevent contact of skin with mucous membranes and the exchange of genital fluids that can transmit STIs.
• There are four rules for their use:

1. Use latex or polyurethane condoms only.
2. Use lubricated condoms.
3. Use condoms with a reservoir tip (or nipple).
4. Don’t use condoms that have expired.

• To use a male condom correctly:
• Open the package carefully.
• Don’t test the condom by filling it with air or water.
• The condom should be placed on the erect penis before any contact between the penis the partner’s genital area.
• To be sure which way the condom unrolls, place it over a finger and unroll it slightly.
• Pinch the end of the condom as you unroll it to leave a small amount of empty space at the tip.
• Unroll the condom all the way to the base of the penis.
• Be sure there is adequate lubrication.
• If you are adding lubrication, do not use oil-based products; use only water-based products.
• If it feels as if the condom has broken off or slipped during intercourse, stop and check.
• Advantages of male condoms include:
• They are highly effective way of preventing conception and reducing STIs.
• They are widely available.
• They come with and without lubrication, with and without spermicide.
• They come in sizes, colors, textures.
• Disadvantages include:
• The Catholic Church doesn’t approve of their use, except in the case specific circumstances for the prevention of HIV.
• Failure rates are typically due to incorrect use.
• Some say they interrupt or interfere with the flow and romance of making love.
• Some men claim that condoms significantly reduce sensitivity during intercourse or interfere with erection.
• The female condom consists of a tube of thin polyurethane with a flexible ring at each end.
• During intercourse, the female condom stays inside the vagina and the penis moves within it.
• After ejaculation, the condom must be removed by twisting the outside ring to trap semen inside and gently pulling the condom out of the vagina.
• This should be done before the woman stands up to be sure none of the semen spills out of the condom into or around the vaginal area.
• Each female condom should be used only once.
• Advantages include:
• Female condoms allow the woman to be in more control of contraception and preventing STIs.
• They allow for greater spontaneity than male condoms because the female condom may be inserted up to eight hours before intercourse.
• If used correctly, it may provide slightly greater protection from STIs than male condoms. This is because the polyurethane material does not degrade with the use of oil-based lubricants, and the shape of the external ring of the condom protects a wider area of skin between the base of the penis and the vulva or anus during intercourse.
• If used correctly and consistently, female condoms are nearly as effective as male condoms.
• Disadvantages include:
• Female condoms cost somewhat more than male condoms, approximately $1 to $2 each.
• The typical-use conception failure rate is slighter higher for female condoms than for male condoms. Errors in use include removing the condom incorrectly, allowing semen to spill out in or near the vagina, or the penis may sometimes be inserted by mistake next to rather than inside of the condom.

1. What are oral contraceptives? Discuss the advantages and disadvantages of this method of contraception. Describe two types of oral contraceptives, how they work, and their effectiveness.

Difficulty: 2
Page ref: 163-168

Topic: Methods for Preventing Pregnancy (But Not STIs)

Skill: Conceptual

Responses should consider:

• Oral contraceptives are also called birth control pills.
• Combination oral contraceptives contain both estrogen and progestin.
• The contraceptive effect on a woman taking these hormones is that her body’s normal hormonal cycle is altered, and ovulation is prevented.
• Advantages include:
• They are very effective.
• There is no interruption of lovemaking.
• They are generally very safe.
• They often make menstrual cycles more regular and reduce or relieve symptoms of PMS and menstrual cramps.
• They may reduce the length of the menstrual period, and the amount of bleeding.
• Disadvantages include:
• They do not protect against STIs.
• It’s easy to miss doses.
• Depending on where they are purchased, they can be relatively expensive.
• There is the possibility of spotting.
• There is the possibility of nausea.
• There are possible side effects; if experiencing any of the following, call a physician immediately: ACHES

A – abdominal pain

C – chest pain (severe) with a cough or shortness of breath

H – headache (severe), dizziness, weakness, numbness

E – eye problems, vision, loss, blurring, slurred speech

S – severe leg pain

• One type is the minipill.
• It is a progestin-only pill, and has approximately the same low failure rate as the combination (progestin and estrogen) pill.
• The main advantage is that it avoids some of the potentially negative side effects associated with estrogen.
• A disadvantage is that many of the health benefits associated with the estrogen in the combined pill are not present in the progestin-only pill.
• It interferes with ovulation.
• It also causes a thickening of the mucus secreted by the cervix, which sets up a barrier that is very difficult for sperm to penetrate.
• If some sperm do get through, the lining of the uterus that develops to support a fertilized egg is thinner in a woman taking the minipill, and is therefore less receptive to implantation and pregnancy.
• Another type is the extended-dosage contraceptive pill, such as Seasonale.
• These pills provide a daily dose or hormones for 84 consecutive days, during which a woman is protected against pregnancy and does not menstruate.
• After the 84 pills are taken, a woman then takes a placebo for 7 days, during which she will typically have her period.
• A woman will only have four menstrual periods a year.
• Research has shown no dangers from menstrual suppression.
• Advantages include:
• These can be recommended by doctors for women with menstruation-related health problems, and have been used by women themselves to delay or skip a period.
• Women who have especially painful period, heavy bleeding, cycle-related migraine headaches, or other serious menstruation-related conditions may benefit from reducing the annual number of periods.
• Disadvantages include:
• The most serious side effect was an increase in bleeding or spotting between periods.
• These extended-dosage contraceptive pills carry the same health risks as other combination pills with similar formulations.

1. Discuss one future method of birth control for men and one future method of birth control for women. Explain how these methods could work to prevent pregnancy.

Difficulty: 3
Page ref: 182-183
Topic: Experimental and Future Methods of Contraception

Skill: Conceptual

Responses should consider:

• A future method of birth control for men is:
• A male hormonal contraceptive.
• This is under investigation in many countries worldwide.
• If it’s brought to the marketplace, it will probably be in the form of an injection, an implant, or a patch.
• In 2008, a pharmaceutical company in China developed a type of injectable testosterone that was 99% effective in preventing pregnancy by suppressing the production of sperm to infertile levels within six months.
• Upon discontinuation of the treatment, nearly all the men’s sperm levels returned to normal fertility levels within four months.
• Some researchers say that a male hormonal method of contraception could become widely available by 2020.
• A future method of birth control for women is:
• Antimicrobial, spermicidal gels that are applied vaginally.
• They are designed to stop sperm dead in their tracks and block most of the pathogens that cause STIs such as HIV, genital herpes, genital warts, gonorrhea, and syphilis.
• One brand name is BufferGel, which did not offer significant protection from HIV
• BufferGel has been shown to be an effective spermicide for use with the diaphragm.

CHAPTER 7:

Sexual Problems and Solutions

Total Assessment Guide (T.A.G.)

Topic	Question Type	Factual	Conceptual	Application
Introduction to Chapter	Multiple Choice
	True/False
	Short Answer
	Essay
Historical Perspectives	Multiple Choice	1	2
	True/False	1-2
	Short Answer	1
	Essay
What Is a Sexual Problem?	Multiple Choice	3, 7, 8, 9	5, 6, 10, 14	4, 11-13
	True/False	3-5	6
	Short Answer	2, 3, 4
	Essay			1
Sources of Sexual Problems	Multiple Choice	15, 20, 24, 25	16, 23	17-19, 21-22
	True/False	7, 10-11	8-9, 12
	Short Answer	5, 6
	Essay		2
General Guidelines for Solving Sexual Problems	Multiple Choice	26, 30, 33	27-28	29, 31-32
	True/False	13, 15-17	14
	Short Answer	8-9	7
	Essay		3
Specific Problems and Solutions	Multiple Choice	38-39, 41-43, 49, 52, 55, 58, 61, 63, 65	35-36, 44, 45, 47-48, 57- 59, 60,	34, 37, 40, 46, 50-51, 53-54, 56, 62, 64
	True/False	18-19, 21- 23, 25, 27, 29	20, 24, 26, 28, 30
	Short Answer	10, 12-15	11
	Essay	4	5

Major Headings:

1. 226-227 Introduction to Chapter
2. 227-228 Historical Perspectives
3. 228-231 What Is a Sexual Problem?
4. 231-238 Sources of Sexual Problems
5. 238-243 General Guidelines for Solving Sexual Problems
6. 243-267 Specific Problems and Solutions

MULTIPLE CHOICE

1. According to the text, the work of _______ revolutionized our understanding of sexual anatomy and sexual responding.
2. Kinsey
3. Masters and Johnson
4. Hite
5. Kaplan

Answer: B
Difficulty: 1
Page ref: 227
Topic: Historical Perspectives
Skill: Factual

Rationale: The work of William Masters and Virginia Johnson in the early 1960s revolutionized our understanding of human sexual anatomy and sexual responding.

1. Today’s treatments of sexual difficulties rely heavily on an interaction of _______ factors.
2. psychological and physical
3. physical and spiritual
4. psychological and spiritual
5. spiritual and cultural

Answer: A
Difficulty: 2
Page ref: 227

Topic: Historical Perspectives

Skill: Conceptual

Rationale: Today’s successful treatments of sexual difficulties rely heavily on an interaction of psychological and physical factors.

1. Most sexual problems are _______.
2. diagnosed by a physician
3. diagnosed by a therapist
4. self-diagnosed
5. diagnosed by family members

Answer: C
Difficulty: 1
Page ref: 228
Topic: What Is a Sexual Problem?
Skill: Factual

Rationale: Most sexual problems are self-diagnosed.

1. Lena feels that she is the only person in the world who has a sexual problem. Given the information discussed in the textbook about sexual problems, what would you tell Lena?
2. Sexual problems are rare.
3. Sexual difficulties are very common.
4. It is important to keep sexual problems a secret.
5. Only women experience sexual problems.

Answer: B
Difficulty: 2
Page ref: 228-230
Topic: What Is a Sexual Problem?
Skill: Application

Rationale: Sexual problems are more common than people think. When people are experiencing a sexual problem, they often assume that they are the only ones suffering from that particular difficulty.

1. Which of the following sexual problems occurs in females?
2. vaginismus
3. erectile problems
4. delayed ejaculation
5. rapid ejaculation

Answer: A
Difficulty: 2
Page ref: 229
Topic: What Is a Sexual Problem?
Skill: Conceptual

Rationale: Vaginismus is painful, involuntary spasms of the musculature of the outer third of the vagina.

1. Which of the following sexual problems can occur in males and in females?
2. sexual aversion
3. inhibited sexual arousal
4. inhibited orgasm
5. hypoactive sexual desire

Answer: D
Difficulty: 1
Page ref: 229
Topic: What Is a Sexual Problem?
Skill: Conceptual

Rationale: Hypoactive sexual desire disorder occurs when an individual has few or no sexual fantasies, and little or no desire for sexual activity.

1. Masters and Johnson estimated that half of all married couples experience a _______ sexual problem at some point in their marriage.
2. diagnosable
3. undiagnosable
4. treatable
5. curable

Answer: A
Difficulty: 2
Page ref: 229
Topic: What Is a Sexual Problem?
Skill: Factual

Rationale: Masters and Johnson (1970) estimated that half of all married couples experience a diagnosable sexual problem at some point in their marriages.

1. According to a national survey conducted in the 1990s, approximately what percentage of men reported having premature ejaculation?
2. 2-5
3. 7-11
4. 15-25
5. 35-45

Answer: C
Difficulty: 3
Page ref: 230
Topic: What Is a Sexual Problem?
Skill: Factual

Rationale: In a national survey conducted in the 1990s, it was discovered that the percentage of men reported having premature ejaculation was 15.7 to 24.7.

1. According to a national survey conducted in the 1990s, which of the following problems were most frequently reported by women?
2. hypoactive sexual desire
3. inability to reach orgasm
4. pain during sex
5. difficulty lubricating

Answer: A
Difficulty: 3
Page ref: 230
Topic: What Is a Sexual Problem?
Skill: Factual

Rationale: In a national survey conducted in the 1990s, it was discovered that the percentage of women reporting hypoactive sexual desire was 16.0 to 33.9; this figure represented the largest percentage of any reported category.

1. Which of the following are the dimensions that comprise the three-dimensional model of sexual problems?
2. duration, context, intensity
3. duration, frequency, intensity
4. frequency, intensity, context
5. duration, context, frequency

Answer: D
Difficulty: 1
Page ref: 230
Topic: What Is a Sexual Problem?
Skill: Conceptual

Rationale: The three-dimensional model of sexual problems is a method of classifying or diagnosing sexual problems according to their duration, context, and frequency.

1. Alyssa is a 40-year-old woman who has never achieved orgasm with a partner, but has done so during masturbation. According to the three-dimensional model of sexual problems, Alyssa would be classified as having a _______ and _______ sexual problem.
2. primary; secondary
3. primary; situational
4. secondary; global
5. secondary; partial

Answer: B
Difficulty: 3
Page ref: 230-231

Topic: What Is a Sexual Problem?
Skill: Application

Rationale: A primary sexual problem is one that has always existed in the person’s sexual life. A situational sexual problem is experienced in specific settings, but is absent in other contexts.

1. Kareem is a 35-year-old man who is unable to maintain an erection with his partner, but has not had this problem with other partners in the past. According to the three-dimensional model of sexual problems, Kareem would be classified as having a _______ and _______ sexual problem.
2. primary; secondary
3. primary; global
4. secondary; situational
5. secondary; partial

Answer: C
Difficulty: 3
Page ref: 230-231
Topic: What Is a Sexual Problem?

