Sexual Medicine Flashcards

Question

What is female sexual interest/arousal disorder?

Answer 1

Failure of female genital response primarily due to vaginal dryness or failure of lubrication

Answer 2

``` 3 or more of the following: Little interest in sex Few thoughts about sex Decreased initiation of sex Little pleasure during sex Decreased interest in sex when exposed to erotic stimuli Little physical response to sex ```

Answer 3

``` Timetabling Communication Negotiation/contracting Addressing intimacy Being sexual Adjusting to difficulties ```

Answer 4

Chronic disease eg diabetes, CVD, neurological/connective tissue disease Hormone disorder eg low oestrogen (post menopausal or thyroid disorder) Medications eg SSRIs Lactation Irritants/douching

Answer 5

``` Psychiatric conditions eg depression, anxiety, eating disorder History of abuse Couples relationship problems Couples script problems Decreased intimacy ```

Answer 6

Couples psychosexual therapy Behavioural techniques eg Sensate focus, new sexual routines, vibrators Eros therapy device

Answer 7

Orgasm that does not occur or is markedly delayed

Answer 8

Chronic medical condition eg CVD, diabetes, neurological disorder, renal/liver disorder Hormonal disorder eg oestrogen or androgen deficiency, hypothyroidism Pelvic floor weakness or damage Ageing SSRIs (citalopram)

Answer 9

``` Psychiatric conditions eg depression, anxiety, substance misuse History of abuse Couple script problems Couple relationship problems Cultural/religious issues Lack of understanding Environmental factors Stress ```

Answer 10

Vaginal or pelvic pain Vaginal Atrophy Dryness Change in self image, mood, memory, cognition Changes in desire Relationship, psychosocial and health factors play their part Physical discomfort – sleeplessness, night sweats

Answer 11

Physical Topical oestrogen cream Medication review Psychosexual Psychosexual therapy Behavioural eg personal sexual growth programme, guided masturbation, lubricants and vibrators, kegel exercises

Answer 12

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

Answer 13

Thrush Pain conditions FGM Congenital abnormality

Answer 14

Mistaken information eg vagina too small, first time will be painful Fear of pregnancy History of abuse/trauma of either a sexual experience or gynae examination Fear or dislike of partner Relationship dissatisfaction Situational Religious/cultural issues

Answer 15

Individual psychosexual therapy Integrated CBT Behavioural interventions eg vaginal trainers, breathing control and relaxation, personal sexual growth programme, kegel exercises, self-exploration and examination

Answer 16

Dyspareunia (or pain during intercourse) occurs in both women and men. It can often be attributed to local pathology and should then be properly categorised under the pathological condition. This category is to be used only if there is no primary nonorganic sexual dysfunction (e.g. Vaginismus or vaginal dryness). Can be superficial or deep

Answer 17

``` Vaginal atrophy Infection eg HSV Lichen sclerosis Episiotomy/vaginal tear scar Trauma ```

Answer 18

``` PID Endometriosis IBS Fibroids/adenomyosis PCOS ```

Answer 19

History of abuse Painful/traumatic sexual experience/gynae examination Poor sexual education and understanding of anatomy and physiology Insufficient relaxation Poor technique of partner eg timing and speed Fear of intimacy Anger / resentment towards partner

Answer 20

``` Physical Testosterone replacement Steroid cream eg dermovate Topical oestrogen Lubricants ``` ``` Psychological Psychosexual therapy Behavioural eg sensate focus, personal sexual growth programme Mindfulness Kegels ```

Answer 21

PDE5 inhibitor - Vasodilator

Answer 22

``` Improve communication Modify dysfunctional behaviour Decrease emotional avoidance Change view of relationships Promote strengths ```

Answer 23

Sex decided upon by doctors and family according to external genitalia

Answer 24

Intrinsic sense of being male/female/other

Answer 25

Personality, appearance and behaviour

Answer 26

Distress due to incongruence between gender identity and sex assigned at birth

Answer 27

Individuals who seek to change or have changed their primary and secondary sexual characteristics to be in line with their gender identity

Answer 28

Sex of persons to whom sexual fantasies, arousal and activities are directed

Answer 29

Methodological issues Funding issues and observer bias Evangelism Fallacy of neuro-genetic determinism

Answer 30

``` Assessment and diagnosis Social transition ± psychotherapy/OT Fertility options Androgens ± GnRH analogues Voice and communication Male chest reconstruction Hysterectomy ± bilateral oophorectomy Phalloplasty/metoidioplasty ```

Answer 31

``` Assessment and diagnosis Social transition ± psychotherapy/OT Fertility options Oestrogens ± antiandrogens Voice and communication Facial hair removal Vaginoplasty Augmentation mammoplasty Facial feminisation surgery ```

Answer 32

Psychotherapy prepuberty GnRH analogues at puberty (tanner stage 2) until adults Transfer to adult services at 18? Adult treatment as above

Sexual Medicine Flashcards

(56 cards)