First Page - SEXUAL MEDICINE......Page 1
Distributor......Page 2
Foreword......Page 3
Members of the Committees 1/4......Page 6
Members 2/4......Page 7
Members (by Committee) 3/4......Page 8
Members (by Committee) 4/4......Page 9
Prof. Robert KRANE 1/2......Page 10
Prof. R. Krane 2/2......Page 11
Contents 1/2......Page 12
Content 2/2......Page 13
ORDER FORM......Page 14
EVIDENCE – BASED MEDICINE 1/2......Page 15
EVIDENCE – BASED MEDICINE 2/2......Page 16
PART 1. BASIC CONSIDERATIONS......Page 17
CHAPTER 1 Historical Highlights of Erectile and Sexual Dysfunction An Illustrated Chronology......Page 19
CONTENTS......Page 20
PREHISTORIC PERIOD......Page 21
GREEK MEDICAL LITERATURE......Page 22
KAMA SUTRA......Page 23
“MUSCULI ERECTORES”......Page 24
REGNIER DE GRAAF I......Page 25
SPERMATORRHŒAAND MASTURBATION......Page 26
FEMALE GENITAL MUTILATION IN VICTORIAN TIMES......Page 27
THE BIRTH OF ANDROGEN THERAPY......Page 28
ERECTILE DISORDERS AND PSYCHOANALYSIS......Page 29
REJUVENATION II......Page 30
SURGICAL TREATMENT OF ERECTILE DYSFUNCTION......Page 31
ERECTILE DYSFUNCTION DUE TO ARTERIAL VASCULAR OCCLUSION......Page 32
WILLIAM H. MASTERS AND VIRGINIA E. JOHNSON: PRACTICAL SEX-THERAPY......Page 33
INTRACAVERNOUS INJECTION THERAPY FOR ERECTILE DYSFUNCTION......Page 34
REFERENCES......Page 35
CHAPTER 2 Definitions, Classification, and Epidemiology of Sexual Dysfunction......Page 37
CONTENTS......Page 38
I. GENERAL INTRODUCTION......Page 39
II. INTRODUCTION TO DEFINITIONS OF SEXUAL DYSFUNCTIONS......Page 40
III. DEFINITIONS OF SEXUAL DYSFUNCTION FROM THIS CONSULTATION......Page 41
IV. DESCRIPTIVE EPIDEMIOLOGY......Page 43
V. ANALYTICAL EPIDEMIOLOGY......Page 60
VII. RECOMMENDATIONS......Page 67
REFERENCES......Page 68
CHAPTER 3 Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction......Page 73
CONTENTS......Page 74
INTRODUCTION......Page 75
I. PREDISPOSING, PRECIPITATING AND MAINTAINING FACTORS......Page 76
I. THE ROLE OF ANXIETY IN SEXUAL FUNCTION AND DYSFUNCTION......Page 80
II. DEPRESSION AND SEXUAL FUNCTION......Page 85
III. OTHER PSYCHOPATHOLOGYAND SEXUAL FUNCTION/ DYSFUNCTION......Page 88
I. RELATIONSHIP DYNAMICS AND HYPOACTIVE SEXUAL DESIRE......Page 89
II. SEXUAL DYSFUNCTION AND RELATIONSHIP VARIABLES......Page 90
III. RELATIONSHIP DYNAMICS......Page 91
D. LOVE AND INTIMACY......Page 92
I. THE CHALLENGE OF OUTCOME RESEARCH IN SEX THERAPY......Page 93
III. METHODOLOGICAL PROBLEMS IN SEX THERAPY OUTCOME STUDIES......Page 94
H. WOMEN’S SEXUAL COMPLAINTS AND DYSFUNCTIONS : OVERVIEW......Page 95
I.TREATMENT OUTCOME FOR FEMALE SEXUAL DYSFUNCTIONS......Page 96
II. PSYCHOTHERAPY OF ERECTILE DYSFUNCTION......Page 102
J. THE SUCCESS OF INTEGRATED TREATMENT FOR THE RESOLUTION OF SEXUAL DYSFUNCTION : RESEARCH EVIDENCE......Page 104
I. INTEGRATED TREATMENTS : ED......Page 106
