User:Hpark1/sandbox

Sexual Medicine

While literature on prevalence of sexual dysfunction is very limited especially in women, about 40-50% of women report at least one sexual dysfunction regardless of age. About 20-30% of men report at least one sexual dysfunction, and most increase with age except for premature ejaculation.

Challenges in Sexual Medicine

While the awareness of sexual health importance has increased in regards to patients' general health and well-being, there is still a taboo that follows sexual health. The discussion of sexual health and taking a sexual history face barriers as not all physicians infrequently address these topics in visits, and patients are reluctant to discuss openly due to the perception that it is the physician's duty to initiate the topic and fears that the conversation will make the physician uncomfortable. The main obstacle that stands between these discussions have been reported as the lack of education regarding sexual issues in patients. The perception of sexual health varies among different cultures, as the notion is tied with many cultural norms, religion, laws, traditions, and many more.

Another challenge in sexual medicine is that in a standard process of drug discovery and development, human tissue and cells are not used in testing the candidate drug. Instead, animal models are often used to study sexual function, pathophysiology of diseases that cause sexual dysfunction, and new drugs. Pharmacokinetic and pharmacodynamic relationships are studied in animal models to test the safety and efficacy of candidate drugs. With animal models, there is a limitation to understanding sexual dysfunction and sexual medicine, as the results achieved can only mount to predictions.

Identification and treatment of female sexual dysfunctions are also a challenge as women often encounter difficulty within multiple disorders and sexual phases. The various sexual phases that are encompassed within female sexual dysfunctions (FSD) include hypoactive sexual desire disorder (HSDD), female sexual arousal disorder (FSAD), female orgasmic disorder (FOD) and female sexual pain disorders (FPD). Because many of these domains overlap, it is difficult to identify the target of treatment and many limitations are placed in research. Risk factors for female sexual dysfunctions were observed to be embedded with biopsychosocial aspects in epidemiological studies such as depression, urinary tract symptoms, cancer and cancer treatment, relationship problems, and menopausal transition. As a result, a multidimensional approach must be taken in the identification and treatment of female sexual dysfunctions.

The issue of psychological dilemmas that are associated with sexual dysfunctions is another challenge that is faced in sexual medicine. There are many psychological and existential aspects that are tied in with sexual dysfunctions. Despite much of sex therapy originating from psychological and cognitive-behavioral practices, much of the psychological dynamics have been lost in sexual medicine protocols. Approaching from a psychological perspective helps link the understanding between sexual function with sexual dysfunction. Because the psychological aspects underneath the sexual distress are not being addressed within sexual therapy and treatment is mostly focused on only the symptoms specifically in sexual medicine, there are many cases where individuals still experience disappointment and dissatisfaction in sexual activities despite the dysfunction being resolved.

Diagnosis

Sexual dysfunctions in men are often associated with testosterone deficiency. Signs and symptoms of testosterone deficiencies vary in each individual. Therefore, physical examinations could be done for men who suspect testosterone deficiencies to identify physical signs of the disorder. Common physical signs include fatigue, increased body fat, weight gain, muscle weakness, and depressed mood.