Skill: Application

Rationale: A secondary sexual problem is one that is occurring now but was not present at some point in the person’s past sexual experiences. A situational sexual problem is experienced in specific settings but is absent in other contexts.

1. According to the three-dimensional model of sexual problems, a woman who has never experienced an orgasm without or without a partner in any setting would be classified as having a _______ and _______ sexual problem.
2. primary; secondary
3. primary; global
4. secondary; situational
5. secondary; partial

Answer: B
Difficulty: 3
Page ref: 230-231
Topic: What Is a Sexual Problem?
Skill: Application

Rationale: A primary sexual problem is one that has always existed in the person’s sexual life. A global problem is one that occurs for an individual or couple in virtually all settings.

1. According to the three-dimensional model of sexual problems, a problem that occurs every time in a given setting is defined as _______.
2. total
3. partial
4. situational
5. global

Answer: A
Difficulty: 2
Page ref: 231
Topic: What Is a Sexual Problem?
Skill: Conceptual

Rationale: A total sexual problem is one that occurs every time in a given setting.

1. Sexual problems stemming from _______ sources typically occur when the physical body is incapable of responding appropriately, regardless of the sexual activities that are occurring.
2. biological
3. psychological
4. relationship
5. cultural

Answer: A
Difficulty: 2
Page ref: 232
Topic: Sources of Sexual Problems
Skill: Factual

Rationale: Sexual problems stemming from biological or physiological sources typically occur when the physical body is incapable of responding appropriately, regardless of the partner, the setting, or the sexual activities that may be occurring.

1. What effect does alcohol have on sexual functioning?
2. It can inhibit penile erection and clitoral engorgement.
3. It enhances physiological sexual response.
4. It increases sexual desire.
5. It speeds up orgasms.

Answer: A
Difficulty: 3
Page ref: 233
Topic: Sources of Sexual Problems

Skill: Conceptual

Rationale: Alcohol causes blood vessels throughout the body to dilate, which can reduce blood flow to the genitals and inhibit such responses as penile erection, clitoral engorgement, and vaginal lubrication.

1. Garth is a heavy cigarette smoker. What types of sexual problems can he possibly experience due to smoking?
2. erectile problems
3. decreased desire
4. inhibited ejaculation
5. dyspareunia

Answer: A
Difficulty: 2
Page ref: 233

Topic: Sources of Sexual Problems

Skill: Application

Rationale: The nicotine in heavy cigarette use has been found to interfere with erections in men by causing plaque to build up in the arteries and reducing blood flow to the genitals.

1. Linda is taking SSRIs to treat depression. Which of the following might she experience as a result of these medications?
2. erectile problems
3. decreased desire
4. inhibited orgasm
5. priapism

Answer: C
Difficulty: 2
Page ref: 233
Topic: Sources of Sexual Problems

Skill: Application

Rationale: A common side effect of SSRIs involves sexual problems, usually relating to inhibition of orgasm.

1. Elsa is currently in a satisfying marriage. However, she has anxiety about getting pregnant that is manifesting in her inability to become sexually aroused. Her sexual problem is the result of _______ causes.
2. biological
3. psychological
4. cultural
5. social

Answer: B
Difficulty: 2
Page ref: 233
Topic: Sources of Sexual Problems

Skill: Application

Rationale: Strong emotions such as stress, fear, guilt, anxiety, and depression trigger responses in the nervous and endocrine systems that are incompatible with sexual arousal.

1. Which of the following is NOT one of the six relationship factors that can affect sexual functioning?
2. poor communication
3. loss of trust
4. cultural differences
5. conflicting sexual expectations

Answer: C
Difficulty: 2
Page ref: 236-237
Topic: Sources of Sexual Problems

Skill: Factual

Rationale: The six factors are: loss of trust, poor communication, anger and resentment, conflicting sexual experiences, lack of respect, and loss of love. Cultural differences is not listed as one of the six factors.

1. Joel has arousal difficulties when attempting to make love with his partner. Which of the following may be a source of his problem?
2. loss of trust in his partner
3. conflicting sexual expectations
4. cultural differences
5. religious differences

Answer: A
Difficulty: 3
Page ref: 236
Topic: Sources of Sexual Problems

Skill: Application

Rationale: Some sexual problems, such as arousal difficulties, can be linked to the lack or loss of trust in a relationship.

1. Marissa and Milo are seeing a counselor because they would like to improve their already satisfying sexual relationship. Which of the following would their counselor most likely recommend?
2. try to be intuitive regarding each other’s needs and wishes
3. make sounds that communicate excitement and pleasure
4. create a list of sexual demands for each other
5. discuss openly their sexual likes, dislikes, and desires

Answer: D
Difficulty: 2
Page ref: 236
Topic: Sources of Sexual Problems

Skill: Application

Rationale: The ability to express sexual feelings, sexual desires, or insecurities about sex is crucial in establishing and maintaining a sexually satisfying relationship.

1. When a person is angry, there are two barriers to sexual intimacy that function simultaneously. These barriers are _______ and _______.
2. physiological responses; psychological distance
3. psychological distance; cultural issues
4. physiological responses; cultural issues
5. social expectations; psychological distance

Answer: A
Difficulty: 2
Page ref: 236
Topic: Sources of Sexual Problems

Skill: Conceptual

Rationale: In anger, two barriers to sexual intimacy are functioning simultaneously. One barrier is the specific physiological responses of the autonomic nervous system, and the other one is the psychological distance and loss of desire for intimacy with the partner that accompanies the anger.

1. Valuing a partner’s wishes, ideas, desires, unique characteristics, and abilities are the components of _______.
2. love
3. respect
4. desire
5. attraction

Answer: B
Difficulty: 2
Page ref: 237
Topic: Sources of Sexual Problems

Skill: Factual

Rationale: Mutual respect involves honoring and valuing the partner’s wishes, ideas, attitudes, desires, abilities, and unique characteristics as a person.

1. When people of different cultures become involved in a romantic relationship, their attitudes and expectations regarding sex may cause _______.
2. sexual problems
3. lack of respect
4. depression
5. low self esteem

Answer: A
Difficulty: 2
Page ref: 238
Topic: Sources of Sexual Problems

Skill: Factual

Rationale: When people from different cultures become involved in a romantic relationship, their deeply ingrained attitudes and expectations about sex and romance may clash, causing relationship or sexual problems.

1. Which of the following researchers wrote Human Sexual Inadequacy?
2. Kaplan
3. Kinsey
4. Money
5. Masters and Johnson

Answer: D
Difficulty: 1
Page ref: 239
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

Rationale: In their groundbreaking book, Human Sexual Inadequacy, Masters and Johnson described a comprehensive sex therapy program for couples dealing with various sexual problems.

