I would advocate that a woman who comes into our office for a sexual medicine evaluation to insist upon getting an appropriate evaluation. The appropriate evaluation for sexual health problems is not an off a lot different that the appropriate evaluation for any other medical problem because it affects sexual medicine is application of medicine to men and women who have sexual problems.
The appropriate evaluation would involve a psychological evaluation with a certified sex therapy or psychologist mental health care provider. A detailed history and that would involve sexual history, medical history and psycho-social history, would involve a detailed physical examination with attention of course to genitals but not exclusively attention to genitals. And the genitals that we are interested in sexual medicine are not necessarily deep inside the vagina such as a cervical pap smear examination, but specifically to what we call the vestibule which is the part of the vulva that engages and includes the clitoris, the hood of the clitoris, the tissue just off the base of the clitoris called the frenulum, the two labia-minora, the urethra that the woman urinates through, the hymenal tissues, the skin in the region, there are minor vestibular glands, there is bartholens, duct opening in the region. This is none fall out of very important tissue that was engaged in sexual activity that the sexual medicine doctor needs to examine.
Above and beyond the history and the physical and the psychological evaluation one would engage blood test for hormones, one should involve or could involve sensation testing in the region compared to other regions such as the fingers and then vascular testing, women who have menopaused or women who have hypertension or cigarette smoking or diabetes may have blood vessel blockages going to the genitals. Clearly, men who have those medical conditions have similar blockages.
So, a woman who wants to be empowered and invalidated for her sexual problems shouldn’t be short changed. It shouldn’t be a quick in and out “well, here’s a pill” there should be a detailed evaluation.
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