Showing posts with label Disorders of sexuality and reproduction. Show all posts
Showing posts with label Disorders of sexuality and reproduction. Show all posts

Sunday, February 20, 2011

Frigidity Diagnosis and treatment

Frigidity

     * Introduction
     * Cases frigiditatii
     * Diagnosis and treatment

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Diagnosis and treatment

Medical examination is always necessary to rule out physical causes. If frigiditatii side may seek a reduction in the level of estrogen or progesterone and prolactin excess. In most cases however, medical evaluation and laboratory tests may point out a physical cause.

The two main treatments are psychotherapy and behavioral therapies.



Psychotherapy always lasts several months or even years and is indicated especially in cases of frigidity and anorgasmia primary (there since the beginning of his sexual life).



Behavioral therapy has a shorter duration and is indicated in cases of secondary frigidity (the one that occurs after a period of relatively satisfactory sexual intercourse). In some cases, couples therapy is necessary.

Frigidity Cases

Frigidity

Cases Frigidity may have many causes, both organic (endocrine) and psycho-behavioral. In general, however, the clinical picture is evocative of hormonal disorders and is manifested by signs that occur prior to sexual problems.
Traditionally, it was believed that frigidity is due to psychological problems. Recent studies have revealed numerous organic causes for female sexual dysfunction. Although many sexual problems are based on a psychological component, possible organic causes must be excluded during initial tests.
- Education with strict prohibitions regarding sexuality (nudity ban, parental emotional gestures, masturbation, etc..) - Low self esteem - Feelings of guilt or shame over sex - History of sexual trauma (rape) - A first sexual intercourse painful or psychologically traumatic - Or painful sexual acts generally unsatisfactory - Poor communication between partners - Anxiety, depression, stress or fatigue - Fear of pain, infection or a pregnancy - Lack of appropriate stimulations - Lack of vaginal lubrication - Changes related to menopause - Nerve damage after surgery or trauma - Some medications (psychotropic, antihypertensives, etc.). - Gynecological infection - Vaginal malformation - Endocrine or cardiovascular diseases
Sometimes no specific cause can be highlighted to explain these issues.

Frigidity

Frigidity

    
* Introduction
    
* Cases frigiditatii
    
* Diagnosis and treatment
Frigidity is a sexual dysfunction that is manifested by indifference or aversion to sexual activity, reduced libido and inability to orgasm.
Frigidity should not be confused with other forms of female sexual dysfunction. Dyspareunia is manifested by the appearance of pain during intercourse and at first evoke an organic cause. Vaginismus is an involuntary contraction of the perineal muscles, because of which the penetration becomes difficult or impossible and is primarily psychological origin. Anorgasmia is absent (or partial) of orgasm, although sexual desire is maintained.
Some sexologists frigidity defined as the total absence of both pleasure and arousal during intercourse, regardless of partner, as well as through masturbation. Regardless of the way down, it is obvious that a woman who is also suffering from frigidity anorgasmia (while a woman is not automatically anorgasmia frigid).
One can distinguish primary frigidity, which still exists at the beginning of sexual life of women of secondary frigidity, which is installed after a period in which the woman had sex more or less satisfactory.
Primary frigidity is associated with negative attitudes about sexuality or intimacy, different phobias, sexual inhibition, strictly religious education, secret masturbation, etc.. Secondary frigidity may be due to fatigue, stress or depression, but may result because of pregnancy, IVS (voluntary interruption of pregnancy), infertility, hysterectomy (surgical removal of the uterus) or menopause.
The statistics show that 10% of women suffering from anorgasmia or frigidity. Instead, a greater number of women, about 30%, absence of orgasm through penetration charge, while I can have orgasms through clitoral stimulation.

Dyspareunia Treatment

Dyspareunia

    
* Introduction
    
* Causes
    
* Diagnosis
    
* Treatment
back Treatment
Superficial pain can be reduced by applying a local anesthetic ointment effect. Also, before sexual intercourse is recommended to apply a lubricant, preferably water based. (Oil-based lubricants can affect contraceptive devices such as condoms or diaphragm). For better vaginal lubrication, foreplay should be given more attention. Deep pain can be reduced by adopting a different position during intercourse.
Dyspareunia caused by vaginal dryness and thinning after menopause can be treated with creams that contain estrogen in hormone replacement therapy. Inflammation and infection can be treated with antibiotics and antifungals. In case of inflammation of the vulva (vulva), wet compresses of aluminum acetate solution may be beneficial.

Treatment may include surgical removal of cysts or abscesses, or repair a defect anatomatice. If the uterine prolapse is due dispareuniei can use a pessary - a device similar to diaphragms, placed in the vagina to support and reposition the uterus. Using a pessary may relieve pain in some women. Couple Therapy often helps to identify negative attitudes about sex, to improve communication between partners and to resolve problems that may be involved in causing dispareuniei.

Dyspareunia Diagnosis

Dyspareunia

     * Introduction
     * Causes
     * Diagnosis
     * Treatment

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Diagnosis

Approximately 40% of women with dyspareunia who seek sexual advice actually suffer a condition that causes pain. A medical examination is therefore necessary to rule out possible physical causes of dispareuniei. This is performed a gynecological examination, ultrasound and other diagnostic tests. Among dispareuniei physical causes include infections, sexually transmitted disease, estrogen deficiency and vulvar vestibules.

