Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dip GUM > Sexual Dysfunction > Flashcards

Sexual Dysfunction Flashcards

1
Q

What is primary vulvodynia?

A

Chronic vulval pain of more than 3 months dating from 1st sexual experience or tampon use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is secondary vulvodynia?

A

Chronic vulval pain of more than 3 months developing after previous pain free sexual intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Associations with vulvodynia

A

Change in sexual partner
Thrush
STI
Depression / anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of dysparunia

A 
Vulvovaginitis (esp thichomoniasis and candida)
Vaginal cysts
Infected bartholins gland
Post menopause
Congenitally small ostium / thick hymen 
Deep retroverted uterus 
Chronic pelvic infection
Endometriosis
Adenomyosis
Pelvic tumours
Ectopic pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is premenstrual syndrome

A

Physical and/or psychological symptoms
affecting some women up to 10 days prior to menstruation.
Acne, breast tenderness, bloating, fatigue, nervousness, irritability, emotional disturbance, headache, mood changes.
Usually resolves with or after menstruation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what conditions are often associated with vulvodynia

A

anxiety
depression
somatisation
hyperchondriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

management options for vulvodynia

A 
pelvic floor excercises
external / internal soft tissue self massage with organic lubricants
trigger point pressure
biofeedback
vaginal trainers
accupuncture
lidocaine gel / capsicum cream
amitryptilline / gabapentin / pregabalin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is hypoactive sexual desire disorder?

A

loss of Iibido
decline in sexual desire
causing distress and interpersonal difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

causes of hypoactive sexual desire disorder?

A 
psychosexual cause
physical causes 
- depression 
- menopause
- TCAs
- SSRIs
- chemotherapy
- radiotherapy
- oophorectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is tokophobia

A

fear of pregnancy and childbirth

more common in primigravid women
anecdotally is increasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

causes of tokophobia

A

primary tokophobia = in nullips / primips

  • adolescence - avoid pregnancy at all costs
  • cultural attitudes
  • family attitudes
  • media
  • childhood or adulthood abuse

secondly tokophobia - occurs after previous birth

  • previous traumatic birth
  • previous instrumental delivery
  • spontaneous birth
  • previous termination
  • previous still birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

factors to explore in women with tokophobia

A 
triggering factors
causes of concern
- fear of pain
- loss of control
- fear of harm to them
- fear of harm to the baby
- lack of support
- concern birth will stretch vagina
- concern anatomy is not normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does LOFTI stand for in a psycho-sexual consultation

A 
Listening
Observing
Feelings
Thinking
Interpreting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

examples of defence mechanisms in psychosexual patients

A 
regression 
dissociation 
introjection 
sublimation
denial
avoidance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is vaginismus

A

involuntary spasm of the pubococcygeus muscle and associated muscles
causing painful and difficult vaginal penetration

can be primary or secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What may erectile dysfunction be an early marker for?

A

coronary artery disease (CAD) and generalized arteriopathy

17
Q

first-line medical treatment for erectile dysfunction

A

Phosphodiesterase inhibitors type 5

  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • Avanafil (Spedra)
  • vardenafil (Levitra)
18
Q

factors potentially contributing to delayed ejaculation in men with HIV

A

medications (especially antidepressants)
penile sensation loss due to neuropathy (incl drug- induced)
endocrinopathies
psychological

19
Q

factors potentially contributing to female sexual dysfunction in women with HIV

A 
Fear of onward transmission 
difficulties negotiating condom use 
menopause
low CD4 count
low mood 
poor body image 
neuropathy (HIV or drug- induced)
endocrine disturbances
atherosclerosis
20
Q

Aetiology of Localised provoked vulvodynia (vestibulodynia)

A

Likely multifactorial

History of vulvovaginal candidiasis, usually recurrent - is commonly reported

21
Q

Symptoms of localised provoked vulvodynia

A

Vulval pain – frequently at the introitus at penetration during sex or on insertion of tampons
Usually a long history

22
Q

Signs of localised provoked vulvodynia

A

Focal tenderness

elicited by gentle application of a cotton wool tip bud at the introitus or around the clitoris

23
Q

Complications of localised provoked vulvodynia

A

Sexual dysfunction and psychological morbidity

24
Q

Diagnosis of localised provoked vulvodynia

A

Clinical diagnosis

history and examination

25
Q

Further investigation of localised provoked vulvodynia

A

Exclusion other treatable causes

Biopsy only if there is any suspicion of an underlying dermatosis

26
Q

Treatment of localised provoked vulvodynia

A 
Avoid irritating factors
Use emollient soap substitute. 
Topical local anaesthetics - e.g. 5% lidocaine ointment / 2% lidocaine gel - use with caution - may cause irritation 
Pelvic floor muscle biofeedback
Vaginal transcutaneous electrical nerve stimulation
Vaginal trainers 
CBT 
Psychosexual counselling.

Pain modifiers – amitriptyline / TCAs, gabapentin, pregabalin.
Surgery – modified vestibulectomy - considered if other measures unsuccessful. Patients who responded to topical lidocaine prior to sex have a better outcome

27
Q

Follow-up for patients with localised provoked vulvodynia

A

As clinically required

Long-term follow-up and psychological support may be needed

28
Q

Aetiology of Unprovoked vulvodynia

A

Aetiology unknown

Condition best managed as a chronic pain syndrome

29
Q

Symptoms of unprovoked vulvodynia

A 
Pain 
Longstanding 
Unexplained
May be associated with urinary symptoms
Can be associated with irritable bowel syndrome and fibromyalgia
30
Q

Signs of unprovoked vulvodynia

A

vulva appears normal

31
Q

Complications of unprovoked vulvodynia

A

Sexual dysfunction

Psychological morbidity.

32
Q

Diagnosis of unprovoked vulvodynia

A

Clinical diagnosis
Made on history and examination
Once excluded other causes

33
Q

Further investigations for suspected unprovoked vulvodynia

A

Exclude other treatable causes

Biopsy ONLY if any suspicion of alternative diagnosis

34
Q

Treatment of unprovoked vulvodynia

A

Use of emollient soap substitute
Pain modifiers – TCAs (amitriptyline) frequently 1st line; gabapentin or pregabalin
Topical local anaesthetic - e.g. 5% lidocaine ointment / 2% lidocaine gel
CBT
Psychotherapy
Acupuncture
Physiotherapy -if evidence of a weak pelvic floor
Referral to a pain clinic

35
Q

Follow up of patients with unprovoked vulvodynia

A

As clinically required

36
Q

recommended dose of amitryptiline for unprovoked vulvodynia

A

Start at 10mg ON

increase by small increments up to 100mg daily according to the patient’s response

37
Q

what is Dyspareunia

A

Pain on sexual intercourse

38
Q

what is anorgasmia

A

female failure to reach orgasm

and finds this a problem

Dip GUM (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions