SIGNS AND TESTS

The health care provider will investigate any physical problems and conduct tests based on the particular type of sexual dysfunction you're experiencing. In any case, a complete medical history should be taken and physical examination should be done to:

• Highlight possible fears, anxieties, or guilt specific to sexual behaviors or performance
• Identify predisposing illness or conditions
• 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 or disabilities.

Sildenafil (Viagra) may be helpful for men who have difficulty attaining an erection. The medication increases blood flow to the penis. It must be taken 1 to 4 hours before intercourse. Men who take nitrates for coronary heart disease should not take sildenafil.

Mechanical aids and penile implants are an option for men who cannot attain an erection and find sildenafil is not 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. Kegel exercises may also increase blood flow to the vulvar/vaginal tissues, as well as strengthen the muscles involved in orgasm.

Vulvodynia can be treated with numbing cream, biofeedback, or low doses of certain antidepressants that also treat nerve pain. Surgery has not been successful.

Images

Male and female reproductive systems

Causes of painful intercourse

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Review Date: 09/11/2010
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)