IV. INTEGRATED MODEL FOR TREATING SEXUAL DYSFUNCTION......Page 108
K. CONCLUSION AND RECOMMENDATIONS......Page 109
REFERENCES......Page 110
CHAPTER 4 Ethical, Socio-cultural and Educational Aspects of Sexual Medicine......Page 117
CONTENTS......Page 118
1. INTRODUCTION......Page 119
2. MORALITY AND COMMUNITY......Page 120
3. A FRAMEWORK OF MORAL PRINCIPLES FOR SEXUAL MEDICINE......Page 121
4. DIVERSITY......Page 124
5.WORLD ASSOCIATION OF SEXOLOGY (WAS) DECLARATION OF SEXUAL RIGHTS......Page 125
1. FEMALE SOCIAL CULTURAL ISSUES (AFRICA)......Page 126
2. MALE PENILE CIRCUMCISION......Page 128
1. UNDERGRADUATE TEACHING AT MEDICAL SCHOOLS......Page 130
2. PROBLEMS OF BOTH EDUCATION AND INFORMATION......Page 132
3. HEALTH (SEXUALITY) INFORMATION ON THE WEB......Page 134
REFERENCES......Page 137
CHAPTER 5 Economical Aspects of Sexual Dysfunctions......Page 139
CONTENTS......Page 140
I. EPIDEMIOLOGY OF SEXUAL DYSFUNCTIONS......Page 141
1. MALE SEXUAL DYSFUNCTION......Page 142
II. AGING AND SEXUAL DYSFUNCTION......Page 143
1. ERECTILE DYSFUNCTION......Page 144
1. ECONOMICAL......Page 146
V. TREATMENT SEEKING BEHAVIOR......Page 147
VI. DIAGNOSTIC EVALUATION......Page 148
VII. COST OF THERAPIES......Page 150
IX. ECONOMIC IMPACT......Page 151
3. SD MANAGEMENT COSTS WORLDWIDE......Page 152
4. FUTURE PREDICTIONS FOR THE SEXUAL DYSFUNCTION MARKET......Page 154
XI. RECOMMENDATIONS......Page 157
REFERENCES......Page 159
CHAPTER 6 Qualitative Health Research and Sexual Dysfunction......Page 161
CONTENTS......Page 162
INTRODUCTION......Page 163
II. SPECIAL RELEVANCE OF QUALITATIVE METHODS IN SEXUAL DYSFUNCTION RESEARCH......Page 164
III. UTILITY OF QUALITATIVE HEALTH RESEARCH TO ADDRESS THESE PROBLEMS......Page 165
V. SPECIFIC EXAMPLES IN SEXUAL MEDICINE RESEARCH......Page 166
1. THE NATURE OF QUALITATIVE EVIDENCE......Page 167
2. DESIGN OF ASSESSMENT AND TREATMENT STUDIES......Page 168
REFERENCES......Page 169
PART 2. SEXUAL DYSFUNCTIONS IN MEN......Page 171
CHAPTER 7 Clinical Evaluation and Symptom Scales: Sexual Dysfunction Assessment in Men......Page 173
CONTENTS......Page 174
I. THE PATIENT-CENTERED MODEL......Page 175
3. EVIDENCE-BASED ASSESSMENT OF SEXUAL DYSFUNCTION......Page 176
1. DEVELOPMENT OF A BASIC MANAGEMENT STRATEGY: “ALLOW”......Page 177
2. IDENTIFYING A SEXUAL PROBLEM: THE BRIEF SEXUAL SYMPTOM CHECKLIST (BSSC)......Page 179
3. MEDICAL AND PSYCHOSOCIAL ASSESSMENT......Page 181
5. SPECIALIST CONSULTATION AND REFERRAL......Page 184
6. SHARED DECISION-MAKING AND TREATMENT PLANNING......Page 185
III. SPECIALIZED EVALUATION OF MALE ERECTILE DYSFUNCTION......Page 186
1. VASCULAR EVALUATION......Page 187
3. NEUROLOGICAL EVALUATION......Page 190
4. HORMONAL EVALUATION......Page 191
1. INTRODUCTION......Page 195
2. RECOMMENDED QUESTIONNAIRES FOR MEN AND WOMEN......Page 196
3. SUMMARY AND CONCLUSIONS......Page 202
