Sexual dysfunction Flashcards Preview

Sexual Medicine > Sexual dysfunction > Flashcards

Flashcards in Sexual dysfunction Deck (34)
Loading flashcards...
1

Classify sexual disorders

Desire and drive
- Hypoactive sexual desire disorders
- Sexual aversion disorder

Arousal
- Erectile dysfunction
- Female sexual arousal disorder

Orgasm
- Rapid ejaculation, delayed ejaculation, retrograde ejaculation

Resolution
- Sexual pain
- Dyspareunia
- Vaginimus
- Vulvodynia

Any sexual disorder must be
- Persistent
- Causes marked distress

2

Define hypoactive sexual desire disorder

Loss of libido and decline in sexual desire causing destress

3

Causes of hypoactive sexual desire disorder

Chronic disease
- DM
- CVD
- Anaemia
- Obesity

Hormonal
- Androgen deficiency
- Hyperprolactaemia
- Hypothyroid

Iatrogenic
- SSRI
- OCP
- HRT
- Surgery

Psychiatric
- Depression
- Anxiety
- Substance abuse
- Previous trauma

4

Treatment of hypoactive sexual desire disorder

Psychosexual
- CBT
- Psychodynamic
- Cognitive
- Intergrative

Medication
- Testosterone replacement (M)
- Flibanserin (F) for premenopausal women

5

Define erectile dysfunction

Difficulty in developing or maintaining an erection suitable for satisfactory intercourse

6

Causes of erectile dysfunction

Chronic
- CVD
- DM
- Neuro

Hormonal disorders
- Androgen deficiency
- Prolactin ( high)

Iatrogenic
- Prostate surgery
- SSRI's
- HTN

Psychiatric
- Relationship problems
- Age
- Depression

7

Treatment of erectile dysfunction

1st Line
Phosphodiesterase inhibitors
Sildenafil

2nd line
Alprostadil

Non medical
- Vacum device
- Kegle excercises
- Psychological (psychosexual therapy)

8

Define female sexual arousal disorder

Failure of the genital response ( vaginal dryness)
Reduced interest in sexual activity, reduced physical response to sex stimuli and reduced sexual pleasure

9

Causes of female sexual arousal disorder

Chronic disease
- DM
- CVD
- Neuro

Hormonal
- Oestrogen deficiency

Iatrogenic
- SSRI's

Lactation

Psychological

10

Treatment of female sexual arousal disorder

Behavioural
- Sensate focus
- Eros therapy device
- Lubricants

Psychosexual couples therapy

11

Define rapid ejaculation

Inability to control ejaculation sufficiently for both partners to enjoy sexual interaction
Ejaculation occurs within 1 minute

12

Causes of rapid ejaculation

Genetic susceptibility
Hyperthyroidism
Penile hypersensitivity
Psychological
- Performance anxiety
- Lack of experience
- Issues
- Early experiences

13

Treatment for rapid ejaculation

1st line
- SSRI's ( Dapoxetine, increase risk of suicide)
- STUD 100 spray (topical anaesthetic)
- Psychosexual therapy
- Behavioural therapy (stop start technique, kegel exercise)

14

Define female orgasmic disorder

Orgasm either does not occur or is markedly delayed

15

Causes of female orgasmic disorder

Chronic
- DM
- CV
- Anaemia
- Obesity

Hormonal
- Androgen deficiency
- Hyperprolacteimia
- Hypothyroid

Pelvic floor weakness/damage

Ageing

SSRIs

Psychological
- Abuse
- Relationships problems

16

Treatment of female orgasmic disorder

Topical oestrogen
Behavioural interventions
- Guided masturbation
- Vibrators

17

Define vaginismus

Spam of the pelvic floor muscles that surround the vaginal opening.
Makes the penile entry painful or impossible

18

Causes of vaginismus

Thrush
FGM
Congenital abnormality

Psychological
Previous trauma/abuse
Fear/dislike partner or pregnancy
Misinformed

19

Treatment of vaginismus

Psychosexual
Behavioural
- Self exploration
- Vaginal dilators
- Graded penetration therapy

20

Define Dyspareunia

Pain during intercourse
Only used if there is no primary nonorganic sexual dysfunction

Can occur in males and females

21

Causes of dyspareunia

Females

SUPERFICIAL
- STI's
- Episiotomies
- Vaginal atrophy

DEEP
- PID
- Endometriosis

Males
- STI
- Urethral strictures
- Varicocels
- Psychological
- Relationship causes ( poor technique of partner)

22

Treatment of dyspareunia

Treatments
- Lubricants
- Couples therapy
- Behavioural therapy
- Refer to Gynae

23

Define vulvodynia

Burning pain, occurring in the absence of relevant visible findings or a specific or a specific clinically identifiable neurological disorder

24

Treatment of vulvodynia

MDT approach
5%/ 2% lidocaine
Pelvic floor exercise/ perineal massage
TGA
Gabapentin

25

Define peyronie's disease

Disorder of the penile connective tissue
Leads to distal flaccidity

26

Define paraphilias

Disorders of sexual preference

27

Define paedophilia

Sexual activity or fantasy involving children

28

Define fetishism

Sexual arousal around an inanimate object or non-genital body part

29

Define transvestism

Sexual arousal obtained by cross-dressing

30

Define bestiality and necrophilia

Sexual activity/arousal with animals

Sexual intercourse with a corpse