Brainscape's Knowledge GenomeTM

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


See full index

Phase 3a > sexual medicine > Flashcards

sexual medicine Flashcards

1
Q

what are the sexual problems which affect sex drive?

A

sexual aversion

sexual addiction

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

what are the sexual problems which can affect desire/libido?

A

hypoactive sexual desire disorder

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

what sexual problems that can affect excitation?

A

female sexual interest/arousal disorder
erectile disorder
paraphilias

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

what are sexual problems that can affect orgasm ?

A

orgasmic disorder, ejaculatory problems (e.g. delayed, rapid or retrograde)

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

what are the sexual problems that can affect resolution?

A

sexual pain/penetration
dyspareunia
vaginismus
vulvodynia

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

what bloods would you do when someone is experiencing sexual problems?

A
  • fasting glucose/lipid ration (diabetes/CVD - useful to rule out for most sexual problems)
  • testosterone, SHBG, albumin (desire disorders, arousal disorders, orgasmic disorders, pain disorders)
  • prolactin (desire disorders, ED)
  • TSH - desire disorders, rapid ejaculation)
  • oestrogen (female sexual arousal disorder, orgasmic disorder)
  • FBC - desire disorders, orgasmic disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is male hypoactive sexual desire disordeR?

A
  • lack or loss of sexual desire - is the principle problem and is not secondary to other sexual difficulties, it does not preclude sexual enjoyment or arousal but makes the initiation of sexual activity less likely
  • persistently or recurrently deficient sexual/erotic thoughts or fantasies and desire for sexual activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are causes of hypoactive sexual desire disorder?

A
  • chronic conditions - obesity - metabolic syndrome, CVD, DM, anaemia
  • Hormonal disorders - males - androgen deficiency, hypogonadism from various aetiologies, hyperprolactinameia. Females- androgen deficiency, hypothyroidism, hyperprolactinaemia, post pregnancy, addison’s disease
  • iatrogenic - men - antidepressants, finasteride, orchidectomy. Female - OCP, oral HRT, tamoxifen, antidepressants and antipsychotics, metal blockers, bilateral oophorectomy
  • others - mental health conditions(depression anxiety), psychological experiences (work stress, previous trauma or abuse), body image disorder, couple relationship problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how can you treat hypoactive sexual desire disorder?

A

combination of psychosexual and physical treatments
CBT - dress unhelpful thinking (cognitive), sensate focus or self growth (behavioural)
psychodynamic therapy
individual psychosexual therapy

testosterone replacement (injection, transdermal patches or gel, buccal, subcutaneous patches)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what would individual psychosexual therapy involve?

A

Sexual education
Encourage vocalisation and acceptance of difficult feelings regarding onerous life circumstances
Normalising and permission giving
Find new solutions for old problems
Surmount barriers to psychological intimacy
Expand communication
Lessen performance anxiety
Transform destructive attitudes that interfere with intimacy
Support

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

what is a personal sexual growth programme?

A

Enables patient to become aware of their own sexual needs through mindful self exploration of their physiological responses
Work with the therapist to understand and overcome negative beliefs and unhelpful thinking patterns in relation to sexual behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is erectile disorder?

A

difficulty in developing or maintaining an erection suitable for satisfactory intercourse

decreased erectile rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some causes of erectile disfunction?

A
  • chronic medical condition (CVD, DM, neurological disease)
  • hormonal disorders (androgen deficiency, high prolactin)
  • iatrogenic (post prostate surgery, prescribed medications - antihypertensive, antidepressants especially SSRI)
  • age related changed
  • ineffective sexual stimuli
  • pain
  • veno-occlusive disorder
  • mental health disorders
  • performance anxiety
  • relationship problems
  • education matters
  • cultural and religious matter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what medications can you use to treat erectile dysfunction?

A
  • oral medications - sildenafil (viagra), avanafil (spedra), Tadalafil (Cialis), Vardenafil (Levitra)
  • injectable - Alprostadil (intra cavernosal injection ICI)
  • intraurethral - Alprostadil MUSE (medical urethral system for ejection) pellet, alprostadil cream (Vitaros)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some non-medical treatments for ED?

