 Treatment Paradigms for Sexual Health Concerns and Chronic Illness
Expiration Date: August 31, 2014
To participate in this activity learners should:
- Read the CME information
- Watch the video
- Review the case vignette
- Take the post-test
This is an internet-based activity that should take 15 minutes to complete.
Technical Requirements: Direct Internet connection with standard browser and Adobe Flash player 10+ may be needed. A broadband connection is recommended.
Learning Objectives
At the conclusion of this activity, participants should be able to:
- Apply effective communication skills about sexual health, including initiating the discussion, evaluation and assessment
- Apply efficient treatment methods to address sexual health concerns in patients with chronic conditions
Case Presentation
Louise is a 47-year-old woman who was diagnosed with depression three months ago after breaking up with her long-term partner of six years. She is currently taking an antidepressant to manage her symptoms; however, she often forgets to take her medication.
As a response to a series of open-ended questions, Louise reported that since her break-up, she hasn’t had intercourse and is concerned that she does not have a sex drive lately. She also reports that masturbation is not satisfying anymore.
Discussion
Sexual health is the state of physical, emotional, mental, and social well-being in relation to sexuality. Louise’s sexual health has been impacted by depression and/or the treatment of her condition. You share with Louise that many people that suffer from depression also experience sexual health concerns and that she is not alone. You discuss with her that there are some antidepressants that have less sexual side effects. If she expresses an interest in trying a different medication that may diminish her sexual side effects, you can prescribe her Bupropion. You also suggest that she may want to consider discussing her depression and sexual health concerns with a practitioner that specializes in psychiatric issues. You schedule a follow-up visit with Louise to check the status of her sexual health concerns after switching medications and to discuss any remaining concerns, if any.
This case illustrates the impact of chronic conditions and their treatment on the sexual health of women. Sexual health is an important factor related to quality of life for most people. As a clinician, it is important to discuss sexual health concerns with your patients with chronic conditions. If sexual health concerns are identified, recommending appropriate treatment or referring your patients to an expert is key in providing patient-centered care.
References
- World Health Organization, Department of Reproductive Health and Research. Developing sexual health programmes: a framework for action. Nov 2010. Available at http://www.who.int/reproductivehealth/publications/sexual_health/rhr_hrp_10_22/en/index.html
- Laumann EO, Nicolosi A, Glasser DB, et al. Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Intl. J of Impotence Research 2005; 17:39-57.
- Nusbaum MRH, Hamilton C, Lenahan P. Chronic Illness and Sexual Functioning. Am Family Physician 2003;67:347-54.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. Text Revision. Washington, DC; American Psychiatric Association: 2000.
- Buck CJ, et al. 2009 ICD-9-CM Professional Edition, Volumes 1 & 2. St. Louis, MO; Saunders Elsevier: 2008.
- Shifren JL, Monz BU, Russo PA, et al. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol 2008;112:970-8.
- Krychman, ML. 100 Questions & Answers About Women’s Sexual Wellness and Vitality. Sudbury, MA: Jones & Bartlett Publishers, LLC, 2010.
- The North American Menopause Society. Sexual health & menopause: effective treatments for sexual problems: androgens, antidepressants, and other drugs on which the jury’s still out. Available at http://www.menopause.org/SHM/5otherdrugs.aspx. Accessed on February 24, 2012.
- Brotto LA, Basson R, Luria M. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. J Sex Med 2008;5:1646-59.
- Brotto LA, Heiman JR, Goff B, et al. A psychoeducational intervention for sexual dysfunction in women with gynecologic cancer. Arch Sex Behav 2008;37:317-29.
- Clayton AH, Warnock JK, Kornstein SG, et al. A placebo-controlled trial of bupropion SR as an antidote for selective serotonin reuptake inhibitor-induced sexual dysfunction. J Clin Psychiatry 2004;65:62–67.
- Association of Reproductive Health Professionals. Handbook on Female Sexual Health and Wellness. September 2011. Available here
Resources
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