Psychosocial Concerns

Question 1

What percent of couples have some soft of sexual dissatisfaction/dysfunction?

Answer 1

50%

Question 2

What are the three levels of arousal?

Answer 2

• Excitement
• Plateau
• Orgasm

Question 3

What happens to the vagina with orgasm? Uterus?

Answer 3

• Contractions of perivaginal muscles and sphincter

- Uterine contractions

Question 4

Is there any change with organsms post hysterectomy?

Answer 4

No

Question 5

What are the different types of female sexual dysfunction?

Answer 5

• Sexual desire disorder
• Sexual arousal disorder
• Female orgasmic disorder
• Sexual pain disorder

Question 6

What is sexual pain disorder?

Answer 6

Dyspareunia/vaginismus

Question 7

What is the most common type of sexual disorder?

Answer 7

Desire disorder

Question 8

Is testosterone therapy recommended for sexual desire disorder? Androgen?

Answer 8

No for either

Question 9

Can vaginal dryness cause desire disorder?

Answer 9

True

Question 10

What are the meds that can cause arousal disorders? (4)

Answer 10

SSRIs
EtOH
Antihypertensives
Anticholinergics

Question 11

What is orgasmic dysfunction?

Answer 11

Inability to have an orgasm

Question 12

What percent of women have never experienced an orgasm?

Answer 12

10-15%

Question 13

What type of dyspareunia is experienced by women with endometriosis?

Answer 13

Deep

Question 14

What are the causes of sexual pain disorders?

Answer 14

• Scarring

- Dryness

Question 15

What percent of women have experienced sexual abuse?

Answer 15

1 in 5

Question 16

What are the common emotional reactions to sexual abuse?

Answer 16

• fear
• Self blame
• depression/anxiety

Question 17

What are the somatic complaints of sexually abused women?

Answer 17

HA
Insomnia
Choking
Hyperventilation

Question 18

What is the best way to screen for sexual abuse?

Answer 18

Universal inquiry sheet

Question 19

How do you counsel women who have had sexual abuse?

Answer 19

-Give pt control over disclosure

Question 20

True or false: it is appropriate to postpone the pelvic exam if a woman is feeling uncomfortable (assuming no emergent need)

Answer 20

True

Question 21

What are the three things that should be explained to patients before you do it?

Answer 21

• What will be done
• What it might feel like
• Why it is necessary

Question 22

What is premenstrual syndrome?

Answer 22

Cyclical recurrence of symptoms during the luteal phase of menstruation

Question 23

What are the somatic symptoms of PMS?

Answer 23

• Breast TTP
• Abdominal bloating
• HA
• Peripheral edema

Question 24

When do PMS s/sx occur? When are they resolved?

Answer 24

• 5 days before menses

- Relieved within 4 days of the onset of menses

Question 25

What is premenstrual dysphoric disorder?

Answer 25

Severe PMS, that interferes with function. Comparable to other mental disorders

Question 26

What is the proposed cause of premenstrual dysphoric disorder?

Answer 26

Serotonergic dysregulation

Question 27

What are the pharmacologic therapies for premenstrual dysphoric disorder?

Answer 27

SSRIs or hormonal ovulation suppression if severe

Question 28

What are the two general types of s/sx of PMS?

Answer 28

Affective | Somatic

Question 29

PMS can be diagnosed if the patient reports s/sx how many days before menstruation? They have to be relieved within how many days? How many menstrual cycles are needed?

Answer 29

- 5 days prior - Relieved within 4 days of the onset of menses - 3 menstrual cycles