A

Vacuum device

Penile/scrotal rings

New stimulating routines e.g. enhancing lubricants, vibrators

Kegel excercises

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

what is female sexual interest/arousal disorder?

A

ICD - failure of genital response (the principle problem is vaginal dryness or failure of lubrication

DSM - lack of, or signifcanly reduced, sexual interest/arousal, as manifested by at least three of the following
Absent/reduced interest in sexual activity
Absent/reduced sexual/erotic thoughts or fantasies
No/reduced initiation of sexual activity, and typically unreceptive to a partner’s attempts to initiate
Absent/reduced sexual excitement/pleasure during sexual activity
Absent/reduced sexual interest/arousal in response to any internal or external sexual/erotic cues
Absent/reduced genital or non-genital sensations during sexual activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the causes of female sexual interest/arousal disorder??

A
  • chronic medical conditions (CVD, DM, neurological disease, connective tissue disorder, CSF/ME)
  • hormonal disorders (oestrogen deficiency, e.g. post menopause, thyroid disorders
  • iatrogenic - prescribed medications e.g. antidepressants
  • lactation - breastfeeding women can suffer
  • mental health conditions (depression, anxiety, eating disorders, excessive dieting)
  • previous abuse
  • decreased intimacy
  • couples relationship problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does couple psychosexual therapy involve?

A 
‘Hierarchy of interventions’
Timetabling
Communication
Negotiation/contracting
Addressing intimacy
Being sexual
Adjusting to difficulties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is a sensate focus therapy?

A

a staged programme of exercise to enable the couple to identify own and others sexual likes/dislikes and explore new techniques

work with the therapist to understand and overcome negative beliefs and unhelpful thinking patterns in relation to sexual behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are some behavioural interventions for sexual dysfunction?

A

sensate focus
new sexual routines, lubricant, vibrators, vile
eros therapy device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is an eros therapy device?

A 
A Small handheld device used in the home
It is the first clinically proven treatment for arousal and orgasmic disorders
Greater clitoral and genital engorgement
Increased vaginal lubrication
Enhanced ability to achieve orgasm
Improved overall sexual satisfaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

female orgasmic disorder?

A

orgasm either does not occur or is markedly delayed

23
Q

what are the causes of female orgasmic disorder?

A
  • chronic medical conditions (CVD,DM, neurological disorder, renal/liver impairment)
  • hormonal disorders (oestrogen and/or androgen insufficiency (post menopause), hypothyroidism)
  • pelvic floor weakness of damage
  • ageing
  • prescribed mediation especially SSRIs
  • mental health conditions
  • previous abuse
  • couple relationship problems
  • cultural and religious issues
  • lack of understanding
  • environmental factors
  • stress
24
Q

how might you manage female orgasmic disorder?

A

Individual psychotherapy with sex therapy focus – promoting changes and attitudes in sexually relevant thoughts

behavioural interventions - education, personal sexual growth programme, guided masturbation - lubricant and vibrators, legal exercises, relaxation, mindfulness

25
Q

how might menopause affect sexual function?

A
  • vaginal or pelvic pain
  • vaginal atrophy
  • dryness
  • change in self image, mood, memory, cognition
  • changes in desire
  • relationship, psychosocial and health play their part
  • physical discomfort - sleeplessness, night sweats.
26
Q

what is rapid ejaculation ?

A

£the inability to control ejaculation sufficiently for both partners to enjoy sexual interaction

premature/early ejaculation - ejeculation occurs approximately 1 minute following vaginal penetration and before the person wishes it

27
Q

causes of rapid ejaculation?

A 
genetic susceptibility 
penile hypersensitivity 
hyperthyroidism 
prostatitis 
co-morbid sexual problems e.g. ED
sympathomimetic medication 
anxiety states 
early learned experiences 
lack of experience/infrequent sexual encounters
psychosocial and environmental factors 
relationship issues 
partner issues
28
Q

what are the treatment options for rapid ejaculation?

