sexual health

Question 1

key sx of primary syphilis

Answer 1

• painless lymph nodes
• single painless genital ulcer = chancre

Question 2

sx of lymphogranuloma venereum

Answer 2

• initially single painless genital ulcer
• secondary stage involves lymphadenitis of the inguinal and femoral lymph nodes

Question 3

when does secondary syphilis occur and what Sx are seen

Answer 3

occurs within 6 months of primary infection

systemic Sx on skin and mucous membranes:

• Maculopapular rash on palms and soles
• Condylomata Lata(grey wart-like lesions around the genitals and anus)
• Low-grade fever + headaches
• Lymphadenopathy – generalised non-tender.
• Alopecia (localised hair loss)
• Oral lesions – snail track ulcers

Question 4

Ix for premature ejaculation

Answer 4

Testosterone: Low levels can impair sexual function and ejaculation control.
Thyroid-stimulating hormone (TSH): Hyperthyroidism is commonly linked with premature ejaculation.
Prolactin: Elevated levels can affect libido and ejaculatory function.
Luteinizing hormone (LH): Assesses pituitary function and testosterone regulation.

ALSO
FSH. + oestrogen

Question 5

what psychological factors can cause premature ejaculation

Answer 5

PERFORMANCE ANXIETY, AND LIFE STRESSORS

Question 6

Mx of premature ejaculation

Answer 6

• Medical = SSRI DAPOXETINE (1), TOPICAL LOCAL ANAESTHETIC (1)
• Behavioural = CBT (1), COUPLES THERAPY (1)

Question 7

conditions that contribute to premature ejaculation

Answer 7

THYROID HYPER/HYPO,
DM,
LOW SEROTONIN e.g. DEPRESSION+ANXIETY,
PROSTATITIS/UTI,
PEYRONIE DISEASE