Sexual Medicine

Question 1

Define erectile disorder

Answer 1

Difficulty in developing or maintaining an erection suitable for satisfactory intercourse

Question 2

Causes of erectile disorder

Answer 2

CVD, diabetes, androgen deficiency, post prostate surgery, SSRIs, pain, depression, anxiety, relationship issues

Question 3

Erectile disorder medial treatment

Answer 3

Oral - Sidenafil (viagra), avanafil (spedra), tadalafil (cialis), vardenafil (levitra)
Injectable - alprostadil
Intraurethral - alprostadil

Question 4

Erectile disorder non-medical treatment

Answer 4

Vaccum device, penile rings, kegel exercises

Question 5

Define female sexual arousal disorder

Answer 5

failure of genital response (vaginal dryness) or lack or or significantly reduced sexual interest/arousal

Question 6

Causes of female sexual arousal disorder

Answer 6

CVD, diabetes, oestrogen deficiency - post menopause, breastfeeding, depression, anxiety, previous abuse

Question 7

Female sexual arousal disorder treatment

Answer 7

couples psychosexual therapy, new sexual routines, lubricant, sensate focus

Question 8

Female orgasmic disorder

Answer 8

Orgasm either does not occur or is markedly delayed

Question 9

Causes of female orgasmic disorder

Answer 9

CVD, diabetes, oestrogen deficiency - post menopause, pelvic floor weakness, SSRIs, depression, anxiety, previous abuse, stress

Question 10

Female orgasmic disorder treatment

Answer 10

psychotherapy, guided masturbation, kegel exercises, relaxation, review medications, look at depression symptoms and review

Question 11

Define rapid ejaculation

Answer 11

The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction

Question 12

Causes of rapid ejaculation

Answer 12

genetic susceptibility, penile hypersensitivity, hyperthyroidism, erectile dysfunction, anxiety, lack of sexual activity

Question 13

Treatment for rapid ejaculation

Answer 13

medication - Dapoxetine

Couple psychotherapy, stop-start technique, kegel exercises

Question 14

Define delayed ejaculation

Answer 14

On almost or all occasions either generalised or situational, without the individual desiring delay: marked delay in ejaculation, marked infrequency or absence of ejaculation

Question 15

Causes of delayed ejaculation

Answer 15

age, trauma, surgery, diabetes, spinal cord injury, alcohol neuropathy, depression, SSRIs, low testosterone levels, insufficient stimulation, poor body image, history of sexual abuse

Question 16

Delayed ejaculation investigations

Answer 16

Physical investigation, bloods - FBC, glucose, testosterone, B12, folate, PSA, urine sample

Question 17

Delayed ejaculation treatments

Answer 17

individual therapy, couples therapy, kegel exercises, use of vibration

Question 18

Define vaginismus

Answer 18

Spasm of the pelvic floor muscles that surround the vagina, causing occlusion of the vaginal opening. Penile entry is either impossible or painful

Question 19

Causes of vaginismus

Answer 19

medical conditions - thrush, congenital abnormality, fear of pregnancy, previous sex abuse/trauma, fear or dislike of partner, relationship dissatisfaction

Question 20

Treatment for vaginismus

Answer 20

psychosexual therapy, CBT, kegel exercises

Question 21

Define dyspareunia

Answer 21

Pain during intercourse, occurs in both women and men

Question 22

Causes of dyspareunia

Answer 22

infection, injury, irritation, lesions, herpes, vaginal atrophy, menopause, lichen sclerosis, interstitial cysitis, endometriosis, irritable bowel
previous experience of pain, previous sexual abuse, insufficient relaxation, fear of intimacy, speed/poor technique

Question 23

Dyspareunia treatment

Answer 23

couples therapy, sensate focus

Question 24

Define hypoactive sexual desire disorder

Answer 24

lack or loss of sexual desire, presistently or recurrently deficient sexual thoughts and desire for sexual activity

Question 25

Causes of hypoactive sexual desire disorder

Answer 25

obesity, CVD, diabetes, anaemia, andorgen deficiency, hypoerprolactinameia, addison’s disease, depression, anxiety, couple relationship problems, stress

Question 26

Treatment for hypoactive sexual desire disorder

Answer 26

psychoseuxal therapy, CBT, sensate focus, testosterone replacement