A

topical local anaesthetic
medication - dapoxetine
couple psychosexual therapy (education, permission giving, normalisation, manage partner expectations)
behavioural interventions (stop start/sqeeze technique, sensate/self focus, practice point of inevitability, legal exercises, midnfulness

29
Q

why is delayed ejaculation?

A
  • on almost or all occasions either generalised or situation, without the individual desiring delay
    1. marked delay in ejaculation
    2. marked infrequency or absence of ejaculation
30
Q

what are some causes of ejaculation delay?

A
  • Congenital disorders
  • Trauma or surgery
  • Age
  • Infectious disorders
  • Neurological disorders eg DM, spinal cord injury, alcohol neuropathy
  • Depression
  • Medication induced eg SSRI, phenothiazines, thiazides, some alpha blockers
  • Low testosterone levels
  • Important to exclude retrograde ejaculation
  • insufficient stimulation/ poor sexual arousal
  • masturbation technique
  • poor body image, history of sexual or emotional abuse
  • relationship factors e.g. poor communication, desire, discrepancies
  • partner issues - ill health, sexual problems
31
Q

what investigations would you perform for delayed ejaculation?

A

Physical examination – testes, epididymis, vasa, prostate
Blood tests – FBC, Glucose, Testosterone, B12, Folate, PSA
Urine sample for presence of spermatozoa and fructose (if retrograde ejaculation suspected)

32
Q

delayed ejaculation treatment options?

A 
PSGP
Individual therapy
Couples therapy
Kegel exercises
Use of vibration/superstimulation (Viberect device)
33
Q

what is vaginismus?

A

Spasm of the pelvic floor muscles that surround the vagina, causing occlusion of the vaginal opening. Penile entry is either impossible or painful

34
Q

what are the cause of vaginismus?

A

physiological - Medical conditions where the vulva is sore to touch (e.g. thrush)
Other pain conditions or where pain is anticipated
Female Genital Mutilation
Congenital abnormality

psychological - Misinformation and mistaken beliefs
Vagina too small
No opening
First intercourse will be painful
Religious or cultural issues
Fear of pregnancy
Previous sexual abuse/trauma, or unpleasant first sexual experience or gynaecological examination
Fear or dislike of partner
Relationship dissatisfaction
Situational
35
Q

what are the treatment options for vaginismus?

A
  • Individual psychosexual therapy; explore family of origin, childhood, social history, relationships, sexual messages, cultural beliefs and sexual abuse.
  • Integrated CBT, deconstruct and eventually control phobic reaction.
  • Discuss physical examination, does she feel ready for this?
  • Behavioural interventions
    Breathing control and relaxation
    Self exploration and examination with mirror, cultural issues?
    Personal sexual growth programme, cultural issues?
    Kegel exercises (and importantly learning to relax pelvic floor)
    Vaginal trainers
36
Q

what is dyspareunia?

A

Dyspareunia (or pain during intercourse) occurs in both women and men. It can often be attributed to local pathology and should then be properly categorised under the pathological condition. This category is to be used only if there is no primary nonorganic sexual dysfunction (e.g. Vaginismus or vaginal dryness)

37
Q

what are some physiological causes of dyspareunia?

A
  • infection, injury, irritation, lesions, hypersensitivity
  • introitus (pain on entry) -Episiotomy/circumcision, recurrent infection, herpes, allergies, lichen sclerosis, Bartholin’s cyst, interstitial cystitis, urethritis, vaginal atrophy, menopause, post-radiotherapy, poor lubrication, insufficient sexual arousal, effects of a substance (drug/medication), penis size

mid-deep vaginal pain - endometriosis, congenital shortened vagina, fixed uterine retroversion, pelvic tumours, surgical adhesions, IBS, constipation

38
Q

what are some psychological causes of dyspareunia?

