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Vaginal or Vulvovaginal Atrophy/Atrophic Vaginitis/Genitourinary Syndrome of Menopause (GSM)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Vaginal symptoms associated with menopause are common, affecting 40%–60% of postmenopausal women.1 Vulvovaginal atrophy, or atrophic vaginitis, is thinning and inflammation of the vaginal walls leading to a loss of elasticity. This leads to symptoms of uncomfortable or painful intercourse (dyspareunia), localized dryness, burning, pruritus, dysuria, and urinary incontinence. Loss of libido is also possible.
Identifying and Managing Problems in Different Settings
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
Most types of problems will be encountered in most settings, although gynaecologists will rarely talk to their patients about erectile dysfunction (ED) and urologists are less likely to hear about tocophobia. But in all settings patients may discuss their partner's problem. For example, a man in an andrology clinic may admit his wife has vaginismus or a woman being investigated for painful sex in a menopause clinic might discuss her husband's ED. In any setting, a relationship problem might be revealed and signposting to Relate or another organisation often useful. Loss of libido is often related to relationship or situational difficulties. It is also of paramount importance that the HCP assesses the patient's mental health. A patient with severe mental illness, personality disorder or learning difficulties may not find the IPM approach useful.
Case 9: Loss of Libido
Published in Iqbal Khan, Medical Histories for the MRCP and Final MB, 2018
Loss of libido is much less common in men compared to women and, if it is a persistent problem, requires formal evaluation and if necessary investigation and treatment. Possible causes are shown in Table 3.
Contemporary Issues for Alcohol Research and Services
Published in Alcoholism Treatment Quarterly, 2023
Regina B. Baronia, Zach Sneed, Susan E. Bergeson
The next section focuses on behavior in people with alcohol and substance use disorders. Yazici & Akhan conducted a semi-structured individual interview schedule to explore sexual problems among people with alcohol use disorder. Themes of perceptions of sexuality, difficulties in sexual relations, barriers to medical support for sexual problems, and help-seeking behaviors were elaborated using a descriptive and phenomenological design. Sexual problems associated with loss of libido, arousal, impotence, and orgasm were reported. Their findings support the importance of sexuality among their subjects with alcohol use disorder. Meshesha and peers held virtual focus group sessions with participants who have alcohol use disorder and endorsed substance-free activities as a key aid to successful recovery. While motivation for initial engagement in substance-free activities may be from external sources such as a therapist, continued participation in these activities are linked more to personal, intrinsic motives. These findings support the necessity of substance-free activities, particularly those related to self-care, social connections, service and creative outlets, in the early recovery period.
‘The feeling of not being entitled to something’: fertility, pregnancy, and sexuality among women with systemic lupus erythematosus in South Africa
Published in Scandinavian Journal of Rheumatology, 2020
A Phuti, B Hodkinson, M Tikly, M Schneider
Five participants reported loss of libido. One of them had self-doubts in her ability to be a ‘good wife’ because of her inability to engage sexually owing to pain, vaginal dryness, and swelling. She had constant fears that her husband would leave her. While it was common for partners to become angry when they were refused intimacy, one participant suffered insults and threats that she would be returned to her family as ‘she was no longer a good wife’. One participant felt pressure from her partner to give him a baby boy, and described how she endured sex: I don’t feel anything when having sex. I’m just doing it because I’m there [laughs]. I won’t lie! (Kefilwe, 27 years, mother of one)It becomes painful down there since I’m not turned on and he adds pressure [points at private parts]. Sometimes he gets angry and asks why I allowed my family to accept the dowry whereas I knew that I won’t be able to give him what he wants [sobbing]. I do love him; he’s the father of my children. (Letty, 26 years, mother of two)
Spinal cord involvement in Lewy body-related α-synucleinopathies
Published in The Journal of Spinal Cord Medicine, 2020
Raffaele Nardone, Yvonne Höller, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Cristina Florea, Kerstin Schwenker, Stefan Golaszewski, Leopold Saltuari, Eugen Trinka
Brown and co-workers first examined systematically sexual dysfunction in PD patients using a questionnaire. A range of problems, especially loss of ejaculation control in males and loss of libido in females, were reported by 65% of male and 36% of female patients.78 These findings were substantially confirmed in several other studies.71,79–83 The dopaminergic therapy often is often not very effective to improve sexual dysfunction.71 Several variables, such as age, drugs, motor and psychiatric symptoms, may interfere with sexuality. However, an early appearance of sexual dysfunction and the importance of the spinal pathways in controlling the sexual response suggest an early involvement of the spinal cord.