Sexual Medicine Diagnosis and Treatments
- For Women
Treatment of women's sexual health concerns follows a step-care process that begins with modification of reversible causes and then proceeds to first-line, second-line, and third-line treatment strategies. Maneuvers to modify reversible causes include sex therapy, cognitive behavior therapy, physical therapy, lifestyle changes including exercise and diet, alteration of prescription medications, discontinuation of recreational drugs, management of partner sexual dysfunction, and other behavior modifications such as relaxation therapy. First-time therapies include hormone therapy (androgens, local and/or systemic estrogens, progestins), dopamine agonist therapy, oral phosphodiesterase type-5 inhibitors and vacuum clitoral device therapy. Second-time therapies include invasive maneuvers such as reconstructive surgery.
The most logical, efficacious way to restare sexual function in women with sexual health problems is to manage the sexual problem with multiple disciplines, proceed in a step-care process and, whenever possible, to engage the partner.
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- For Men
Treatment of men's sexual health concerns follows a step-care process that begins with modification of reversible causes and then proceeds to first-line, second-line, and third-line treatment strategies. Maneuvers to modify reversible causes include sex therapy, cognitive behavior therapy, physical therapy, lifestyle changes including exercise and diet, alteration of prescription medications, discontinuation of recreational drugs, management of partner sexual dysfunction, and other behavior modifications such as relaxation therapy. First-time therapies include hormone therapy (androgens), dopamine agonist therapy, oral phosphodiesterase type-5 inhibitors and vacuum erection device therapy. Second-time therapies include penile self-injection therapy and intra-urethral alprostadil therapy. Third-line therapies include surgery for placement of penile prosthesis, surgery for penile revascularization, and surgery for correction of penile curvature.
The most logical, efficacious way to restore sexual function in men with sexual health problems is to manage the sexual problem with multiple disciplines, proceed in a step-care process and, whenever possible, to engage the partner.
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