After exclusion of all organic causes, a psychological evaluation is needed to identify possible psychosocial causes. Women who were past victims of sexual abuse in general suffer post-traumatic stress disorder.

Primary dyspareunia is usually associated with a strict religious education, with a childhood sexual abuse, fear of sex or a first painful experience. Secondary dyspareunia occurs after a period of normal sexual activity and is often the result of trauma.

Dyspareunia Causes

Dyspareunia

    
* Introduction
    
* Causes
    
* Diagnosis
    
* Treatment
back Causes
Superficial dyspareunia may have numerous causes:
- Insufficient lubrication - is often the result of an insufficient foreplay, but can be caused by decreased estrogen levels after menopause - An inflammation or infection in the genital region - which can affect the vulva, vagina Bartholin glands - Urinary tract infections - Genital herpes - Diaphragm or cervical dome - Allergic reaction to latex condoms - Congenital anomaly - Surgery - Some medications (antihistamines) cause a temporary drying of the vagina - Menopause - as you get older the woman, the vaginal lining becomes thinner as estrogen levels decrease (atrophic vaginitis).

Dispareuniei root causes:
- Infection of the cervix, uterus or fallopian tubes - Endometriosis - Pelvic inflammatory disease - Pelvic tumors - Ovarian cysts - Scar tissue (adhesions) - Uterine prolapse - Radiotherapy - cancer treatment

Psycho-social causes:
Sexual trauma history. Many women who have been victims of sexual abuse suffer from dyspareunia. Also, vaginismus is often in these women. Fear, anxiety, fear of a possible pregnancy, religious education - all these factors can interfere with arousal, sexual relationships are so painful. Physical trauma of the vaginal area - Women who have suffered a local trauma or surgery are susceptible to penetration. Vaginismus is more common in these cases. Depression - can lead to a decrease in libido. This case occurs in both sexes. Marital problems - dyspareunia may occur in women whose partners are distant or negligent. In men, similar situations lead to erectile dysfunction (impotence) and not to dyspareunia.
All these factors may be responsible for painful intercourse. The patient will then associate the pain with sexual activity, and sometimes losing interest in sex.

Dyspareunia

Dyspareunia

    
* Introduction
    
* Causes
    
* Diagnosis
    
* Treatment
Dyspareunia is manifested by the appearance of continuous or intermittent pain during intercourse. Pain may be superficial, affecting the vulva and vaginal opening, or deep. Dyspareunia may occur both during and immediately after intercourse.
Dyspareunia may be psychological or organic origin. In men, the diagnosis of dyspareunia is rare and often has physical causes dyspareunia.
One can distinguish several types of dyspareunia:
- Superficial dyspareunia (penetration) - occurs at the beginning of penetration - Deep dyspareunia - translates into pain when penetration is complete - Primary dyspareunia - comes from the first sexual relationship - Secondary dyspareunia - occurs after a period of time in which the woman had sexual intercourse without pain and is generally caused by a psychological trauma
Superficial dyspareunia is characterized by initial discomfort, which occurs at the beginning of penetration. Its symptoms are pain in the vulva, burning or stinging sensation. Its causes are insufficient lubrication, vaginal infections, rashes, trauma or radiotherapy. Deep pain is more common and can be caused by pelvic inflammatory disease, pelvic tumors, irritable bowel syndrome, urinary tract infections or ovarian cysts.
Approximately 15% of women have painful sex at some point in life, but 1-2% of women experience dyspareunia really. Incidence is higher in women who were past victims of sexual abuse. In men, dyspareunia is rare and has mostly natural causes.

Andropauza Treatment

Andropauza

    
* Introduction
    
* Signs and symptoms
    
* Causes
    
* Treatment
back Treatment
Hormone replacement therapy aims to increase testosterone levels to prevent the effects of aging in men. Some studies have shown an increase in muscle mass and muscle strength with testosterone supplementation. It has also been studied the link between low testosterone levels and coronary heart disease in men.
Risk management of sex hormones in men of middle age concern prostate and cardiovascular system. It is known that androgens aggravate the evolution of prostate cancer. Some studies show that the SPA (prostate-specific antigen) increases in 92% of patients receiving testosterone supplementation and not return to normal in 30% of cases after discontinuation. Another side effect of testosterone replacement therapy in sleep apnea. Currently, HRT can not be recommended without restrictions. Large scale studies are needed to document the risks and benefits of androgen supplementation in preventing the effects of aging in men. Administration of testosterone contraindications: severe psychiatric problems, prostate cancer, enlarged prostate, sleep apnea, respiratory disorders and some important musculoskeletal disorders (tendinitis). Administration of testosterone is determined under certain conditions: the existence of unpleasant symptoms and testosterone levels <2.5 to 3 ng / ml. The goal of therapy is to prevent the effects of aging and restore libido and satisfying sexual activity. Positive reactions to testosterone hormone replacement therapy in men with low levels of this hormone are: - Improve the mood - Reduce irritability, depression, fatigue and anxiety - Improve sleep quality - Improving libido and sexual activity - Muscle growth - Reduction of fat mass, especially abdominal
Time to be noted that these benefits vary from one individual to another, but it is important to note that treatment effects are not immediate, but can be felt after a few months. Patients are advised to note their positive and negative changes they observe in order to choose an appropriate dose and time, can benefit from a significant improvement in quality of life. Methodical and rigorous monitoring of the prostate in the treatment of androgen-based is by rectal examination and by determining the APS (prostate-specific antigen), every 6 months - 1 year. Replacement therapy (testosterone in the form of drug intake) is made orally in the form of intramuscular injections or using a patch that allows penetration of testosterone through the skin.

