female-sexal-dysfunction.doc

Female Sexual Dysfunction - Questions J. Vannerson, MD July 2003 Regarding the physiology of sexual function, classify the following statements as true or false: Normal sexual function is dependent upon the orchestration of multiple psychologic, neurologic, endocrinologic and vascular factors. When one of these areas is dysfunctional, problems with sexual satisfaction can occur. Studies suggest that nitric oxide is involved in modulating vaginal relaxation and secretory processes. Animal studies suggest adrenergic nerves mediate vaginal smooth muscle contractile response. Estrogen is the primary hormone mediating libido and sexual arousal. Testosterone is the primary precursor for estradiol biosynthesis in the brain. Regarding the epidemiology of female sexual dysfunction (FSD), classify the following statements as true or false: Based on survey reports, FSD most commonly occurs in women over 60. National surveys indicate FSD affects up to 50% of American women. FSD is more prevalent in women than in men. Risk factors include hypertension, cigarette smoking, hyperlipidemia and previous pelvic surgery. Regarding the etiology of FSD, classify the following statements as true or false: Atherosclerosis of the iliohypogastric/pudendal arterial bed is a common cause of vasculogenic FSD. Neurogenic etiologies of FSD include spinal cord injury and diseases of the CNS or PNS such as diabetes. There is no direct correlation between the presence of sexual complaints and levels of serum estradiol. Hypotonia of the pelvic floor muscles has a negative effect on sexual function whereas hypertonia enhances function. Mood disorders, history of sexual abuse, poor general health and low income have all been shown to be associated with FSD. Regarding the diagnosis of FSD, classify the following statements as true or false: Absence of sexual activity in a relationship always signifies sexual dysfunction. The evaluation of the patient with complaints of FSD must start with a comp