Gyneacological sexological assessment of female sexual dysfunction in Slovenia
1: General hospital Novo mesto, Slovenia
Objective: The aim is to show gynaeco-sexological treatment approach with sexual dysfunction at the gynaecology out-patient clinic ‘General hospital Novo mesto’ including analysis report.
Material and Methods: Between 2013 and 2016, the bio-psycho-social and PLISSIT models were used in the assessment of 182 women with sexual dysfunction at the gynaecology outpatient clinic “General hospital Novo mesto”. Our approach started with a clinical interview, using the bio-psycho-social model and focusing on a specific sexual problem and possible etiological factors. The assessment is based on an educative gyneaco-sexological examination with a hand mirror, a Q-tip test and pelvic flour muscles testing; giving information about sexual dysfunction; an evaluation of a significant distress and a couple assessment. Different therapeutic approaches follow: self-exploration of genitals, mucosal desensitization, relaxation of pelvic floor hypertonia, Kegel exercises, biofeedback by means of digital control or with the aid of vaginal dilators and lubricants, together with a temporary coitus prohibition. Normalizing, reframing and encouraging sexual activity without penetration are necessary to avoid negative feelings. If required, individual psychosexual counselling or therapy is continued with an individual alone or together with their sex partner. The purpose is to improve the woman’s body-image and sexual functions (physical and non-coital sexual contact) as well as self-esteem.
Results: Between 2013 and 2016, 182 women were assessed, most of them accompanied by a partner. All of the women had had sexual dysfunction for at least 6 months. In 157 (86.3%) women sexual dysfunctions were caused by psychological factors, while the rest also had organic causes (cancer, sacral spinal cord injury, endometriosis, lichen planus, etc.). Out of 182 women, 100 (55%) were diagnosed with dyspareunia, 28 (15.4%) with vaginismus, 15 (8.2%) with hypoactive desire disorders, 25 (13.7%) with the lack of sexual enjoyment and 14 (7.7%) with orgasmic disorder. The average age of the women diagnosed with dyspareunia was 33.6, 28.6 with vaginismus, 43 with hypoactive desire disorders, 34.6 with the lack of sexual enjoyment and 38.4 with orgasmic disorder. The youngest woman was 17 and the oldest 66. Both had dyspareunia.
Conclusion: These have been the first examples of the bio-psycho-social gynaeco-sexological interventions. The PLISSIT model as the basic modelling system of sexual therapy has proved to be simple and effective. Our out-patient clinic is currently the only one in Slovenia to use this model of treatment.
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