Andropauza Causes

Andropauza

    
* Introduction
    
* Signs and symptoms
    
* Causes
    
* Treatment
back Causes
Androgens (male sex hormones) are secreted by Leydig cells in the testes, testosterone and form the adrenal (the periphery of the adrenal gland).
Starting at the age of 30, testosterone levels diminish by 10% in each decade of life. In the normal functioning of the male hormone system, the bulk of testosterone (about 98%) is related to two components of blood: albumin and globulin - and carry you to participate in the regulation. The remaining 2% is free or bioavailable testosterone.
Although testosterone levels decrease progressively with the age, he remains in a range of values considered normal. Free testosterone level falls very much between 40 and 70 years. These changes are important, but always remained within normal limits. For this reason, it is not known what clinical significance is decreasing androgen levels. Sexual dysfunction can not be ascribed only to low testosterone levels. As in most men of a certain age, testosterone levels remain within a range considered normal, it may not be a factor contributing to erectile dysfunction.
The middle-aged men was a progressive decrease in the number of Leydig cells and Sertoli cell function impairment - two possible causes of the general decline of androgen levels. Unlike ovaries, testes involution function is not accompanied by a halt to activity, but a progressive change.

Andropauza Signs and symptoms

Andropauza

    
* Introduction
    
* Signs and symptoms
    
* Causes
    
* Treatment
back Signs and symptoms
In general, andropauza is not well defined: the symptoms are vague and vary greatly from one individual to another. In addition, the reduction of male hormone production is progressive, occurring from 30 years and continuing over the coming decades of life.
Psychological changes are of emotional fatigue, irritability, reduced concentration capacity, depressive symptoms, loss of self esteem, sometimes indifferent, etc..
Regarding sexual activity, phenomena that lead to orgasm are diminished in middle-aged man. Also, there is a noticeable deterioration in quantity and quality of erections and especially the night. Spermatogenesis to persist but an advanced age.
Other hormonal changes relating to melatonin and leptin. Melatonin is a hormone secreted by the epiphysis gland and plays an important role in regulating the sleep cycle biorhythm-old in the body. Leptin is a hormone of protein secreted in adipose tissue and which plays a role in controlling body fat mass, regulating food intake and energy expenditure.
Other manifestations of andropauzei not present in all men:
- Memory problems - Reduction of muscle volume, accompanied by a decrease in muscle strength and increased body fat - Acceleration of osteopenia (brittle bone tissue progressive) - Occurrence of abdominal obesity - Asthenia (fatigue) emphasized - Sleep problems (insomnia) - Changes in sweat glands - Vasomotor manifestations: hot flashes (hot flushes, change in skin color due to local circulation disorders)
According to some studies, androgens (testosterone and DHEA) is beneficial in preventing coronary heart disease by destroying fat. On the other hand, male hormones have a vasodilatory action (increase the size of blood vessels) and is the origin of increased sensitivity to insulin (a hormone that allows blood glucose levels drop).

Andropauza

Andropauza

    
* Introduction
    
* Signs and symptoms
    
* Causes
    
* Treatment
Andropauza term covers all organic and psychological events seen in men between 50 and 70 years, due to the gradual reduction of androgen production. The term was created by analogy with "menopause", even though men do not have a landmark such as cessation of menstruation to mark this transition. Menopause is the physiological interruption of menstrual function in women between 45 and 55 years, accompanied by unpleasant symptoms and bone loss over the years.
Although there is an analogous phenomenon for men, the term "andropauza" is increasingly used to describe some symptoms common in middle-aged men and attributed to the decrease of testosterone. Andropauza is a hormone deficiency due to a reduced testicular function.
Androgens are male sex hormones produced by the testes and adrenal glands. Testosterone, whose concentration is 20 times higher in men than in women, is the principal hormone androgen. In men, androgens are the origin of secondary sexual characteristics (hair growth, voice, etc.). And maintain spermatogenesis (sperm production). They also play an important role in libido (sexual desire) and influences emotional behavior. In women, androgens are produced by the ovaries and adrenal glands.
Andropauza is defined as a decrease in serum levels of testosterone in men of a certain age, in the range of normal values observed in young men associated with a corresponding clinical syndrome of androgen deficiency.
Clinical syndrome consists of some symptoms (fatigue, reduced capacity to concentrate, irritability, loss of interest in sex) and signs (anemia, loss of muscle strength, muscle mass changes, decreased bone density, erectile dysfunction).