Male Sexual Dysfunction 1 Flashcards

The learner will be able to discuss the four different broad categories of sexual dysfunction.

1
Q

What are the four broad categories of male sexual dysfunction?

A
  • Disorders of libido
  • Erectile dysfunction
  • Ejaculatory dysfunction
  • Orgasmic dysfunction
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2
Q

What are disorders of libido and what are the general types of management?

A
  • Organic causes
    • hypogonadism
  • Functional causes
    • stress
    • anxiety
    • depression
    • relationship issues
  • Differentiating organic from functional causes can be aided by an early morning serum testosterone blood test.
  • For organic low libido due to hypogonadism, testosterone replacement therapy is usually an effective therapeutic maneuver
  • For men with functionally low libido, counseling is recommended
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3
Q

What are the major types of ejaculatory dysfunction?

A
  • Premature ejaculation
  • Retrograde ejaculation
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4
Q

What is premature ejaculation and how is treated?

A
  • Climax with minimal stimulation
  • Can occur before, during, or shortly after penetration
  • 20-30% prevalence
  • Treatment options:
    • behavioral therapy
    • squeeze technique
    • pause technique
    • psychotherapy
    • medical therapy
    • selective serotonin reuptake inhibitor (SSRI) therapy
    • topical lidocaine/prilocaine cream
    • condom use
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5
Q

What is retrograde ejaculation? What are the risk factors and treatment options?

A
  • Risk factors
    • diabetes mellitus: common due to autonomic neuropathy
    • retroperitoneal/pelvic surgery: nerve injury (sympathetic)
    • prior prostate/bladder neck surgery (i.e. “TURP”)
    • use of alpha adrenergic blocking medications
  • Need to consider possibility of failure of seminal emission (can verify via a postejaculate urinalysis to check for sperm)
  • Treatment
    • cessation of alpha adrenergic antagonist agents
    • initiation of alpha adrenergic agonist agents
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6
Q

What is the definition of male orgasmic dysfunction?

A
  • definition: difficulty or inability of a male to reach climax/orgasm when sexually excited
    • ability to reach climax/orgasm but they are not satisfying.
  • can be primary (no prior history of orgasm) or secondary (prior history of orgasm)
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7
Q

What are the risk factors for male orgasmic dysfunction?

A
  • Antidepressant drugs (SSRI agents)
  • Hypogonadism
  • Chronic illness
  • Central and/or peripheral nervous system changes
  • Boredom, monotony with sexual activity
  • Negative attitudes about sex
  • A history of sexual abuse, rape
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8
Q

What are some good prevention methods for male orgasmic dysfunction?

A
  • Partner expression of sexual desires
  • Understanding that orgasm is an integrated byproduct of mind and body
  • If either is not functioning normally, orgasm can be impaired
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9
Q

What is involved in the diagnosis and treatment of male orgasmic dysfunction?

A
  • Diagnosis:
    • medical history and physical exam
    • check for medications that inhibit orgasm
    • hormonal testing
  • Treatment
    • sex therapy (trained, qualified specialist)
    • education
    • cognitive behavioral therapy
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