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Identification, Management and Prevention of Sexually Transmitted Infections
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Sarah Denny, Zahra Ameen, Rita Issa, Black Benjamin
For male patients, depending on history, the examination should include:full genital examination of the genital skin, testicles and penisswab from the tip of the penisurine sample to test for Chlamydia and gonorrhoeablood sample for HIV and syphilis and, in some cases, hepatitis B and Crectal ± throat examination and swabs, if indicated.
Sexually transmitted infections
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
It is important that you ask all clients and don’t make assumptions about their sexuality as this can lead to you missing someone who may be at risk. Finally, if a client requires a genital examination you should have undergone training to do this; if you are not trained to do these procedures, you would need to refer the client to a sexual health clinic.
Assessment and Diagnosis of the Male Infertility Patient
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Muhannad M. Alsyouf, Cayde Ritchie, David Kim, Edmund Ko
Genital examination should be performed in all patients with focus on urethral meatus, penis, and testis. The Tanner stage should be noted because an adult that is not stage V may have an underlying endocrinological or genetic abnormality as the cause of their underdevelopment and infertility. Findings of a hypospadic urethra or pathologic penile curvature can be discovered on examination and can be the cause of infertility due to abnormal sperm expulsion. Testicular examination should include palpation and sizing. Volume estimation can be performed using a pachymeter or an orchidometer (Figure 2.1). Testicular hypertrophy may be seen in both primary and secondary testicular failure. The epididymis should be evaluated for complete development and the presence or absence of cysts, masses, and enlargement. The absence of part of the epididymis may be related to an absent vas deference on the ipsilateral side and further evaluation is warranted.
Misdiagnosis of associated mullerian agenesis in a female with 46, XX gonadal dysgenesis: a case report and review of literature
Published in Journal of Obstetrics and Gynaecology, 2021
Lynn Opdecam, Jorge Barudy Vasquez, Michael Camerlinck, Amin Makar
A 21-year-old female of South-American origin presented herself to our hospital with complaints of primary amenorrhoea. Her medical history was unremarkable. Her height was 158 cm and her weight 51 kg. Breast development was at Tanner stage II, pubic hair at Tanner stage III. The patient had no evidence of facial dysmorphism, webbing of the neck or skeletal deformity. No genital examination was performed because our patient was a virgin. Internal genitalia could not be identified on abdominal ultrasound. An endocrine study revealed hypergonadotropic hypogonadism (LH 20.8 IU/L, FSH 58.2 IU/L, oestradiol < 5 ng/L, progesterone: 0.140 µg/L). MRI of the pelvis showed a rudimentary tubular uterus measuring 19×9mm and the ovaries were not visualised (Figure 1(a)). Her karyotype was 46, XX and no SRY gen was found with FISH analysis. Hormonal therapy was initiated to promote the development of secondary sexual characteristics and prevent osteoporosis. We performed a second MRI six months after initiation of hormonal replacement therapy. This showed a normally-shaped uterus measuring 50×16mm with a regular endometrial thickness of 3 mm (Figure 1(b)). The ovaries were still absent. At present, she has already had two normal menstrual periods.
Sexual well-being after menopause: An International Menopause Society White Paper
Published in Climacteric, 2018
J. A. Simon, S. R. Davis, S. E. Althof, P. Chedraui, A. H. Clayton, S. A. Kingsberg, R. E. Nappi, S. J. Parish, W. Wolfman
A biopsychosocial assessment is vital in ascertaining potentially reversible factors and is especially important with aging in postmenopausal women. These factors include medical and psychiatric conditions, such as endocrine disorders, menopausal status, genitourinary conditions, neurologic diseases, cancer diagnoses, and depression; the effect of medications/substances; relationship difficulties; partner sexual dysfunction; as well as any history of sexual trauma. Depression is the most common co-morbidity associated with distressing low sexual desire, occurring in about 40% of women with HSDD63, and is bi-directionally related to sexual dysfunction, with its presence associated with a 50–70% increased risk of sexual dysfunction, while the occurrence of sexual dysfunction increases the risk of depression by 130–210%64. Antidepressant medications are common contributors to sexual dysfunction, as are other psychotropic medications, narcotics, hormonal preparations, cardiovascular drugs, antihistamines and histamine-2 blockers, chemotherapeutic and adjunctive cancer agents, and drugs of abuse60. When indicated by the woman’s history, a focused physical/genital examination to identify vulvovaginal conditions such as atrophy, neurologic processes, dermatologic and traumatic/infectious illnesses, and to evaluate genital pain, and laboratory studies (e.g. sex steroid levels to assess reproductive status; sex hormone binding globulin (SHBG) and testosterone levels if considering supplementation; thyroid function tests; metabolic status; and prolactin levels) may direct care60.
Psychological Predictors of Sexual Quality of Life Among Iranian Women With Vaginismus: A Cross-Sectional Study
Published in International Journal of Sexual Health, 2022
Atefeh Velayati, Shahideh Jahanian Sadatmahalleh, Saeideh Ziaei, Anoshirvan Kazemnejad
After the referrals’ of women with sexual disorders (difficulties with vaginal penetration during intercourse due to pain, fear, anxiety and tightening of the pelvic floor muscles during attempted vaginal) to the Sex Clinics, they are initially examined by experienced gynecologists, who had trained in sex-therapy. The diagnosis of vaginismus was initially identified through Pelvic examination, which included assessment of the external appearance of the vulva, vulvar sensitivity (QT test: using a cotton swab). Also, external genital examination included the evaluation of scratch, erosion, wound, erythema, edema and unusual vaginal discharge. Through an external examination any cases of itchiness, odor, pain was noticed. Moreover, self-report of cases such as unusual color of vaginal discharge, burning during urinating or vaginal bleeding and spotting were also taken into account during the examination. Sometimes women were also referred to urologist to make sure they did not have any urinary infection/or diseases. In the absence of any physical and structural abnormalities, disease or any active vaginal infection, women then were referred to psychologists. Phycologists by using DSM5 indicators and going through the sexual history of women confirmed diagnose. 300 women who had been referred to Sex clinics were screened. Out of 300 women, 44 women who had been referred to the clinics were excluded from our sample due to other conditions such as endometriosis, pelvic inflammatory disease, active genitourinary infection and vulvodynia. A total number of 256 women identified with vaginismus condition. 240 of them met our inclusion criteria, and finally 236 individuals signed the informed consent forms and completed the questionnaires (Figure 1).