REFERENCES......Page 203
CHAPTER 8 Standards for Clinical Trials in Male Sexual Dysfunction: Erectile Dysfunction and Rapid Ejaculation......Page 221
CONTENTS......Page 222
I. INTRODUCTION......Page 223
II. RATIONALE AND DESIGN OF CLINICAL TRIALS......Page 224
1. GENERAL PRINCIPLES OF PATIENT SELECTION......Page 228
2. DEFINING THE DISEASE STATE AND PATIENT POPULATION: PROPOSED INCLUSION AND EXCLUSION CRITERIA IN CLINICAL TRIALS FOR ED AND FOR RE......Page 230
1. OUTCOME ASSESSMENTS IN ED......Page 232
2. OUTCOME ASSESSMENTS IN RE......Page 234
V. DATAANALYSIS AND STATISTICAL CONSIDERATIONS......Page 236
3. STATISTICAL ANALYSIS ISSUES FOR PHASE 3 STUDIES......Page 237
VI. OVERALL SUMMARY POINTS: STANDARDS FOR CLINICAL TRIALS......Page 238
REFERENCES......Page 240
CHAPTER 9 Experimental Models for the Study of Male Sexual Function......Page 241
CONTENTS......Page 242
I. PENILE ERECTION......Page 243
II. PHARMACOLOGICAL STIMULATION......Page 248
IV. URETHROGENITAL REFLEX......Page 249
VI. EJACULATION......Page 250
VII. HEMODYNAMIC STUDIES OF ERECTION IN HUMANS......Page 252
VIII. PENILE TUMESCENCE MONITORING AND VISUAL SEXUAL STIMULATION......Page 253
IX. METHODS FOR ASSESSING SEXUAL MOTIVATION IN ANIMALS......Page 255
X. MICRODIALYSIS......Page 258
XI. DISEASE ANIMAL MODELS OF ERECTILE DYSFUNCTION......Page 259
XII. MALE COPULATORY BEHAVIOR......Page 265
XIII. VASCULAR SMOOTH MUSCLE CELLS IN VITRO AS A MODEL SYSTEM IN SEXUAL MEDICINE RESEARCH......Page 266
XIV. BRAIN IMAGING OF SEXUAL AROUSAL IN HUMANS......Page 269
REFERENCES......Page 275
CHAPTER 10 Physiology of Erectile Function and Pathophysiology of Erectile Dysfunction......Page 287
CONTENTS......Page 288
A. ANATOMY......Page 289
I. REGULATION OF PENILE ERECTION BY THE CENTRAL NERVOUS SYSTEM......Page 292
II. PHYSIOLOGICAL REGULATION OF PENILE SMOOTH MUSCLE TONE.......Page 297
IIa. PENILE SMOOTH MUSCLE CONTRACTION......Page 298
IIc. PENILE SMOOTH MUSCLE RELAXATION......Page 300
IId. REGULATION OF THE BALANCE BETWEEN THE DILATOR AND CONSTRICTOR MECHANISMS......Page 309
I. NEUROGENIC ERECTILE DYSFUNCTION......Page 311
II. VASCULAR ERECTILE DYSFUNCTION......Page 312
III. PATHOPHYSIOLOGICAL MECHANISMS IN VASCULAR ERECTILE DYSFUNCTION......Page 314
IV. DIABETES......Page 317
V. PRIMARY ERECTILE DYSFUNCTION......Page 321
VI. CHRONIC RENAL FAILURE AND ERECTILE DYSFUNCTION......Page 322
VII. DRUGS CAUSING ERECTILE DYSFUNCTION......Page 323
REFERENCES......Page 329
CHAPTER 11 Endocrine Aspects of Men Sexual Dysfunction......Page 345
CONTENTS......Page 346
I. AGING, HYPOGONADISM AND SEXUAL FUNCTION : NEW CONCEPTS......Page 347
III. PHYSIOLOGICAL ASPECTS OF HORMONES INVOLVED IN SEXUAL FUNCTION......Page 349
IV. DIAGNOSIS OF HYPOGONADISM......Page 362
V. TREATMENT OF HORMONAL (NON-DIABETIC) ABNORMALITIES......Page 366
VI. ABUSE OF ANDROGENS......Page 371
