Sexual Dysfunction

Sexual Dysfunction in the Female
Sexual dysfunction may occur in the female at any time of her sexual life, although it tends to be more common during the perimenopause/menopausal years. There may be psychological or emotional reasons for sexual dysfunction at any age due to rape, molestation and other forms of abuse. Some common problems directly or indirectly related to sexual dysfunction are low libido, poor vaginal lubrication, painful sexual intercourse, depression and poor self image and hormonal imbalances.

Low libido, or poor desire for sexual intercourse, is accompanied by other symptoms of hormonal imbalance: insomnia, fatigue, night sweats, vaginal dryness, fuzzy thinking. Causes may vary:
    Decreased blood flow,
    Adrenal exhaustion,
    Some birth defects,
    Hormonal deficiencies,
    Chronic diseases,
    Relationship issues
    Abuse of drugs and alcohol,
    Diabetes and degenerative neurological disorders,
    Painful intercourse
Treatment: depends on the cause, determined by the following in office assessments:
    Medical history with medications
    Psychosocial history with current and previous partners
    Diet and Nutrition assessment
    Stress Management
    Hormonal panels
Erectile Dysfunction (formerly Impotence) in the Male
A male with Erectile Dysfunction will have difficulty getting or maintaining an erection firm enough for sexual intercourse. Thirty million men in the US have this health challenge, which may increase with age. Erection problems may occur at any age although it is a more common problem after the age of 75. It is not a given to develop erectile dysfunction with age.

Statistics in the U.S.:
    50y/o range: 4%
    60y/o range: 17%
    Over 75y/o: 47%
Causes: ED usually has a physical cause:
Health conditions such as diabetes, heart disease, multiple sclerosis, atherosclerosis, and injury of the nerves, arteries, smooth muscles and fibrous tissues. Surgeries such as a radical prostatectomy or bladder surgery may also be a cause. Lifestyle issues may be smoking, drinking excessively, being overweight and lacking regular exercise. Many prescriptive medications may be a cause as well as psychological factors. Hormonal abnormalities such as low testosterone are less frequent causes of ED.

An erection requires a precise sequence of events, and ED may occur when any of these events are disrupted. For example, if the nerve impulses are interrupted between the brain and pelvis (penis), as in a spinal cord injury, then ED may occur.

An office visit will consist of:
    Medical history with medication list
    Physical assessment/exam if indicated
    Labs with saliva hormonal testing
    Nutritional Profile
    Psychosocial assessment