Disorders of sexual function

1. Big picture

Disorders of sexual function are common, underreported, and frequently multifactorial. In a gynaecology exam, the key is not to “label” the patient quickly, but to think clinically:

Sexual symptom
→ Is it desire, arousal, orgasm, or pain/penetration?
→ Is it lifelong or acquired?
→ Generalized or situational?
→ Organic, psychological, relationship-related, drug-related, or mixed?
→ Is there a treatable gynaecological cause?

The most exam-relevant sexual function disorders in gynaecology are:

• Hypoactive sexual desire disorder
• Female sexual arousal disorder
• Female orgasmic disorder
• Genito-pelvic pain/penetration disorder, including dyspareunia and vaginismus
• Sexual dysfunction related to menopause, postpartum state, pelvic pain, endometriosis, infections, surgery, cancer treatment, and medications

The examiner mainly wants a safe, respectful, structured approach: define the problem, exclude organic disease, identify psychosocial factors, treat the cause, and refer when needed.

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