AUAUniversity Podcast Series: Episode No. 60

Summer School: Current Urologic Management Of Female Sexual Dysfunction

This course will teach the urologist and advanced practice provider the skills needed to better communicate with the female patient about her sexual health needs and better manage her sexual dysfunctions. The course will start with normal physiology and pathophysiology of the genitals including how to examine them under magnification in order to better understand sexual dysfunctions in women. Diagnostic tools and treatment strategies for the management of desire, arousal, orgasm and pain disorders including unusual arousal/orgasm issues such as persistent genital arousal disorder will be discussed. Included in this course is an overview of to use the latest FDA approved drugs, off label options, devices such as CO2 fractional laser and surgical therapies. Women with distressing sexual health concerns should undergo biopsychosocial diagnostic evaluations to assess pathophysiology, starting with a history and physical with vulvoscopy. Risks and benefits of hormone therapy for pre- and post-menopausal women will be included, as well as information about neurologic issues affecting sexual function. Also discussed are risk factors for female sexual dysfunction and co-morbid conditions such as genitourinary syndrome of menopause, interstitial cystitis and sexual dysfunction, clitoral phimosis and previous genital surgeries including mid-urethral surgical slings. Women presenting with urologic concerns may, in fact, have sexual dysfunction as the primary issue.

Upon completion of this activity, participants will be able to:

  1. Associate basic science principles with physiology and pathophysiology of female sexual function and dysfunction.
  2. Apply principles of history and physical examination to the woman with sexual dysfunction.
  3. Characterize the consensus paradigms for identification of sexual problems in women, hypoactive sexual desire disorder, and persistent genital arousal disorder developed by the International Society for the Study of Women’s Sexual Health.
  4. Diagnose and treat woman with sexual dysfunction presenting in a community setting with FDA-approved and off label medical therapies including estrogen (and progesterone) and androgen therapies as well as centrally-acting drugs.
  5. Identify when sexual pain should be treated surgically.