1. Sensate focus _______.
2. redirects emphasis away from intercourse and focuses on sensuality
3. redirects emphasis away from sensuality and focuses on intercourse
4. emphasizes teaching clients mutual masturbation techniques
5. emphasizes teaching clients oral sex and creative intercourse techniques

Answer: A
Difficulty: 2
Page ref: 239-240
Topic: General Guidelines for Solving Sexual Problems

Skill: Conceptual

Rationale: The comprehensive sex therapy program for couples described in Human Sexual Inadequacy was known as sensate focus.

1. The beginning stages of the Masters and Johnson technique of sensate focus involve _______.
2. caressing the genitals and breasts in order to reach an intense orgasm
3. removal of all clothing and caressing all non-genital body parts without reaching orgasm
4. the use of strictly nonverbal techniques to determine one’s partner’s erogenous zones
5. the use of specific exercises by a female surrogate with a male client

Answer: B
Difficulty: 2
Page ref: 240
Topic: General Guidelines for Solving Sexual Problems

Skill: Conceptual

Rationale: In the beginning states, couples are to remove their clothing and spend time taking turns touching and caressing each other, focusing on the pleasure they feel in touching and being touched. They must not touch each other’s breasts or genital areas.

1. Lizzie and Lucas are at a point in their sensate focus sex therapy where they are allowed to caress each other’s nipples and genitals. They are at a point in therapy where the goal is to _______.
2. have sex several times per week
3. orgasm
4. achieve sensual and pleasurable sensations
5. learn sexy behaviors

Answer: C
Difficulty: 2
Page ref: 240
Topic: General Guidelines for Solving Sexual Problems

Skill: Application

Rationale: When the caressing is allowed to expand to include nipples and genitals, the goal continues to be sensual and pleasurable sensations, not orgasm.

1. Which of the following is NOT a reason why masturbation is a central component in the treatment of various sexual problems?
2. It allows individuals to become more aware of their own bodily sensations.
3. It helps individuals work on specific sexual difficulties without a partner.
4. It serves as a sexual release while couples are working on sexual problems.
5. It enables couples to reconnect on a sensual level rather than focus on sexual release.

Answer: D
Difficulty: 3
Page ref: 241
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

Rationale: The reasons given for why masturbation is a central component in the treatment of various sexual problems include: allowing individuals to become more aware of their own bodily sensations during arousal and orgasm; this, in turn helps partners explain to each other what kinds of stimulation feels best; it also serves as a sexual release while couples are working on solving their sexual problems; and it helps individuals work on specific sexual difficulties without a partner or issues they are not comfortable exploring with a partner.

1. Erica and Manny’s therapist gave them masturbation activities to help them overcome a sexual problem. Their therapist is using which of the following strategies?
2. sensate focus
3. communication enhancement
4. directed masturbation
5. spectatoring

Answer: C
Difficulty: 2
Page ref: 241-242
Topic: General Guidelines for Solving Sexual Problems

Skill: Application

Rationale: Directed masturbation is a sex therapy strategy in which the therapist advises the client on how to use masturbation activities to help overcome a sexual problem.

1. Which of the following is the best way to communicate sexual preferences and desires to one’s partner?
2. make sounds or movements to communicate excitement and pleasure
3. use mirroring techniques while making love
4. verbally express sexual needs, likes, dislikes, and feelings
5. use nonverbal communication in the form of touch

Answer: C
Difficulty: 2
Page ref: 242-243
Topic: General Guidelines for Solving Sexual Problems

Skill: Application

Rationale: Unless people communicate their sexual desires, likes, dislikes, preferences, and feelings, their partners won’t know what they are. Communication plays a significant role in the success or failure of relationships.

1. Virtually all sex therapies involve _______.
2. directed masturbation strategies
3. medication
4. enhancing communication
5. touch mirroring

Answer: C
Difficulty: 2
Page ref: 243
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

Rationale: Virtually all sex therapy strategies involve an element of enhancing communication between partners.

1. Moe and Flo have been partners for several years. Over the past year they have lost their sexual desire even though they say they still love each other. Moe and Flo are experiencing _______.
2. generalized arousal disorder
3. hypoactive sexual desire
4. sexual disinhibition
5. sexual rejection disorder

Answer: B
Difficulty: 2
Page ref: 243-244
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Hypoactive sexual desire is a persistently low level or lack of sexual fantasies or desire for sexual activity.

1. Which general category of sexual problems are the most common problems presented in therapy?
2. problems with desire
3. erectile problems
4. problems reaching orgasm
5. problems with arousal

Answer: A
Difficulty: 2
Page ref: 244
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Problems with desire are the most common sexual problems presented in therapy, and are generally considered the most difficult to treat.

1. Sensate focus is used as a treatment for hypoactive sexual desire by _______.
2. reacquainting each partner with the pleasurable sensation of sexual response
3. teaching couples how to communicate their feelings to each other
4. helping couples reduce their anxiety about intercourse and fears about performance
5. gradually eliminating specific thoughts that may be causing their sexual problems

Answer: C
Difficulty: 2
Page ref: 245
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Sensate focus, in reducing anxiety about intercourse and fears about performance, may reawaken sensuality for the couple and spark new sexual feelings.

1. Louis is seeking therapy for hypoactive sexual desire. His therapist is using an intervention technique that is designed to gradually eliminate his self-defeating beliefs and attitudes that underlie his sexual problems. What technique is Louis’ therapist using?
2. sensate focus
3. communication enhancement
4. masturbation exercises
5. cognitive-behavioral therapy

Answer: D
Difficulty: 2
Page ref: 245
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Cognitive-behavioral therapy is designed to gradually eliminate specific thoughts and associated behaviors that may be contributing to sexual problems.

1. Male erectile disorder was once referred to as _______.
2. dyspareunia
3. vaginismus
4. spectatoring
5. impotence

Answer: D
Difficulty: 1
Page ref: 248
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Male erectile disorder used to be called impotence.

1. Male erectile problems are most common in which of the following age groups?
2. 15-20
3. 20-40
4. 40-60
5. 60-75

Answer: D
Difficulty: 2
Page ref: 248
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Difficulties with erections at some point in a man’s life are extremely common, but they are most common for men between 60 and 75. Ninety-four percent of men between 60 and 75 report frequent erectile difficulties.

1. Luke has experienced erectile difficulty on several occasions. As a result, he developed a fear of not being able to achieve an erection. Luke has _______.
2. dyspareunia
3. vaginismus
4. depression
5. performance anxiety

Answer: D
Difficulty: 2
Page ref: 249
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Performance anxiety is the fear of not being able to perform as expected.

1. Mentally observing and judging oneself during sexual activities with a partner is

called _______.

1. dyspareunia
2. impotence
3. spectatoring
4. performance anxiety

Answer: C
Difficulty: 2
Page ref: 249
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Spectatoring refers to mentally observing and judging oneself during sexual activities with a partner; it may cause sexual problems.