RECOMMENDATIONS......Page 374
REFERENCES......Page 376
CHAPTER 12 Priapism, Peyronie’s Disease, Penile Reconstructive Surgery......Page 383
CONTENTS......Page 384
2. INITIAL MANAGEMENT OF PRIAPISM......Page 385
3. ISCHAEMIC PRIAPISM......Page 386
4. HIGH FLOW PRIAPISM......Page 389
5. RECURRENT OR STUTTERING PRIAPISM......Page 390
1. PATHOPHYSIOLOGY OF PEYRONIE'S DISEASE......Page 391
3. ORAL THERAPY......Page 392
4. INTRAPLAQUE INJECTION THERAPY......Page 395
6. SUMMARY OF NON SURGICAL TREATMENT OF PEYRONIE'S DISEASE......Page 396
7. SURGICAL MANAGEMENT OF PEYRONIE'S DISEASE......Page 398
1. CONGENITAL PROBLEMS OF THE PENIS CAUSING ERECTILE DYSFUNCTION......Page 400
3. PENILE ENLARGEMENT......Page 401
4. PENILE INJURIES......Page 402
6. PHALLIC CONSTRUCTION......Page 403
IV. SUMMARY AND RECOMMANDATIONS......Page 404
REFERENCES......Page 405
CHAPTER 13 Disorders of Orgasm and Ejaculation in Men......Page 409
CONTENTS......Page 410
A. PHYSIOLOGY OF EJACULATION......Page 411
I. NERVOUS CONTROL OF EJACULATION AND ORGASM......Page 412
II. NEUROCHEMICAL CONTROL OF EJACULATION......Page 416
I. ANIMAL STUDIES......Page 420
III. SIDE EFFECTS OF SPECIFIC
DRUGS ON EJACULATION......Page 421
I. EVALUATION OF PREMATURE
EJACULATION......Page 427
II. THE ETIOLOGY OF PREMATURE
EJACULATION......Page 430
III. PSYCHOLOGICAL TREATMENT
OF PREMATURE EJACULATION......Page 434
IV. PHARMACOLOGICAL
TREATMENT OF PREMATURE
EJACULATION......Page 438
D. DELAYED EJACULATION,
ANEJACULATION AND
ANORGASMIA......Page 442
I. PATHOPHYSIOLOGY......Page 444
II. ETIOLOGY......Page 450
III. EVALUATION......Page 452
IV. TREATMENT......Page 454
V. OFFICE MANAGEMENT OF DELAYED EJACULATION, ANEJACULATION AND ANORGASMIA......Page 457
VI. THE FUTURE......Page 458
REFERENCES......Page 460
CHAPTER 14 Implants, Mechanical Devices and Vascular Surgery for Erectile Dysfunction......Page 469
CONTENTS......Page 470
A. PENILE IMPLANT......Page 471
I. TYPES OF PENILE IMPLANTS......Page 472
III. PRE-OPERATIVE PREPARATION......Page 474
IV. INCISONS......Page 475
VI. OPERATIVE TECHNIQUE......Page 476
VII. RESULTS......Page 478
VIII. IMPLANT REPAIR......Page 479
IX. SCARRED COPORAL BODIES......Page 480
X. CORPOROPLASTY – GLANS FIXATION......Page 481
XI. INFECTION......Page 482
XII. SATISFACTION......Page 484
II. MECHANISM OF ACTION......Page 485
VII. EFFICACY......Page 486
X. COMPLICATIONS......Page 487
I. ARTERIAL SURGERY - HISTORY......Page 488
IV. DEEP DORSAL VEIN ARTERIALIZATION (DDVA) PROCEDURES......Page 489
VI. HEMODYNAMIC CHANGES OF PENILE REVASCULARIZATION......Page 490
I. VENOUS SURGERY - HISTORY......Page 491
II. OUTCOMES OF VENOUS LIGATION SURGERY......Page 495
VIII. RESULTS OF VENOUS ARTERIALIZATION......Page 497
REFERENCES......Page 498
CHAPTER 15 Pharmacotherapy for Erectile Dysfunction......Page 503
CONTENTS......Page 504
