Female Sexual Dysfunction: Demystifying the Secret Garden

Phyllis MacGilvray, MD, FAAFP

Phyllis MacGilvray, MD, FAAFP

Time and place: 9:15–10:15 a.m., Room 221AB; and 10:30–11:30 a.m., Room 217AB

About the presenter: Phyllis MacGilvray, MD, FAAFP, is Vice Chair of Medical Student Education at UT Health-San Antonio in addition to being a family physician. Her experience has found that female sexual dysfunction is an under-recognized condition and one that physicians struggle to discuss with their patients. Some of that can be attributed to the lack of training physicians have in this area, she said.

"What I've learned over years of practice is that as you ask the sensitive questions and identify and address sexual problems, patients become very thankful that you took the time," MacGilvray said. "So, the reason I am presenting on this is to increase awareness and hopefully to decrease trepidation that physicians may have about bringing up this topic."

Session overview: MacGilvray will review the DSM-5 criteria for female sexual dysfunction and briefly discuss diagnosis and treatment for each category. She'll start by describing what normal sexual response is and go through a checklist physicians can use to start the conversation in the clinic to identify patients.

"Specifically, I'm going to talk a little more about sexual desire disorders which is the most prevalent, and then I'm going to talk about some of the key neurotransmitters in the brain that are associated with female sexual desire disorder," she said.

The session also includes a review of the co-morbid conditions that may co-exist, as well as medication side effects and social and cultural factors that can impact dysfunction. MacGilvray will end with a discussion of evidence-based treatment approaches including FDA- and non-FDA approved therapies.

Why this session matters to you: Many patients — and physicians — don't know how to treat sexual dysfunction in women, or that there are treatments available. "Everybody knows about the little blue pill that treats sexual dysfunction in men," MacGilvray said. "With women, it's not that straightforward. Realizing that we do have options for women and learning about effective therapies that can be used is important."

The take-home: Patients want their physicians to ask about their sexual function, MacGilvray said. Physicians also need to understand that medications can cause sexual dysfunction and altering those medications can greatly improve the dysfunction. "I want participants to leave with an awareness that there is a multidisciplinary approach to female sexual dysfunction treatment that should be patient-centered and comprehensive," she said.