1. Viagra is used as a treatment for _______.
2. hypoactive sexual desire
3. erectile disorder
4. male orgasmic disorder
5. premature ejaculation

Answer: B
Difficulty: 2
Page ref: 250
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Viagra is a medication for the treatment of erectile problems.

1. Which of the following is a treatment for male erectile disorder?
2. penile implants
3. spectatoring
4. squeeze technique
5. hormone therapy

Answer: A
Difficulty: 2
Page ref: 250
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: One method used to treat erectile dysfunction is penile implants; they are surgically inserted into the penis and virtually guarantee an erection.

1. Which of the following is a way of determining if the cause of a man’s erectile dysfunction is physiological?
2. monitor erections while viewing pornographic materials
3. use the squeeze or start/stop technique
4. monitor erections during REM sleep
5. count the amount of erections he has each day

Answer: C
Difficulty: 2
Page ref: 250-252
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: A common test for determining the underlying cause of erectile dysfunction is to monitor nocturnal penile tumescence during REM sleep.

1. One approach to treating erectile problems that are caused by psychological factors is to encourage a couple to _______.
2. make more effective use of power and control in the course of foreplay and coitus
3. eliminate specific thoughts that may be causing the problems
4. engage in kissing and caressing for pleasure rather than as preludes to intercourse
5. incorporate the kinds of fantasies into their sex life that will lead to erections

Answer: C
Difficulty: 3
Page ref: 252
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: When the agreement has been made between partners to engage in non-demand pleasuring, such as kissing, touching, and caressing, for the sake of pleasure itself and not as preludes to intercourse, many men who have been dealing with erectile disorder find themselves very aroused and very erect throughout the entire session.

1. Zora has a persistent inability to attain an adequate lubrication-swelling response of sexual excitement. She probably has _______.
2. female sexual arousal disorder
3. female orgasmic disorder
4. hypoactive sexual desire
5. sexual aversion disorder

Answer: A
Difficulty: 2
Page ref: 252
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Female sexual arousal disorder is a persistent or recurrent inability to attain or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement.

1. Which of the following is a physiological cause of female sexual arousal disorder?
2. hormonal imbalances
3. blocked coronary arteries
4. migraine headaches
5. dyspareunia

Answer: A
Difficulty: 2
Page ref: 254
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: One common biological issue involved in FSAD relates to hormonal levels and imbalances. Hormone levels are associated with sexual responses in women.

1. Low levels of _______ are linked with low levels of arousal.
2. thyroxin
3. progesterone
4. testosterone
5. estrogen

Answer: C
Difficulty: 2
Page ref: 254
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Testosterone is produced by the ovaries, and it appears to be an important factor in female sexuality. Abnormally low levels of testosterone in women seem to be linked to low levels of desire, arousal, and even low sexual sensitivity in the nipples, vagina, and clitoris.

1. Which of the following is NOT considered a general treatment for female sexual arousal disorder?
2. enhanced communication
3. sensate focus exercises
4. cognitive behavioral therapy
5. directed masturbation

Answer: C
Difficulty: 2
Page ref: 255

Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Therapy for FSAD typically includes a combination of treatments, such as enhanced communication, specific sensate focus exercises, and directed masturbation.

1. Elsie has been married for seven years. During this time she has never reached orgasm. Elsie probably has which of the following disorders?
2. female sexual arousal disorder
3. female orgasmic disorder
4. hypoactive sexual desire
5. sexual aversion disorder

Answer: B
Difficulty: 2
Page ref: 256
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Female orgasmic disorder is a sexual problem in which a woman rarely or never reaches orgasm, or in which orgasms are delayed.

1. Joanna is a 55-year-old woman who has been sexually active for many years but has never experienced an orgasm. Joanna would most likely be diagnosed with _______.
2. primary anorgasmia
3. situational anorgasmia
4. sexual aversion disorder
5. hypoactive sexual desire

Answer: A
Difficulty: 3
Page ref: 256
Topic: Specific Problems and Solutions

Skill: Application

Rationale: A woman who has never experienced an orgasm under any conditions is referred to as preorgasmic, implying that all women have the capacity for orgasm, even if they never had one. This type of problem would be classified as primary anorgasmia.

1. Which of the following is NOT a cause of female orgasmic disorder?
2. lack of desired stimulation
3. hormonal imbalances
4. medication side effects
5. blocked coronary arteries

Answer: D
Difficulty: 2
Page ref: 257
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: Causes of female orgasmic disorder include organic, psychological, and relationship-based issues. Blocked coronary arties is not considered to be a possible cause of female orgasmic disorder.

1. Leila is concerned that she has female orgasmic disorder because she rarely has an orgasm during intercourse. What should she know about female orgasms?
2. Most women do not routinely have orgasms through intercourse.
3. Millions of women should be diagnosed with anorgasmic disorder.
4. The only way for a woman to have an orgasm is by self-masturbation.
5. Most women prefer to have sexual relations without orgasm.

Answer: A
Difficulty: 2
Page ref: 258
Topic: Specific Problems and Solutions

Skill: Application

Rationale: It is quite common for women not to experience orgasm during intercourse alone without additional simultaneous clitoral stimulation.

1. Morris has difficulty reaching orgasm after long periods of stimulation. He most likely has _______.
2. hypoactive sexual desire
3. erectile disorder
4. male orgasmic disorder
5. premature ejaculation

Answer: C
Difficulty: 2
Page ref: 259
Topic: Specific Problems and Solutions

Skill: Application

Rationale: A small percentage of men experience delayed or inhibited ejaculation, currently referred to as male orgasmic disorder.

1. Which of the following is a cause of male orgasmic disorder?
2. psychological issues
3. cultural issues
4. diabetes
5. hormonal imbalances

Answer: A
Difficulty: 2
Page ref: 259
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: The causes of inhibited ejaculation include many psychological and relationship issues, such as anger, fear, guilt, or the sexual side effects of some antidepressants.

1. Wolfgang tends to have orgasms before he attempts to penetrate his girlfriend’s vagina. This is an example of _______.
2. hypoactive sexual desire
3. erectile disorder
4. male orgasmic disorder
5. premature ejaculation

Answer: D
Difficulty: 1
Page ref: 259-260
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Premature ejaculation refers to achieving orgasm and ejaculating “too soon” with a partner. It is also referred to as rapid or early ejaculation.

1. Men are more likely to be concerned about premature ejaculation when engaging in sexual activities with a partner, such as _______.
2. masturbation
3. oral sex
4. vaginal sex or anal sex
5. kissing

Answer: C
Difficulty: 2
Page ref: 260
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Premature ejaculation revolves around sexual activities with a partner, usually vaginal or anal sex.

1. Which of the following is a possible cause for premature ejaculation?
2. a man may be less physically sensitive to sexual stimulation
3. shorter periods of abstinence between sexual encounters
4. lower levels of testosterone
5. faster-acting pelvic reflexes and genital muscles that control orgasm

Answer: D
Difficulty: 2
Page ref: 261
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: One suggested cause of premature ejaculation is that some men may have faster-acting reflexes in the pelvic and genital muscles that control orgasm and ejaculation, so that ejaculation may occur prior to full arousal.

