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
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
3
Q
What are the major types of ejaculatory dysfunction?
A
- Premature ejaculation
- Retrograde ejaculation
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
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
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)
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
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
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