How to Answer Apply Four Plissit Questions (Complete Guide)

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apply the four PLISSIT principles with comparable descriptions Female Orgasmic Disorder (inability to achieve orgasm) Permission. Granting permission to be sexual and to talk about it is incredibly freeing. Reassuring women that they aren’t alone, and empathizing with their problems and concerns, can provide relief from shame or guilt. Limited Information. Some women may lack a general knowledge about genital anatomy or have been poorly educated about sex and sexuality. Providing psychoeducational resources naming and normalizing sexual anatomy shapes and body part functioning can be very helpful. Specific Suggestions. Various effective suggestions can include directed genital examination using a handheld mirror to explore their own genitalia coupled with normalizing messages, the use of specific lubricants, and/or altering sexual positions to make sex more exciting. Intensive Therapy. If none of the previous suggestions have worked, refer your clients to sex therapy. Having several culturally sensitive go-to referrals available will save you time looking up names. Telehealth is a good option for patients who live in rural areas. nosis and adherence to treatment for VVA may prevent these geni- tourinary conditions (Constantine et al., 2014). Chronic Pelvic Pain Chronic pelvic pain is a com- plex syndrome involving muscu- loskeletal, gynecologic, urologic, gastrointestinal, and/or neurolog- ical conditions affecting about 9 million women from 15 to 50 years old (Apte et al., 2011; Vural, 2018); it is almost as com- mon as low back pain and asth- ma with respect to financial impact (Apte et al., 2011). Injury to the pelvic floor musculature (PFM) due to birth trauma, phys- ical abuse, or episiotomy is often the cause of chronic pelvic pain; although, it can occur without obvious injury. Injuries can shorten and weaken the PFM, leading to associated conditions, such as urinary frequency, urgency, nocturia or even nonin- fectious cystitis (Berghmans, 2018). Pelvic floor dysfunction can incorporate vaginismus, dys- pareunia, and chronic pelvic pain. Evidence suggests that the condition of the PFM is extreme- ly important in terms of sexual dysfunction (Berghmans, 2018). In addition, symptomatic VVA can trigger an increase in PFM tone as a protective guarding response. Orgasmic Disorder Female orgasmic disorder is the significant delay, infrequency, or absence of orgasm during occa- sions of sexual activity 75% to 100% of the time, and a substan- tial reduction in the intensity of orgasmic sensations. Symptoms must be present for 6 months and cause marked distress or interper- sonal difficulty for the woman. Symptoms cannot be better explained by another psychologi- cal condition, such as severe rela- tionship distress as in cases of intimate partner violence; the direct physiological effects of a substance, such as sertraline; or a medical condition, such as dia- betes or UI (Cohen & Goldstein, 2016). In a series of focus groups 42 with 657 women experiencing difficulties in reaching orgasm, 92% were bothered to some degree by the condition, with 68% being very or extremely bothered, and 46% described feel- ing frustrated, indicating lack of orgasm is a distressing condition (Kingsberg et al., 2013). Women with female orgasmic disorder may have co-occurring FSIAD. PFM contraction is known to play an important role in the female orgasmic response (Ozdemir, Pehlivan, & Melekoglu, 2017). There are several symptoms and conditions that can contribute to this diagnosis, for exa

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