Sexual medicine Flashcards
What is a paraphilia?
sexual interest in an object/situation which is atypical
What is a sexual aversion disorder?
persistant avoidance of genital contact with a sexual partner
Causes of sexual aversion disorder?
bad previous experiences, violent experiences, anxiety
what is hypoactive sexual desire disorder?
low sexual desire, rarely engages in sexual activities and don’t initiate sexual activity
causes of hypoactive sexual desire disorder?
pregnancy, menopause, relationship problems, mental illness, fatigue, low confidence, ED, delayed ejaculation, neurological issues
Ix for hypoactive sex drive?
hormone levels, pelvic exam, BP check, CHD check, prostate exam
What is orgasmic disorder?
difficulty reaching orgasm despite sufficient sexual stimulation
causes of orgasmic disorder?
age, SSRIs, depression, anxiety, Hx sexual abuse, low confidence, relationship issues
Ix for orgasmic disorder?
physical exam, sexual history, bloods
what is delayed ejaculation?
takes >30 minutes of penetrative sex in order for male climax (sometimes not possible to climax at all)
causes of delayed ejaculation?
psych - depression, anxiety
meds - SSRI, alcohol, antipsychotics
physical - pelvic nerve injury, prostate surgery
what is retrograde ejaculation?
semen enters the bladder instead of through the penis. DRY ORGASM - followed by cloudy urine, and reduced fertility
causes of retrograde ejaculation?
bladder neck surgery, nerve damage (diabetes/MS/PD)
what is peyronies disease?
fibrous tissue develops on the penis - creates a curved shape and painful erectionss
what is ED?
persistant inability to attain or maintain an erection for sexual performance
RF for ED?
CVD, obesity, diabetes, hyperlipidaemia, HTN, smoking, SSRIs, B blockers
name a medication and class used to treat ED
PD5 inhibitors - e.g Viagra
what is vaginismus?
difficulty with vaginal penetration despite wanting to, due to involuntary contraction of the pelvic floor muscles and thigh adductors
how do you manage vaginismus?
vaginal dilators
what is vulvodynia?
burning pain around the vagina in absence of physical findings/neuro findings
Mx for vulvodynia?
1st line = pelvic floor exercises, internal and external massage, topical LA
2nd line - TCA, gabapentin
