Fast Five Quiz: Sexual Disorders

Steve Soreff, MD; Bradley Schwartz, DO; Michel E. Rivlin, MD

Disclosures

August 11, 2020

Female sexual dysfunction was redefined to include female sexual interest/arousal disorder, female orgasmic disorder, and genitopelvic pain/penetration disorder. According to DSM-5, to be considered dysfunctional, these symptoms must cause distress and must occur at least 75% of the time over a 6-month period.

According to the ACOG 2019 Practice Bulletin, the prevalence of female sexual distress peaks among women aged 45 to 64 years (15%). The prevalence is approximately 10% in women aged 18 to 44 years and women older than 65 years.

ACOG recommends that the initial evaluation of a patient with female sexual dysfunction may require an extended visit and should include a comprehensive history and physical examination. However, laboratory testing is typically not necessary in the initial evaluation unless an undiagnosed medical etiology is suspected.

ACOG states that systemic dehydroepiandrosterone (DHEA) is not effective and is not recommended for use in the treatment of women with sexual interest/arousal disorders. For women with antidepressant-induced female sexual dysfunction, ACOG notes that supplementation with bupropion (a norepinephrine-dopamine reuptake inhibitor) may improve symptoms.

Psychologic interventions include sexual skills training, cognitive behavioral therapy, mindfulness-based therapy, and couples therapy. A consultation with or referral to a mental health specialist is recommended by ACOG as part of female sexual dysfunction treatment.

Read more about female sexual dysfunction.

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