Sexual dysfunction resident survival guide: Difference between revisions
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{{familytree/start |summary=Sexual dysfunction diagnosis Algorithm.}} | {{familytree/start |summary=Sexual dysfunction diagnosis Algorithm.}} | ||
{{familytree | | | | A01 | | | A01= }} | {{familytree | | | | | | | | | | | | | A01 | | | A01=<div style="float: left; text-align: left; width: 10em; padding:1em;">'''Seek proper history, ask patients to describe in their own words, what do they mean by sexual dysfunction?''' <br> This will help distinguish the various causes of sexual dysfunction'''The history should also determine the characteristics, severity, and frequency of dysfunction:'''<BR>❑ Onset – Abrupt or gradual, relationship to illness or life event <BR>❑ Course – Stable, improving, or worsening <br>❑ Duration and pattern<BR>❑ Factors that alleviate or exacerbate it<BR>❑ Impact on life – Causing emotional or psychological distress, marital discord?<BR>❑ Any recent changes that the patient has made such as change in contraceptive, any other medication <br>❑ Menstrual history including [[menopause|menopausal]] status</div> }} | ||
{{familytree | | | | |!| | | | }} | {{familytree | | | | | | | | | | | | | |!| | | | | | }} | ||
{{familytree | | | | | {{familytree | | | | | | | | | | | | | B01 |B01=<div style="float: left; text-align: left; width: 10em; padding:1em;">'''Rule out medical conditions''' such as<br> ❑ Chronic [[diabetes mellitus]] <br>❑ [[Hypertension]] <br>❑ [[Hypothyroidism]] <br>❑ [[Depression]] <br>❑ [[Psychosis]]</div?}} | ||
{{familytree | | |,|-| | {{familytree | | | | | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|.| | | | | }} | ||
{{familytree | | C01 | | C02 | C01= | C02= }} | {{familytree | | | | | |!| | | |!| | | |!| | | |!| | | |!| | | | | | }} | ||
{{familytree | | | | | C01 | | C02 | | C03 | | C04 | | C05 |C01=Persistent lack of interest in sexual arousal|C02=Difficulty in becoming sexually aroused|C03=Diminished ability in achieving orgasm|C04=Pain associated with sexual activity|C05=Other sexual concerns}} | |||
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Revision as of 14:26, 13 January 2021
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[2]
Synonyms and keywords: Approach to sexual dysfunction, Approach to dyspareunia
| Sexual dysfunction Resident Survival Guide Microchapters |
|---|
| Overview |
| Causes |
| Diagnosis |
| Treatment |
| Do's |
| Don'ts |
Overview
Sexual dysfunction is defined as recurrent and persistent issues with sexual response, desire, experience of pain or achieving orgasm. Sexual dysfunction often causes distress to the partners in a relationship. Sexual dysfunction conditions are broadly classified into disorders of sexual desire, arousal, orgasm and pain disorders. Treatment often includes identifying the underlying cause and treatment along with counselling and supportive care.
Causes
Disorders of sexual desire
- Psychological disorders or stress
- Advanced age
- Menopause
- Emotional distress
- Medications such as antidepressants, anxiolytics, antihypertensives
Disorders of sexual arousal
- Trauma
- Chronic disorders such as diabetes, multiple sclerosis
- Neuropathy
- Stroke
- Previous genital surgery
Disorders of orgasm
- History of sexual or emotional abuse
- Medication such as antihypertensives, anxiolytics
- Previous trauma or surgery
Disorders of sexual pain
- Endometriosis
- Pelvic inflammatory disease
- Decreased vagina lubrication
- Sexually transmitted infections
- Vaginismus
Diagnosis
Shown below is an algorithm summarizing the diagnosis of Sexual dysfunction according the the Journal of Sexual Medicine 2017 Opinion paper on The Diagnosis/Classification of sexual arousal concerns in women and the American College of Obstetricians and Gynecologists' Committee Practice Bulletin Summary on Sexual Dysfunction. [1][2]
Seek proper history, ask patients to describe in their own words, what do they mean by sexual dysfunction? This will help distinguish the various causes of sexual dysfunctionThe history should also determine the characteristics, severity, and frequency of dysfunction: ❑ Onset – Abrupt or gradual, relationship to illness or life event ❑ Course – Stable, improving, or worsening ❑ Duration and pattern ❑ Factors that alleviate or exacerbate it ❑ Impact on life – Causing emotional or psychological distress, marital discord? ❑ Any recent changes that the patient has made such as change in contraceptive, any other medication ❑ Menstrual history including menopausal status | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rule out medical conditions such as ❑ Chronic diabetes mellitus ❑ Hypertension ❑ Hypothyroidism ❑ Depression ❑ Psychosis</div? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Persistent lack of interest in sexual arousal | Difficulty in becoming sexually aroused | Diminished ability in achieving orgasm | Pain associated with sexual activity | Other sexual concerns | |||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Althof SE, Meston CM, Perelman MA, Handy AB, Kilimnik CD, Stanton AM (2017). "Opinion Paper: On the Diagnosis/Classification of Sexual Arousal Concerns in Women". J Sex Med. 14 (11): 1365–1371. doi:10.1016/j.jsxm.2017.08.013. PMID 28958593.
- ↑ "Female Sexual Dysfunction: ACOG Practice Bulletin Summary, NUMBER 213". Obstet Gynecol. 134 (1): 203–205. 2019. doi:10.1097/AOG.0000000000003325. PMID 31241595.