Sexual medicine often uses a multidisciplinary approach involving physicians, mental health professionals, social workers, and sex therapists.
The field connects to multiple medical disciplines with varying degrees of overlap including reproductive medicine, urology, psychiatry, genetics, gynaecology, andrology, endocrinology, and primary care.
Psychoanalytic theories about sexuality, such as those proposed by Sigmund Freud and Helene Deutsch, were considered highly controversial.
Today, sexual medicine has reached a wider range of medical specialties, as well as psychologists and social workers, to name a few.
It is reported that only 35% of primary care physicians have taken a sexual history and, due to this, there is a gap in achieving holistic healthcare.
[4] Issues related to sexual or reproductive medicine may be inhibited by a reluctance of an individual to disclose intimate or uncomfortable information.
[9] When visiting a health care provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.
[11] Common physical signs include fatigue, increased body fat, weight gain, muscle weakness, and depressed mood.
[11] Laboratory tests may also be used to assist with diagnosis, such as blood glucose levels, lipid panel, and hormonal profile.
Congenital or acquired, these conditions refer to any pathology which interferes with the perception of satisfactory sexual health.
Varied conditions include absent sexual organs, hermaphrodite and other genetic malformations, or trauma such as amputation or lacerations.
Examples of conditions which may be treated by specialists in this field include: Female Male Non-exclusive Once a diagnosis of sexual dysfunction has been made, treatment is often integrative and individualized.
As of 2018, the American Urological Association (AUA) ED guidelines recommend shared medical decision-making between patient and provider over first-, second-.
However, phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), are often recommended due to their favorable efficacy and side effect profile and work by increasing the lifespan of the vasodilator nitric oxide in the corpus cavernosum.
Alternative treatments for ED are the use of vacuum-assisted erection devices, intracavernosal injection or intraurethral administration of alprostadil (prostaglandin E1), and surgery if necessary.
Referral of the woman or couple to a sex therapist is also common to increase communication and expression of concerns and desires.
Finally, conditions associated with the documented sexual dysfunction are simultaneously treated and included in the treatment plan.
[22] Non-pharmacologic treatment for female sexual dysfunction can include lifestyle modifications, biofeedback, and physical therapy.
Sexual pain is another large factor for women, caused by Genitourinary Syndrome of Menopause (GSM), which includes hypoestrogenic vulvovaginal atrophy, provoked pelvic floor hypertonus, and vulvodynia.
Depression and anxiety disorders are strongly connected with reduced sex drive and a lack of sexual enjoyment.
[24] Both obesity and tobacco smoking have negative impacts on cardiovascular and metabolic function, which contributes to the development of sexual dysfunctions.
Chronic smoking causes erectile dysfunction in men due to a decrease in vasodilation of vascular endothelial tissue.
[24] Chronic stress may potentially contribute to sexual dysfunction, as it can induce high levels of cortisol, which may cause harmful effects in if it remains altered long term.
Adoption of healthy lifestyle routines include: avoiding drugs, smoke, and excessive alcohol, as well as incorporating regular physical activity accompanied by a balanced diet and use of stress-management strategies.
[30] Pharmacokinetic and pharmacodynamic relationships are studied in animal models to test the safety and efficacy of candidate drugs.