1. The “squeeze technique” is used to treat _______.
2. premature ejaculation
3. male orgasmic disorder
4. erectile dysfunction
5. male dyspareunia

Answer: A
Difficulty: 2
Page ref: 261-262
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Most treatments for premature ejaculation employ one of many variations on a treatment developed by Masters and Johnson called the “squeeze technique. ”

1. Generally speaking, the most effective treatment for premature ejaculation focuses on _______.
2. increasing the man’s awareness of the moment of ejaculatory inevitability
3. the use of sexual surrogates
4. the consistent use of the male‑superior position for coitus
5. use of strategies that help distract the man from sexual sensations

Answer: A
Difficulty: 2
Page ref: 263
Topic: Specific Problems and Solutions

Skill: Conceptual

Rationale: Some treatments for premature ejaculation are effective because they teach men to recognize their moment of ejaculatory inevitability.

1. Which of the following is a treatment for premature ejaculation?
2. SSRIs
3. cognitive behavioral therapy
4. communication enhancement
5. Viagra

Answer: A
Difficulty: 2
Page ref: 263
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: One treatment for PE is SSRI medications, as they frequently produce the side effect of delaying orgasm in both men and women.

1. Maria went to the doctor because she experiences pain in her vagina during sexual intercourse. Her doctor most likely diagnosed her with _______.
2. dyspareunia
3. vaginismus
4. sexual aversion disorder
5. female orgasmic disorder

Answer: A
Difficulty: 2
Page ref: 263
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Dyspareunia means painful sexual intercourse. In women, it refers to physical pain experienced in the vagina, the vaginal opening, or deeper in the abdominal cavity during or following intercourse.

1. The most common cause for vaginal dyspareunia is _______.
2. inadequate clitoral stimulation prior to intercourse
3. lack of adequate lubrication prior to and during intercourse
4. a small vaginal opening
5. deep and rapid thrusting of the penis during intercourse

Answer: B
Difficulty: 2
Page ref: 263
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: The most common cause for vaginal pain during sexual intercourse is a lack of adequate vaginal lubrication prior to and during intercourse.

1. Lucia went to the doctor because she experiences pain in her vagina just prior to sexual intercourse. Her doctor most likely diagnosed her with _______.
2. dyspareunia
3. vaginismus
4. sexual aversion disorder
5. female orgasmic disorder

Answer: B
Difficulty: 2
Page ref: 264
Topic: Specific Problems and Solutions

Skill: Application

Rationale: Vaginismus refers to a condition in women that causes pain prior to intercourse due to involuntary contractions and spasms of the muscles controlling the opening to and the outer third of the vagina.

1. A cause of vaginismus is _______.
2. fear that penetration will be painful
3. a lack of lubrication of the vaginal walls
4. hormonal imbalances
5. a lack of sexual desire

Answer: A
Difficulty: 2
Page ref: 265
Topic: Specific Problems and Solutions

Skill: Factual

Rationale: This sexual problem is primarily psychological and probably based on a deeply conditioned fear that penetration will be painful or traumatic in some way.

TRUE-FALSE

1. It was once believed that a cause of sexual dysfunction was demonic possession.

Answer: True
Difficulty: 2
Page ref: 227
Topic: Historical Perspectives

Skill: Factual

1. Masters and Johnson’s research revealed what types of stimulation produce sexual excitement.

Answer: True
Difficulty: 1
Page ref: 227
Topic: Historical Perspectives

Skill: Factual

1. Sexual problems are uncommon.

Answer: False
Difficulty: 2
Page ref: 228-230
Topic: What Is a Sexual Problem?

Skill: Factual

1. Masters and Johnson estimated that half of all married couples experience a diagnosable sexual problem at some point in their marriage.

Answer: True
Difficulty: 2
Page ref: 229
Topic: What Is a Sexual Problem?

Skill: Factual

1. The three-dimensional model of sexual problems is a method of treating orgasmic disorders.

Answer: False
Difficulty: 1
Page ref: 230
Topic: What Is a Sexual Problem?

Skill: Factual

1. According to the three-dimensional model of sexual problems, a primary sexual problem is one that is occurring now, but was not present in the person’s past.

Answer: False
Difficulty: 2
Page ref: 230
Topic: What Is a Sexual Problem?

Skill: Conceptual

1. Most recreational drugs interfere with normal, desirable sexual functioning.

Answer: True
Difficulty: 2
Page ref: 232-233
Topic: Sources of Sexual Problems

Skill: Factual

1. Stress triggers responses in the nervous and endocrine systems that are compatible with sexual arousal.

Answer: False
Difficulty: 2
Page ref: 233
Topic: Sources of Sexual Problems

Skill: Conceptual

1. Good sexual communication is the foundation of a healthy sexual relationship.

Answer: True
Difficulty: 1
Page ref: 236
Topic: Sources of Sexual Problems

Skill: Conceptual

1. One of the most difficult tasks in sex therapy is helping resentful couples move past their hostility.

Answer: True
Difficulty: 1
Page ref: 236
Topic: Sources of Sexual Problems

Skill: Factual

1. When mutual respect between partners is absent, the foundation for satisfying sexual interactions dissolves.

Answer: True
Difficulty: 2
Page ref: 237
Topic: Sources of Sexual Problems

Skill: Factual

1. When people from different cultures become involved romantically, their attitudes about sex may clash, causing sexual problems.

Answer: True
Difficulty: 2
Page ref: 238
Topic: Sources of Sexual Problems

Skill: Conceptual

1. Sensate focus plays an important role in sexual therapy.

Answer: True
Difficulty: 2
Page ref: 239-241
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. Sensate focus exercises are designed to help a couple reconnect on a sexual level with the expectation of intercourse.

Answer: False
Difficulty: 2
Page ref: 240
Topic: General Guidelines for Solving Sexual Problems

Skill: Conceptual

1. Directed masturbation is an effective therapeutic component in the treatment of common sexual problems.

Answer: True
Difficulty: 2
Page ref: 242
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. Virtually all sex therapy strategies involve an element of enhancing communication.

Answer: True
Difficulty: 1
Page ref: 243
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. Poor communication is an important factor in the development of many sexual problems.

Answer: True
Difficulty: 1
Page ref: 243
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. Problems with desire are the most common sexual problems presented in therapy.

