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Sexual dysfunction includes desire, arousal, orgasmic and sex pain disorders (dyspareunia and vaginismus). Primary care physicians must assume a proactive role in the diagnosis and treatment of these disorders. Long-term medical diseases, minor ailments, medications and psychosocial difficulties, including prior physical or sexual abuse, are etiologic factors. Gynecologic maladies and cancers (including breast cancer) are also frequent sources of sexual dysfunction. ... Patient history and physical examination techniques, normal sexual responses and the factors that influence these responses, and the application of medical and gynecologic treatments to sexual issues are discussed
Dyspareunia is the clinical name for painful intercourse. ...
Because there are so many potential causes of dyspareunia, it is important to report any pain during sexual intercourse to a medical care provider, who can check for potentially dangerous underlying disorders and suggest the best treatment or preventative measures. ... 13)
This is frequently due to a lack of sexual arousal and effective stimulation, and sometimes due to medication that decreases vaginal lubrication (such as antihistamines).
Psychological factors are infrequently involved and will most commonly be associated with previous sexual trauma (rape or abuse), feelings of guilt, or negative attitudes toward sex. ... This is often associated with a recent reduction in the frequency of sexual activity (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. ... Other causes include inadequate lubrication, usually secondary to improper or insufficient foreplay; forceful pressure against a sensitive urethra during coitus; improper intromission; introital lesions due to inflammatory conditions (eg, vestibulitis); infections (eg, abscesses of Bartholins glands or ducts); inflammation of labial sweat glands; irritation due to the use of improperly fitted or inadequately lubricated condoms; allergic reactions to the contents of contraceptive foams and jellies and condoms; abnormalities of the female genital tract (eg, congenital septum, a rigid hymen); and dermatologic disorders (eg, lichen sclerosis). ... A general medical and sexual history and a physical and pelvic examination usually uncover the etiology. ... Your medical and sexual history and your physical examination will help your doctor to determine the cause of your symptoms. ... He or she also will ask you:
If there was ever a time you had painless intercourse, or if you have always had dyspareunia
If you have adequate natural lubrication, and if your symptoms improve if you use commercially available lubricants
About your sexual history (to help assess your risk for sexually transmitted infections)
If you have ever been sexually abused, or had a traumatic injury involving your genitals
If you are middle-aged, your doctor will ask whether you are experiencing irregular periods, hot flashes or vaginal dryness, symptoms suggesting that you may have atrophic vaginitis.
Approximate Word count = 1989
Approximate Pages = 8
(250 words per page double spaced)
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