Sexual problems overview

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Causes of painful intercourse

Male and female reproductive systems

CALL YOUR HEALTH CARE PROVIDER IF...

Call for an appointment with your health care provider if sexual problems persist and are a concern.

SIGNS AND TESTS

Specific physical findings and testing procedures depend on the form of sexual dysfunction being investigated. In any case, a complete history and physical examination should be done to:

• Identify predisposing illness or conditions
• Highlight possible fears, anxieties, or guilt specific to sexual behaviors or performance
• Uncover any history of prior sexual trauma

A physical examination of both the partners should include the whole body and not be limited to the reproductive system.

TREATMENT

Treatment depends on the cause of the sexual dysfunction. Medical causes that are reversible or treatable are usually managed medically or surgically. Physical therapy and mechanical aides may prove helpful for some people experiencing sexual dysfunction due to physical illnesses, conditions, or disabilities.

For men who have difficulty attaining an erection, the medication sildenafil (Viagra), which increases blood flow to the penis, may be very helpful, though it must be taken 1 to 4 hours prior to intercourse.

Men who take nitrates for coronary heart disease should not take sildenafil. Mechanical aids and penile implants are also an option for men who cannot attain an erection and find sildenafil isn't helpful.

Women with vaginal dryness may be helped with lubricating gels, hormone creams, and -- in cases of premenopausal or menopausal women -- with hormone replacement therapy. In some cases, women with androgen deficiency can be helped by taking testosterone.

Vulvodynia can be treated with testosterone cream, with use of biofeedback and with low doses of some antidepressants which also treat nerve pain. Surgery has not been successful.

Behavioral treatments involve many different techniques to treat problems associated with orgasm and sexual arousal disorders. Self-stimulation and the Masters and Johnson treatment strategies are among the many behavioral therapies used.