Psych Vivas · Specialty psychiatry — sexual medicine interface
Female sexual interest, arousal and pain disorders — structured clinical viva
Fellowship viva on FSIAD/GPPPD interface: classification, mechanisms, SSRI effects, assessment, and stepped pharmacological/psychosexual care.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar in clinic. A 42-year-old woman on long-term escitalopram reports 1 year of low desire, poor arousal, and new dyspareunia after perimenopausal symptoms. Her partner wants 'the female Viagra.' Discuss DSM-5-TR vs ICD-11 nosology, Basson/dual-control framing, SSRI contribution, assessment including FSFI, stepped care, flibanserin vs bremelanotide safety, GSM/pain pathways, and how you respond to the partner demand.
Interpretation
Reveal interpretationShowHide
This is a biopsychosocial FSIAD + pain/GSM interface case with high likelihood of SSRI contribution and a partner request for a simplistic “female Viagra” fix. The viva tests nosology, mechanism models, medication literacy, process-of-care sequencing, and ethical couple framing without collusion.[3][6]
References7ShowHide
- [1]Basson R The female sexual response: a different model J Sex Marital Ther, 2000.PMID 10693116
- [2]Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function J Sex Marital Ther, 2000.PMID 10782451
- [3]Montejo AL, Llorca G, Izquierdo JA, Rico-Villademoros F Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients J Clin Psychiatry, 2001.PMID 11229449
- [4]Katz M, DeRogatis LR, Ackerman R, et al. Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial J Sex Med, 2013.PMID 23672269
- [5]Kingsberg SA, Clayton AH, Portman D, et al. Bremelanotide for the Treatment of Hypoactive Sexual Desire Disorder: Two Randomized Phase 3 Trials Obstet Gynecol, 2019.PMID 31599840
- [6]Clayton AH, Goldstein I, Kim NN, et al. The International Society for the Study of Women's Sexual Health Process of Care for Management of Hypoactive Sexual Desire Disorder in Women Mayo Clin Proc, 2018.PMID 29545008
- [7]Bancroft J, Graham CA, Janssen E, Sanders SA The dual control model: current status and future directions J Sex Res, 2009.PMID 19308839