sexual dysfunction

Question 1

what are the categories of sexual disorders in the DSM-V?

Answer 1

• sexual arousal/interest disorder
• anorgasmic disorder
• genito-pelvic pain/penetration \ disorder
• medicatoin/substance induced
• other

Question 2

what are the categories of anorgasmia?

Answer 2

• primary: never had orgasm

- secondary: used to but don’t or change in ability/sensation

Question 3

treatment options - arousal/interest disorder?

Answer 3

• psychological: CBT, sexual skills training, mindfulness
• transdermal testoterone: 3-6 mo max; assess in 3-6 weeks for serum testerone level (cannot be more than higher limit for female) for post-menopausal pt
• filbaserin (addyi): serotonin agonist/antagonist. hypotension/sycnope with ETOH. in pts without depression

Question 4

treatment options - orgasm

Answer 4

• can try transdermal testosterone
• education
• vibrator

Question 5

for gentiopelvic pain/penetrative

Answer 5

• education
• pfpt
• dilators
• vaginal estrogen for postemenopausal
• can use ospemifene for GSM
• intravaginal prasterone (DHEA) for GSM
• moisturizers, lubcricants PRN