INTRODUCTION......Page 505
1.I. APOMORPHINE......Page 509
1.II. MELANOCORTIN AGONIST: MELANOTAN II and PT-141......Page 510
1.IV. DELEQUAMINE......Page 511
1.VI. NALTREXONE......Page 512
2.I. YOHIMBINE......Page 513
2.II. PHENTOLAMINE......Page 514
3.I. PDE 5 INHIBITORS......Page 515
3.II. VASOACTIVE INTESTINAL POLYPEPTIDE......Page 519
3.IV. ALPROSTADIL (PGE1)......Page 520
3.VI. COMBINATIONS......Page 521
4. TOPICAL THERAPIES......Page 522
GENERAL PRINCIPLES OF TOPICALAGENTS......Page 523
4.III. TOPICAL MINOXIDIL......Page 524
4.IV. TOPICAL PAPAVERINE......Page 525
4.V. TOPICAL NITROGLYCERIN......Page 526
II. ORAL ED PHARMACOTHERAPIES......Page 529
III. LOCAL ED THERAPIES......Page 551
IV. HIGH AND INTERMEDIATE LEVEL OF EVIDENCE CARDIO VASCULAR PUBLICATIONS IN THE FIELD OF ED PHARMACO-THERAPY......Page 555
CHAPTER 16 Future Treatment Targets......Page 567
CONTENTS......Page 568
I. DOPAMINE AND DOPAMINE RECEPTORS......Page 569
III. OXYTOCIN RECEPTORS......Page 571
IV. HEXARELIN ANALOGUE RECEPTORS......Page 572
VII. THE NITRIC OXIDE SYSTEM......Page 574
I. NORADRENALINE AND •-ADRENOCEPTORS......Page 576
III. PROSTANOIDS AND PROSTANOID RECEPTORS......Page 577
IV. THE RHOA/RHO-KINASE SIGNALING PATHWAY......Page 578
V. NO, GUANYLYL CYCLASES, AND THE cGMP PATHWAY......Page 583
VI. PHOSPHODIESTERASES......Page 586
I. NEUROPROTECTION......Page 590
III. NERVE RECONSTRUCTION......Page 591
V. GENE THERAPY......Page 592
REFERENCES......Page 595
CHAPTER 17 SUMMARY OF THE RECOMMENDATION FOR MEN......Page 605
CONTENT......Page 606
II. DEFINITION......Page 607
I. BASIC EVALUATION......Page 608
II. OPTIONALAND/OR SPECIALIZED DIAGNOSTIC TESTING......Page 612
I. ADDRESS RISK FACTORS AND COMORBIDITIES......Page 614
III. MEDICAL TREATMENT FOR ED......Page 615
IV. SURGICAL THERAPY......Page 618
I. PREMATURE EJACULATION (PE)......Page 620
II. DELAYED EJACULATION, ANEJACULATION AND MALE ANORGASMIA......Page 622
VI. MANAGEMENT OF RECURRENT STUTTERING”) PRIAPISM......Page 624
IV. SURGICAL MANAGEMENT......Page 626
PART 3.SEXUAL DYSFUNCTIONS IN WOMEN 3......Page 629
CHAPTER 18 Standards for Clinical Trials in Sexual Dysfunctions of Women: Research Designs and Outcomes Assessment......Page 631
CONTENTS......Page 632
I. INTRODUCTION......Page 633
2. PHASE II......Page 634
3. PHASE III......Page 635
5. DRUG INTERACTION STUDIES......Page 636
III. STUDY POPULATIONS: GENERAL PRINCIPLES FOR SELECTING STUDY POPULATIONS......Page 637
DEFINING THE DISORDER OF THE PATIENT POPULATION......Page 638
1. PHYSIOLOGICALMEASURES......Page 639
2. SELF REPORT MEASURES OF SYMPTOMS AND DISTRESS......Page 655
3. DAILY DIARY AND EVENT LOGS......Page 656
6. QUALITY OF LIFE AND TREATMENT SATISFACTION......Page 663
V. PROTOCOL DESIGN AND IMPLEMENTATION......Page 664
7. ADMINISTRATIVE CONSIDERATIONS......Page 665
