Sexuality Ch 28.pptVIP

SexualityCh 28 2009-2010 Academic Year MSIII Ob/Gyn Clerkship Self-Directed Study Case Study 42 yo G4P4 presents to gyn clinic with c/o decreased libido. She states that she is happily married for 14 years. After further discussion, she confides that she rarely has orgasm and worries that her husband will leave her if she does not have more interest in their sex life. APGO Educational Topic 56: A. Obtain a basic sexual history, including sexual function and sexual orientation. B. Describe the physiology of female sexual response. C. Discuss female sexuality across the lifespan. D. Categorize common patterns of female sexual dysfunction. E. Identify physical, psychological and societal contributions to female sexual dysfunction. Basic History (Page 356) Are you sexually active? Are there any problems with your sexual function? (Can preface with “Many people experience sexual dysfunction…”) What is our sexual orientation? What age did you first have intercourse? How many partners have you had? Do you use birth control? How do you protect yourself from STD’s (if multiple partners)? Sexual Orientation Heterosexual Engage in sexual activity with opposite sex Homosexual Engage in sexual activity with same sex Bisexual Engage in sexual activity with both sexes at same or different times of their life Sexual Response Cycle Excitement Phase Stimulation Plateau Phase Continuation of physiologic changes Orgasmic Phase Release of sexual tension Resolution Phase Return to baseline physiologic state Excitement Phase Plateau Phase Orgasmic Phase Resoluton Phase Lifespan - Sexuality Increasing age associated with decreased frequency and satisfaction of intercourse. Decreased estrogen Vaginal atrophy and dryness Dypareunia Difficulty in achieving orgasm Female Sexual Dysfunction Sexual dysfunction Failure of 1 or more of the phases of the sexual response cycle (desire, aousal, orgasm) or pain disorders. Primary Realistic expectations have never been met. Secondary All phase