A

Previous experience of pain
Previous sexual abuse
Poor sexual education
Poor understanding of anatomy and physiology
Insufficient relaxation
Painful or unpleasant Gynaecological examination

Poor technique of partner
Speed / timing of partner
Fear of intimacy
Anger / resentment towards partner

39
Q

how could you manage dyspareunia?

A

steroid creams
couples therapy
personal sexual growth program
sensate focus to restart and relearn sexual contact with the additional pain and how it can be managed in a sexual context

40
Q

what are the main relationship issues?

A
  • communication issues
  • timetabling
  • conflict resolution
  • difficulties with compromise
  • power issues
  • trust issues
  • sexual problems
41
Q

for sexual medicine and psychosexual therapy to be effective what needs to be addressed?

A

the relationship sexual and relationship problems

our professional and personal values and beliefs

issues of diversity

changes in relationships brought by the internet and technology

awareness of relationship therapy and what it can help with

42
Q

what is the link between sexual and relationship functioning?

A
  • sexual problems can be a ticket in
  • admitting a limited problem can be easier than a general one
  • persistent relationship problems are likely to result in a sexual problem
43
Q

how does our professional values and beliefs affect treatment?

A

Ideas about appropriate treatment
Environment of costings and scarce resources
Deserving and undeserving categories
Ideas about what is ok and not ok in sex – erotic diversity
Beliefs about how relationship should operate
General ethical and moral positions
GSERD(Gender, Sexual, Erotic, Relationship Diversity)

44
Q

how do you address a patient’s values and beliefs?

A
  • Assess the degree to which patients are being pressurised about what is normal or what constitutes a problem
  • Be aware of ideas and beliefs that may impact on advice or treatment
45
Q

what with diversity involves…

A

Being aware of the diversity issues in the geographical and clinical areas in which we work

Taking account of the variety and complexity of the relationship arrangements in contemporary society compared with the past

Seeing relationships in the context of wider family values and culture and the variable importance of these

Taking account of ethnicity and culture

46
Q

taking account of ethnicity and culture involves…

A

Not making assumptions around relationship arrangements and sexual practices

Knowing about and taking account of issues around relationship arrangements and sexual practices in consultations

Addressing religion where relevant

47
Q

what are petok’s four principles?

A

Ask about religious beliefs during the initial visit
Ask about religious teachings regarding sexual behavior
When in doubt, consult with a religious expert
Help couples set reasonable expectations consistent with their beliefs

48
Q

what are the main factors in the impact of chronic illness on relationship?

A
  • disturbance of body image
  • tiredness, low mood, anxiety
  • disturbance of roles and life narratives
  • limitations on mobility and social contact
  • disturbance of mental functioning
  • postponement of breakdown
49
Q

what are the general princes in relationship therapy?

A

Create a working alliance with the those involved in relationship
Offer insight and understanding into problem and their origins
Enable feelings to be tolerated and managed
Facilitate more effective communication
Change dysfunctional thought patterns
Help resolve conflict and enable compromise
Help shift major dysfunctional dynamics eg intimacy and power

50
Q

what are the four main relationship therapy approaches?

A
  • cognitive-behavioural
  • psychodynamic
  • systemic
  • intergrative
51
Q

what is CBT in relationship therapy?

A
  • focuses on dysfunctional patterns of thoughts, beliefs and how behaviour in the here-and-now
52
Q

what is psychodynamic relationship therapy?

A

Focuses on the relationship between current problems and earlier patterns of response and behaviour from earlier life and takes into account unconscious processes

53
Q

what is systemic relationship therapy?

A

Focuses on process and context rather than and content to bring about change which is not necessarily based on understanding and intent
is concerned with the web of connections between persons and world, self and others. Systemic therapy tackles problems arising not within the individual as such, but rather within their wider life: their family and friends, work, and in the social (cultural, political, economic) context.

54
Q

what is integrative relation therapy?

A
  • useful understanding and interventions from more than one approach
  • can appear to offer the best of possible worlds but has risks and limitations

Phase 3a (41 decks)

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