VI. DATAANALYSIS AND REPORTING OF RESULTS: ETHICALAND CLINICAL ISSUES RELATED TO SEXUAL DYSFUNCTION RESEARCH......Page 666
VII. ETHICAL AND CLINICAL ISSUES RELATED TO SEXUAL DYSFUNCTION RESEARCH......Page 668
VIII. FINAL RECOMMENDATIONS FOR CLINICAL TRIAL DESIGN AND OUTCOMES ASSESSMENT FOR WOMEN’S SEXUAL DYSFUNCTIONS......Page 669
GLOSSARY OF KEY TERMS......Page 671
APPENDIX A. THE FEMALE SEXUAL FUNCTION INDEX (FSFI)......Page 674
REFERENCES......Page 678
CHAPTER 19 Committee 7 Physiology of Female Sexual Function and Pathophysiology of Female Sexual Dysfunction......Page 683
CONTENTS......Page 684
I. DESIRE......Page 685
II. AROUSAL: PHYSIOLOGY OF GENITALAROUSAL IN FEMALES......Page 692
III. AROUSAL: ROLE OF SEX
STEROIDS MODULATING
PHYSIOLOGY OF GENITAL
AROUSAL IN FEMALES......Page 697
IV. PHYSIOLOGY OF ORGASM IN
FEMALES......Page 704
I. AROUSAL......Page 708
II. ORGASM: PHYSIOLOGY OF ORGASM IN FEMALES......Page 716
D. CLINICAL PATHOPHYSIOLOGIES OF SEXUAL DESIRE, AROUSALAND ORGASMIC DYSFUNCTION IN WOMEN......Page 718
2. SPECIFIC DISORDERS AFFECTING SEXUAL DYSFUNCTION......Page 719
3. NEUROLOGICAL DISORDERS......Page 720
4. DEPRESSION AND ANTIDEPRESSANTS......Page 722
5. ENDOCRINE ALTERATIONS......Page 724
6. PELVIC SURGERY......Page 726
E. SUMMARY......Page 728
CONCLUSION......Page 729
REFERENCES......Page 730
CHAPTER 20 Endocrine Aspects of Female Sexual Dysfunction......Page 749
CONTENTS......Page 750
1. ESTROGEN PHYSIOLOGY (LEVEL 3-4 EVIDENCE)......Page 751
3. TESTOSTERONE AND OTHER ANDROGENS......Page 752
1. THE CENTRAL ROLE OF ESTROGENS IN SEXUAL FUNCTION......Page 754
3. ADRENAL PRE-ANDROGENS (LEVEL 2B-......Page 756
4. ROLE OF TESTOSTERONE IN HSDD......Page 757
7. OXYTOCIN AND SEXUAL BEHAVIOR......Page 761
IV. HORMONES AND DYSPAREUNIA (LEVEL 1-2)......Page 762
2. LABORATORY ASSESSMENT......Page 763
VI. HORMONAL THERAPIES FOR THE TREATMENT OF SEXUAL PROBLEMS IN WOMEN : INDICATIONS FOR THEIR USE, EVIDENCE OF EFFECTIVENESS, AND SAFETY ISSUES......Page 765
2. ESTROGEN-PROGESTIN COMBINATIONS......Page 766
3. PROGESTIN-ONLY......Page 770
4. TESTOSTERONE......Page 771
6. MISCELLANEOUS HORMONES......Page 772
VII. CONCLUSIONS AND RECOMMENDATIONS......Page 773
VIII. RESEARCH AGENDA......Page 774
REFERENCE......Page 776
CHAPTER 21 Women’s Orgasm......Page 783
CONTENTS......Page 784
II. TYPOLOGIES OF WOMEN’S ORGASM......Page 785
IV. WHY DO WOMEN HAVE ORGASM ?......Page 786
B. OBJECTIVE SIGNS OF ORGASM......Page 788
I. PROSPECTIVE CHANGES - LABIA MINORA COLOR CHANGES......Page 789
II. CURRENT INDICATORS OF ORGASM......Page 790
III. RETROSPECTIVE CHANGES......Page 793
I. CENTRAL NERVOUS SYSTEM CONTROL OF WOMEN’S ORGASM......Page 796
II. SPINAL CORD PATHWAYS INVOLVED IN WOMEN’S ORGASM......Page 800
III. PERIPHERAL NERVOUS SYSTEM INVOLVEMENT IN WOMEN’S ORGASM......Page 811
I. PSYCHOSOCIAL FACTORS RELATED TO WOMEN’S ORGASM......Page 813
