Sexual Difficulties Flashcards
Most common symptoms women with sexual difficulties presents?
Pain* Libido* Inability to have intercourse* Arousal/orgasm Relationships
Treatment approach?
Biopsychosociocultural appraoch.
How in prevention?
Trust, respect
Ask
Reassure: you’re not the only one
Gynecological exam what to ask?
Ask about past history of abuse
Hx of presenting problem?
Nature Development Primary, secondary Reactions Attempts to resolve Consequences Why coming for help NOW?
Examination assessment? What to look out for?
Thighs, tense?
Stop if distressed
Look at the face
Dyspareunia, most common cause of superficial?
Lack of arousal Vaginal dryness (From lack of estrogen, menopause and breast feeding) Candida, meds, neoplasia, structural
Causes of deep dyspareunia?
Endometriosis
Bowel and bladder
What is vulvodynia?
Pain at the intro it’s, often burning, absence of visible signs, neuropathic type pain
How to diagnose vulvodynia?
Cotton bud test
Touch intro it’s
Vaginismus
Involuntary pelvic contraction/reflex, makes any penetration painful. Like blinking
Psychosexual causes of vaginismus?
Fear, anxiety, pain
What’s secondary vaginismus?
Other causes such as infections
Most Continue to have sex despite pain
How to manage dyspareunia
Not the only one
Education
Stop trying intercourse until assessment is complete
Refer: Ax, physical Mx, psychosexual, Physio
Meds for vulvodynia?
Skin care
Meds: TCAs,
