Sexual dysfunction and dyspareunia

Overview & definition

It is 19:00 in clinic. A patient says, “Sex has become difficult, but I do not know how to explain it.” Your first task is not a label. It is to make the consultation safe and specific.

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Female sexual dysfunction (FSD) means persistent or recurrent sexual symptoms that cause personal distress or interpersonal difficulty. A partner's preference, a frequency difference, or a culturally unusual practice is not a disorder without the patient's own distress or impairment. ^[2]

Use the patient's goal as your organising question: “Is the main problem desire, physical arousal, orgasm, pain, or a mixture?” Pain commonly suppresses desire secondarily, so do not diagnose primary low desire until pain and other contributors are addressed.

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References15ShowHide

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