Sexual Function in a Gynegology Practice
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Marilyn C. Jerome, MD, FACOG, a practicing gynecologist at Foxhall OB-GYN Associates in Washington, DC, explored how to encourage open dialogue with patients on healthy sexuality and pleasure and how health care providers can address patients’ sexual function and satisfaction.
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Sexual Function in a Gynegology Practice
- 1. Sexual Function in a Gynecology Practice Marilyn C. Jerome, MD Foxhall Ob-Gyn Associates
- 2. Speaking to different ages • Younger women • Fertility • Child bearing women • Perimenopause • Menopausal women • The older women
- 3. How to start the discussion • Comfortable environment • Intake forms: asking the correct questions • Trust • Time • Clues • Open-ended questions • Sexual dysfunction comes with discussion of menopause, birth control, etc.
- 4. Environment • Visuals • Pamphlets • Comfort: Why would you talk to me about it?
- 5. Intake forms • Items on your problem list: painful intercourse, decreased sex drive • Open ended questions: What would you like to talk about today? • Sexual orientation • Do you feel safe at home?
- 6. Intake forms
- 7. Questions
- 8. Visuals
- 10. Visuals
- 11. Visuals
- 12. Younger women • Inability to have penetration • STD’s • Contraception • Painful intercourse • Inability to have orgasm • Multiple partners • Decreased libido
- 13. Trying to conceive • Understanding the physiology • How to manage contraception • Avoiding toxins • Positions, lubricants, etc.
- 14. Childbearing • Physical changes after pregnancy • Vaginal laxity • Decreased interest • Exhaustion • Breastfeeding
- 15. Peri-menopause • Decreased testosterone levels: decreased libido • Anatomy • Having sex after taking a break • STD’s • Contraception
- 16. Decreased libido • It is complicated • Relationship issues • Physical issues • Emotional issues • Biological issues: testosterone decreases after 40 • Treatments: supplements, testosterone, new injectable drug: Vyleesi, Addyi
- 17. Menopause • Vaginal dryness • Painful intercourse • Decreased libido • Lack of orgasm
- 18. The older adult • Erectile dysfunction • Difficulty with positions • Learning other techniques of sexual satisfaction
- 19. Using sexual aids • Dilators • Vibrators • Lubricants • Moisturizers • Enhancing interest
- 20. It’s complicated • Relationship issues: “I don’t find my husband attractive anymore” • Relationships outside marriage • Pain: pelvic floor physical therapy • Marriage counseling • Sex therapists
- 21. Biggest problem • So much to discuss, so little time!!!