How to Approach Female Sexual Dysfunction in a Urogynecology Practice.

Area of Science:

• Urogynecology
• Sexual Medicine
• Pelvic Floor Disorders

Background:

• Sexual dysfunction is common in women with pelvic floor disorders seeking urogynecological care.
• Effective management strategies are crucial for improving quality of life.

Purpose of the Study:

• To review current treatments for sexual dysfunction in urogynecology.
• To discuss the impact of pelvic floor surgery on sexual health.
• To outline referral pathways for specialized care.

Main Methods:

• Summary of a workshop at the 2024 International Urogynecology Association meeting.
• Discussion of medical, physical therapy, and sex therapy interventions.
• Review of surgical outcomes on sexual function.

Main Results:

• Female sexual interest/arousal disorder and orgasmic disorder can be treated with various methods, including medical management, pelvic floor physical therapy, sex therapy, and devices.
• Pelvic floor surgery, including prolapse repair and midurethral sling procedures, generally maintains or improves sexual function.
• Postoperative dyspareunia rates are lower after prolapse surgery compared to preoperative rates, with de novo rates ranging from 0-9%.

Conclusions:

• Managing pelvic floor disorders positively impacts female sexual function.
• Multidisciplinary treatment approaches are often required.
• Referrals to pelvic floor physical therapists or sex therapists are key components of comprehensive care.