Answer: True
Difficulty: 2
Page ref: 244
Topic: Specific Problems and Solutions

Skill: Factual

1. Both men and women may suffer from sexual arousal disorder.

Answer: True
Difficulty: 2
Page ref: 246
Topic: Specific Problems and Solutions

Skill: Factual

1. Erectile problems decrease with a man’s age.

Answer: False
Difficulty: 2
Page ref: 248
Topic: Specific Problems and Solutions

Skill: Conceptual

1. Erectile problems that have psychological causes can be treated without medication.

Answer: True
Difficulty: 2
Page ref: 252
Topic: Specific Problems and Solutions

Skill: Factual

1. Female sexual arousal disorder can be caused by hormonal levels and imbalances.

Answer: True
Difficulty: 2
Page ref: 254
Topic: Specific Problems and Solutions

Skill: Factual

1. The most common nonphysical cause of female orgasmic disorder is lack of adequate sexual stimulation.

Answer: True
Difficulty: 2
Page ref: 257
Topic: Specific Problems and Solutions

Skill: Factual

1. Men diagnosed with male orgasmic disorder have difficulty obtaining an erection.

Answer: False
Difficulty: 2
Page ref: 259
Topic: Specific Problems and Solutions

Skill: Conceptual

1. Sensate focus is a treatment for premature ejaculation.

Answer: True
Difficulty: 2
Page ref: 261
Topic: Specific Problems and Solutions

Skill: Factual

1. Dyspareunia means vaginal pain just prior to intercourse.

Answer: False
Difficulty: 2
Page ref: 263-264
Topic: Specific Problems and Solutions

Skill: Conceptual

1. Sexual pain in men is often due to a localized infection.

Answer: True
Difficulty: 2
Page ref: 264
Topic: Specific Problems and Solutions

Skill: Factual

1. Vaginismus refers to a condition in women that causes pain prior to sexual intercourse.

Answer: True
Difficulty: 2
Page ref: 264
Topic: Specific Problems and Solutions

Skill: Conceptual

1. Vaginismus is generally treated using a combination of psychological and physical strategies.

Answer: True
Difficulty: 2
Page ref: 265
Topic: Specific Problems and Solutions

Skill: Factual

1. The underlying assumption of a “New View” is that men’s and women’s sexual problems cannot be explained using the same classification scheme.

Answer: True
Difficulty: 2
Page ref: 266
Topic: Specific Problems and Solutions

Skill: Conceptual

SHORT ANSWER

1. _______ were the first to reveal the types of stimulation that produce sexual excitement and orgasm.

Answer: Masters and Johnson
Difficulty: 1
Page ref: 227
Topic: Historical Perspectives

Skill: Factual

1. The three-dimensional model of sexual problems classifies sexual problems according to their duration, context, and _______.

Answer: frequency
Difficulty: 2
Page ref: 230
Topic: What Is a Sexual Problem?

Skill: Factual

1. According to the three-dimensional model of sexual problems, a problem is defined as _______ if it occurs in virtually all settings.

Answer: global
Difficulty: 2
Page ref: 231
Topic: What Is a Sexual Problem?

Skill: Factual

1. According to the three-dimensional model of sexual problems, a problem is defined as _______ if it occurs often enough to cause distress but not on every occasion in that particular setting.

Answer: partial
Difficulty: 2
Page ref: 231
Topic: What Is a Sexual Problem?

Skill: Factual

1. _______ causes of sexual problems can be neurological, hormonal, or vascular; they can also stem from physical injuries or trauma.

Answer: Physiological
Difficulty: 2
Page ref: 232
Topic: Sources of Sexual Problems

Skill: Factual

1. SSRIs are drugs administered to treat _______ that may cause various sexual side effects.

Answer: depression
Difficulty: 2
Page ref: 233
Topic: Sources of Sexual Problems

Skill: Factual

1. _______ exercises are designed to help a couple reconnect on a sensual rather than sexual level.

Answer: Sensate focus
Difficulty: 1
Page ref: 240
Topic: General Guidelines for Solving Sexual Problems

Skill: Conceptual

1. The use of masturbation in sex therapy is usually referred to as _______.

Answer: directed masturbation

Difficulty: 2
Page ref: 241
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. Virtually all sex therapy strategies involve an element of enhancing _______ between partners.

Answer: communication

Difficulty: 2
Page ref: 243
Topic: General Guidelines for Solving Sexual Problems

Skill: Factual

1. A persistently low level or lack of sexual fantasies or desire for sexual activity is referred to as _______.

Answer: hypoactive sexual desire

Difficulty: 2
Page ref: 243
Topic: Specific Problems and Solutions

Skill: Factual

1. A common test for the underlying cause of erectile disorder is _______.

Answer: nocturnal penile tumescence

Difficulty: 3
Page ref: 250-252
Topic: Specific Problems and Solutions

Skill: Conceptual

1. _______ is a frequent or recurring delay or inhibition of orgasm and ejaculation.

Answer: Male orgasmic disorder

Difficulty: 2
Page ref: 259
Topic: Specific Problems and Solutions

Skill: Factual

1. A man’s tendency to have an orgasm suddenly with little penile stimulation is called _______.

Answer: premature ejaculation

Difficulty: 2
Page ref: 260
Topic: Specific Problems and Solutions

Skill: Factual

1. _______ is the term used to describe painful sexual intercourse.

Answer: Dyspareunia

Difficulty: 2
Page ref: 263
Topic: Specific Problems and Solutions

Skill: Factual

1. _______ refers to a condition in women that causes pain prior to intercourse.

Answer: Vaginismus

Difficulty: 2
Page ref: 264
Topic: Specific Problems and Solutions

Skill: Factual

ESSAY

1. Identify and explain the three-dimensional model of sexual problems. Using the model, diagnose the following situation: a 35-year-old woman is unable to achieve orgasm with her current partner; however, she has had orgasms with past partners.

Difficulty: 2
Page ref: 230-231
Topic: What Is a Sexual Problem?

Skill: Application

Responses should consider:

The three-dimensional model of sexual problems is a method of classifying or diagnosing sexual problems according to their duration, context, and frequency.

• Duration (primary or secondary): This refers to how long a person has been experiencing the problem. A primary sexual problem is one that has always existed in the person’s sexual life.
• A secondary problem is one that is occurring now but was not present at some point in the person’s past sexual experiences.
• Context (global or situational): A global problem is one that occurs for an individual or couple in virtually all settings. A situational problem is experienced in specific settings, but is absent in other contexts.
• Frequency (total or partial): A total sexual problem is one that occurs invariably, that is, every time, in a given setting. A problem defined as partial occurs often enough to cause distress, but not on every occasion in that particular setting.
• The hypothetical woman described above is experiencing a secondary problem; she was orgasmic in the past, and now she is not. Her problem cold also be considered situational if she was orgasmic in previous settings, but not with the current partner.

1. Identify and define the six factors that cause relationship problems. Explain how these factors can contribute to sexual problems in a relationship.