II. ORGASM AS A GOAL OF WOMEN’S SEXUAL ENCOUNTERS......Page 815
I. INTRODUCTION......Page 816
III. TREATMENT......Page 817
REFERENCES......Page 842
CHAPTER 22 Women’s Sexual Desire and Arousal Disorders and Sexual Pain......Page 851
CONTENTS......Page 852
A. INTRODUCTION......Page 853
B. WOMEN’S SEXUAL DESIRE AND INTEREST : DISORDERS OF DESIRE AND INTEREST......Page 858
C. WOMEN’S SEXUAL AROUSALAND AROUSAL DISORDERS......Page 859
D. BIOLOGICAL BASIS OF AROUSALAND DESIRE......Page 863
E. ASSESSMENT OF WOMEN’S SEXUAL DYSFUNCTION......Page 864
F. PSYCHOLOGICAL ETIOLOGICAL FACTORS INVOLVED IN AROUSALAND DESIRE DISORDERS......Page 869
G. MANAGEMENT OF DESIRE AND COMORBID AROUSAL DISORDERS IN WOMEN......Page 884
H. MANAGEMENT OF GENITALAROUSAL DISORDER......Page 891
J. THE ROLE OF ANDROGENS IN WOMEN’S SEXUAL FUNCTION AND DYSFUNCTION......Page 894
K. THE ROLE OF ESTROGEN IN WOMEN’S SEXUAL RESPONSE AND DYSFUNCTION......Page 901
L. CONTEXTUAL NATURE OF WOMEN’S SEXUALITY AND DYSFUNCTION......Page 905
M. CHILD SEXUAL ABUSE AND SEXUAL DYSFUNCTION......Page 919
N. FEMALE GENITAL MUTILATION AND SEXUAL DYSFUNCTION......Page 923
O. MANAGEMENT OF ANTIDEPRESSANT- ASSOCIATED SEXUAL DYSFUNCTION......Page 926
P. SEXUAL PAIN AND ITS MANAGEMENT......Page 927
Q. NEUROBIOLOGY OF THE PELVIS......Page 928
R. CHRONIC PAIN PHYSIOLOGY AND SEXUAL PAIN DISORDERS......Page 932
S. CLINICAL PRESENTATION OF SEXUAL PAIN DISORDERS......Page 933
T. PSYCHOLOGICALASPECTS OF SEXUAL PAIN DISORDERS......Page 937
U. PELVIC FLOOR AND SEXUAL PAIN DISORDERS......Page 950
V. MUCOUS MEMBRANES AND SEXUAL PAIN DISORDERS......Page 954
W. MANAGEMENT OF SEXUAL PAIN DISORDERS......Page 956
X. CONCLUSIONS RE SEXUAL PAIN......Page 960
REFERENCES......Page 962
CHAPTER 23 SUMMARY OF THE RECOMMENDATION FOR WOMEN......Page 976
I. GENERAL REMARKS......Page 977
II. A COMPREHENSIVE MEDICAL AND PSYCHOSEXUAL HISTORY IS HIGHLY RECOMMENDED FOR ALL SEXUAL DYSFUNCTIONS – SEE TABLE 1......Page 978
IV. FURTHER DETAILS RE THE COMPONENTS OF ENQUIRY FOR INDIVIDUAL DYSFUNCTIONS ARE RECOMMENDED......Page 979
VI. PSYCHOSOCIAL HISTORY......Page 980
VIII. LABORATORY INVESTIGATIONS......Page 981
I. RECENTLY REVISED DEFINITIONS OF WOMEN’S SEXUAL DYSFUNCTIONS AND MODELS OF SEXUAL RESPONSE THAT UNDERLY THESE DEFINITIONS......Page 982
II. ALGORITHM TO AID DIAGNOSIS......Page 985
III. DESCRIPTORS: INTEGRAL COMPONENTS OF THE DIAGNOSIS(ES)......Page 986
II. RECOMMENDATIONS REGARDING MANAGEMENT OF SEXUAL INTEREST/ DESIRE AND COMORBID AROUSAL DISORDERS (COMBINED AND SUBJECTIVE)......Page 987
III. RECOMMENDATIONS REGARDING MANAGEMENT OF GENITAL AROUSAL DISORDER......Page 989
V. RECOMMENDATIONS REGARDING MANAGEMENT OF DYSPAREUNIA ND VAGINISMUS......Page 990
VII. RECOMMENDATIONS REGARDING MANAGEMENT OF SEXUAL DYSFUNCTION FOR THE WOMAN WITH PREVIOUS GENITAL MUTILATION......Page 991