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Introduction
Today, there are many women with a significant history of sexual desire and arousal complaints. Therefore, womens sexual health turns out to be a considerably growing area of research interest among the representatives of different countries (Youngkin, Davis, Schadewald, & Juve, 2013). In this paper, the topic of sexual dysfunctions in women in the form of sexual desire (interest) and arousal disorder will be discussed from the point of view of its etiology, clinical findings, patient history, exams, lab studies, diagnoses, and care plans.
Etiology
The peculiar feature of sexual arousal disorders is that they have almost the same etiology as sexual desire (interest) disorder has. The list of causes is long indeed. For example, women with signs of depression, anxiety, and low self-esteem can be under threat of having sexual problems (Graham, 2016). Relationship factors like poor communication and abuse may cause this type of disorder. There are a number of stressors that may cause sexual dysfunctions among women, including divorce, job loss, the death of a family member or a close relative, or even a regular quarrel. Infections may cause painful sexual acts and an unwillingness to continue. Finally, the impact of cultural and religious beliefs should not be ignored (Graham, 2016). Some women develop special attitudes to sexuality and sexual relations from their childhood.
Clinical Findings
The main sign of sexual desire and arousal disorders is, first of all, reduced or absent interest in sexual activities. Women may demonstrate low or no initiation of sexual activities with decreased or poorly/no developed erotic fantasies (OLoughlin, Basson, & Brotto, 2018). In addition, through an adequate lubrication-swelling response to the sexual excitement is observed, the patient may demonstrate no genital/non-genital sensations (OLoughlin et al., 2018). Still, the inability to reach orgasm is defined as the main complaint of many women who suffer from sexual desire and arousal disorders.
Patient History
Many patient histories may be pertinent to the problem of sexual desire and arousal among women. For example, a 27-year-old woman is fired and has to search for a new job. She is depressed and anxious about the inability to find a good alternative to her previous place of work. In addition, she sued her ex-husband because of several cases of domestic violence. The combination of physical abuse and psychological factors results in increased sexual dysfunction and the inability to become sexually active again. She wants to have a baby. Still, she is afraid to make a mistake and not sure if she can handle all her problems to make a correct decision.
Exams
Several exams need to be done to prove the chosen diagnosis of sexual desire and arousal disorder. First, a pelvic examination is required to be checked for the signs of infections, physical changes, and vaginal problems. Second, general blood and urine tests should help to define the level of hormones and possible problems with other body systems (Kingsberg & Woodard, 2015). Finally, psychological tests should be ordered to check the mental condition of the patient.
Labs and Studies
In many cases, women with sexual desire and arousal problems have normal findings. Kingsberg and Woodard (2015) admit that laboratory evaluation can be rarely helpful in this type of diagnosis. Still, it is necessary to pay more attention to patient history and the presence or absence of psychological and physical changes. Some therapists may suggest checking prolactin levels and testing the thyroid function (Kingsberg & Woodard, 2015). Though androgen levels do not have a real effect alone, they can be applied to analyze the testosterone level.
Differential Diagnoses
Differential diagnoses for women who have sexual desire and arousal disorder may vary. For example, non-sexual mental disorders like depression or anxiety can be diagnosed because of behavioral changes and decreased interest and energy. Substance abuse may explain sexual arousal. Poor interpersonal relationships and stress because of domestic violence or work-associated problems should also be identified and treated. Finally, urinary tract infections can be the reason for decreased sexual desire.
Plan of Care
Regardless of the reasons for the chosen sexual dysfunctional disorder, the patient has to be provided with an effective plan of care. In this case, education, regular counseling, and medications have to be prescribed. Nurses are responsible for sex education and counseling for the female patient. The age of the woman presupposes the possibility to have a baby. It is necessary to be ready for regular sexual intercourses and to demonstrate an appropriate sexual response. Antidepressants like Prozac may reduce sexual desire, and patients should carefully choose medications to deal with depression or anxiety (OLoughlin et al., 2018). Antibiotics can improve the condition of the patient after cases of violence. Therefore, the plan of care must be mainly based on communication and discussion of sexual fantasies so that the woman can remember her sexuality and deal with her domestic problems.
Conclusion
In general, patients with sexual desire and arousal disorders have a variety of options to be chosen for treatment. Some women suffer from this condition because of physical abuse. Some patients have to survive considerable personal or professional traumas and concerns. In any situation, communication with a healthcare expert is the solution to be made. The sexuality of women is a complex subject, and associated disorders have to be treated in a timely manner.
References
Graham, C. A. (2016). Reconceptualising womens sexual desire and arousal in DSM-5. Psychology & Sexuality, 7(1), 34-47.
Kingsberg, S. A., & Woodard, T. (2015). Female sexual dysfunction: Focus on low desire. Obstetrics & Gynecology, 125(2), 477-486.
OLoughlin, J. I., Basson, R., & Brotto, L. A. (2018). Women with hypoactive sexual desire disorder versus sexual interest/arousal disorder: An empirical test of raising the bar. The Journal of Sex Research, 55(6), 734-746.
Youngkin, E. Q., Davis, M. S., Schadewald, D., & Juve, C. (Eds.). (2013). Womens health: A primary care clinical guide (4th ed.). New Jersey, NJ: Pearson Education.
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