Difficulty: 2
Page ref: 236-238
Topic: Sources of Sexual Problems

Skill: Conceptual

Responses should consider:

1. Loss of trust. Most couples need to trust that their partners are faithful, honest in expressing feelings, will not inflict emotional or physical pain, and are not withholding important information that might negatively affect the relationship. Sexual problems such as desire disorders, arousal difficulties, among others, may sometimes be linked to the lack or loss of trust in a relationship. When this basic trust is lost, the overall relationship will suffer.
2. Poor communication. Effective communication is a cornerstone of a good relationship, and good sexual communication is usually the foundation of a good sexual relationship. The ability to express sexual feelings, sexual desires, or insecurities about sex is crucial to establishing and maintaining a sexually satisfying relationship.
3. Anger and resentment. Strong negative emotional reactions, especially anger and resentment, work directly against sexual responding. If one is feeling angry or resentful toward a partner, responding sexually is going to be problematic. One barrier is the specific physiological responses of the autonomic nervous system, which are incompatible with sexual arousal. The other is the psychological distance and loss of desire for intimacy with the partner that accompanies the anger.
4. Conflicting sexual expectations. When two people enter into a sexually intimate relationship, they are sure to have some differing expectations about sex that will have to be negotiated and reconciled. If differing expectations are not reconciled, they can lead to a serious imbalance in the relationship and to potential sexual problems. When both partners are willing and able to communicate and discuss differences in expectations, chances are good that they can work them out.
5. Lack of respect. Lack of respect in an intimate relationship will invariably undermine sexual feelings, desire and responses. Two related types of respect are fundamental to successful and satisfying relationships: self-respect and mutual respect. A lack of self-respect, and the low self-esteem that invariably accompanies it, usually cause one or both partners to feel unworthy of experiencing sexual pleasure and undeserving of sexual pleasure. Mutual respect is equally important, in that each partner needs to feel that his/her wishes, ideas, attitudes, desires, abilities, and unique characteristics as a person are honored and valued by the other. When mutual respect is absent, the foundation for successful and satisfying sexual interactions crumbles away.
6. Loss of love. In an intimate relationship, sexual satisfaction and functioning often falter. Of all the factors in intimate relationships that can influence sexual functioning, love is possibly the most important of all. Sex combined with love is very different from sex without love. People make very clear distinctions between making love and having sex.

1. Define sensate focus. Provide a step-by-step explanation as to how this method is used as a therapeutic intervention.

Difficulty: 2
Page ref: 239-241
Topic: General Guidelines for Solving Sexual Problems

Skill: Conceptual

Responses should consider:

Sensate focus is a sex therapy technique described by Masters and Johnson that requires a couple to redirect emphasis away from intercourse and focus on their capacity for mutual sensuality.

• A couple who is experiencing a sexual problem are instructed to find quiet, private time together one or more times each week.
• During theses sessions they are to remove their clothing and spend time taking turns touching and caressing each other, focusing on the pleasure they feel in touching and being touched. They must not touch each other’s breasts or genital areas.
• Over the course of several weeks the caressing is allowed to expand to include nipples and genitals, but the goal continues to be sensual and pleasurable sensations, not orgasm. Genital touching that may lead to orgasm is prohibited.
• Within a few weeks, the couple usually find that with the pressures and expectations of intercourse removed, the sexual, sensual, and romantic feelings anad responses are reawakened in them.
• As the process continues, they are allowed to touch each other to orgasm and eventually to engage in intercourse once again.
• Couples feel emotionally closer, and sexual desire increases for couples whose desire had been waning. Orgasm problems are often resolved.

1. Describe hypoactive sexual desire. Provide an explanation of its causes and two treatment strategies.

Difficulty: 2
Page ref: 243-246
Topic: Specific Problems and Solutions

Skill: Factual

Responses should consider:

Hypoactive sexual desire is a persistently low level or lack of sexual fantasies or desire for sexual activity. It’s also known as inhibited sexual desire. This applies to individuals or couples who do not think about sex very much, who do not feel desirous of sexual activities very often, and who find this to be a problem in their lives and relationships.

• Causes
• For low desire that is primary, global, and total, underlying causes such as hormonal imbalances or neurological pathology must be considered.
• For desire difficulties that are secondary, situational, and partial, nonphysical factors such as psychological, relationship, or cultural must be considered.
• Among the most commonly suggested nonphysical causes are anxiety over relationship and other sexual issues, depression, fear (of pregnancy, STIs, or pain), and past sexual victimization.
• Treatment Strategies
• One treatment strategy is cognitive behavioral therapy, which is designed to:

1. assist an individual or couple in identifying and exploring irrational, fault, and self-defeating beliefs and attitudes that underlie sexual difficulties
2. develop strategies to discard those ineffective cognitions and replace them with new, more accurate, and more constructive thought processes
3. gradually eliminate undesirable behaviors that were based on the old ways of thinking and replace them with new and effective actions stemming from the new belief systems.

• Another treatment strategy is sensate focus, as it can reduce anxiety about intercourse and fears about performance, and may reawaken sensuality for the couple and spark new feelings.

1. Define female orgasmic disorder. Provide an explanation of its causes. Explain how sensate focus and masturbation exercises are used as a treatment for it.

Difficulty: 2
Page ref: 256-259
Topic: Specific Problems and Solutions

Skill: Conceptual

Responses should consider:

Female orgasmic disorder is a sexual problem in which a woman rarely or never reaches orgasm or orgasms are delayed. It’s also known as inhibited female orgasm or anorgasmia.

• Causes:
• Organic or psychological causes may include hormonal imbalances, use or abuse of alcohol or other recreational drugs, or side effects of prescription medications. Alcohol is a central nervous system depressant, moderate to heavy amounts of alcohol interfere with the body’s ability to respond to sexual stimuli.
• One recent cause is side effects of the new class of prescription antidepressant medications known as SSRIs. They are prescribed for depression and other psychological difficulties. Most of these medications have been shown to produce sexual side effects in some users, the most common of which is delayed or inhibited orgasm in both men and women.
• As a treatment sexual self-exploration through masturbation can be a powerful tool for a woman to discover that she is capable of achieving orgasms and where and how she needs to be touched to achieve them. Sometimes using a vibrator along with masturbation can assist a woman who has never or rarely experienced orgasm by providing maximum stimulation, leading to more predictable orgasms.
• Once a woman is reasonably comfortable with her own body and her ability to have orgasms, non-demanding sexual exercises, such as sensate focus, can begin to include her partner. As part of their sensate focus program, Masters and Johnson developed a specific position to allow the woman to guide her partner in ways of touching and pleasuring that provide the sensations and stimulation that are most effective for her. Not only does this exercise help inform her partner abut what feels best to her, but it also tends to enhance closeness and communication in general. When the woman is comfortable with her ability to have orgasms though sensate focus exercises, intercourse may be resumed. If the goal for the couple is for both to reach orgasm during intercourse, this is now usually accomplished through the addition of manual stimulation by either partner to the clitoral area during penetration.