ITEMS IN AFP WITH KEYWORD:
Dyspareunia is recurrent or persistent pain with sexual intercourse that causes distress. Women with sexual pain are at increased risk of sexual dysfunction, relationship distress, and diminished quality of life. Clinicians should create a safe and welcoming environment when taking a sexual history, in which patients describe the characteristics of the pain. Physical examination of the external genitalia includes visual inspection and sequential pressure with a cotton swab. A single-digit vaginal examination may identify tender pelvic floor muscles; a bimanual examination can assess for uterine retroversion and pelvic masses. Common diagnoses include vulvodynia, inadequate lubrication, vaginal atrophy, and postpartum causes. Treatment may include lubricants, pelvic floor physical therapy, vaginal estrogen, and cognitive behavior therapy.
The American College of Physicians published guidelines for testosterone therapy in cis gender men with age-related low testosterone based on a systematic review.
Feb 1, 2020 Issue
Treatments for Postmenopausal Hypoactive Sexual Desire Disorder [FPIN's Clinical Inquiries]
Transdermal testosterone for the treatment of hypoactive sexual desire disorder in postmenopausal women results in an additional 0.92 sexually satisfying events per month, acne, and increased androgenic effects without major complications
Transdermal, but not oral, estrogen produced a small improvement in sexual function scores in menopausal women. The increases were very small and may not be noticeable by most women.
Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.
Although flibanserin results in a modest improvement in the number of satisfying sexual events (approximately one more per month vs. placebo), it does not improve other measures, is considerably expensive, and has significant adverse effects.
Female sexual dysfunction is often multifactorial, necessitating a multidisciplinary evaluation and treatment approach. Learn the criteria for diagnosing sexual dysfunction and possible treatment options.
Learn how the history and physical examination can help identify the most common causes, including vulvodynia, inadequate lubrication, postpartum dyspareunia, and vaginal atrophy.
Dec 1, 2012 Issue
AHA Releases Statement on Sexual Activity and Cardiovascular Disease [Practice Guidelines]
Decreased sexual activity and sexual dysfunction are common in patients with cardiovascular disease (CVD), and can lead to anxiety and depression. The American Heart Association (AHA) has published a scientific statement synthesizing data relevant to sexual activity and heart disease to provide reco...
The American College of Obstetricians and Gynecologists (ACOG) has released guidelines on sexual dysfunction in women. Sexual dysfunction is common in U.S. women but is underdiagnosed and undertreated, partly because patients are not likely to discuss it with their physician unless they are asked. ...