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Practice Algorithm
Female Sexual Dysfunction
Michael L. Krychman, MD
SEXUAL MEDICINE DIAGNOSIS
Sexual complaints in women may be lifelong,
acquired, situational, or global, and the etiology
is often complex. Diagnosis of female sexual dysfunction hinges
on a comprehensive history and physical examination. Evaluation
may encompass several disciplines, and a sexual history combined
with a detailed psychosexual assessment are critical for determining
the differential diagnosis. A careful pelvic examination is essential,
with specific laboratory and/or imaging tests as adjuncts for elucidating
any underlying medical cause. The following algorithm outlines a
stepwise approach to diagnosing female sexual complaints (Figure
1).1
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Figure not available online
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FIGURE
1. Evaluation
of female sexual dysfunction. |
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SEXUAL TREATMENT
Because the etiology of female sexual complaints is often multifactorial, the
treatment regimen may also involve interaction among several complementary disciplines.
Sexual functioning in women comprises a complex interplay of hormonal milieu,
social and psychological issues, underlying medical illnesses, and their influences
on the sexual response cycle. The following algorithm presents a multidimensional
model for the treatment of female sexual complaints (Figure
2).1 Clearly, all
of the therapies suggested will not be applied to every patient; rather, modalities
should be tailored to each patient’s specific complaints and needs.
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Figure not available online
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FIGURE
2. Treatment
options for female sexual dysfunction. |
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Michael L. Krychman, MD, is assistant clinical attending and codirector, Sexual Medicine Program, Department of Surgery, Division of Gynecology, Memorial Sloan-Kettering Cancer Center, New York, NY.
References
- Goldstein I, Alexander JL. Practical aspects in the management of vaginal atrophy and sexual dysfunction in perimenopausal and postmenopausal women. J
Sex Med. 2005;2(suppl 3):154-165.
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