Presentations and conditions
- Chronic pelvic pain syndrome and prostatitis
- Ejaculatory dysfunction, such as:
- anejaculation
- delayed ejaculation
- haematospermia
- painful ejaculation
- premature ejaculation
- retrograde ejaculation
- Erectile dysfunction:
- mixed
- organic
- psychogenic
- Genitopelvic pain / penetration dysfunction:
- dyspareunia
- vaginismus
- vulvodynia
- Hypoactive sexual desire disorders
- Orgasm / Ejaculation issues, including anorgasmia
- Other specified dysfunction, such as aversion, or in the context of gender dysphoria
- Penile deformity, including Peyronie disease
- Priapism
- Sexual arousal disorders
- Sexual dysfunction related to medication or substance use
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Problematic sexual behaviour, including in children
- Specific issues of sexual dysfunction which may be experienced by:
- people with cognitive impairment
- people with drug addiction
- people with mental health conditions
- Biological, psychological, relational, and sociocultural factors affecting sexual function
- Coexisting medical, psychiatric, and surgical conditions contributing to sexual dysfunction
- Human sexual response cycle
- Physical and psychological influences on sexual pleasure and function
- Range of sexual behaviours and activities that constitute normal sexual activity in consenting relationships
- Relationship between asexual identity and sexual function, acknowledging that varying levels of sexual activity, arousal, attraction, desire, and function may be normal for different individuals
- Develop management plans and prescribe medication
- Discuss effects of prescribed and recreational drugs on sexual function
- Discuss sexual behaviours and anxieties
- Display sensitivity in understanding psychosocial sequelae of sexual dysfunction
- Examine patients to determine any underlying organic factors contributing to sexual dysfunction
- Exhibit respect for patient autonomy and informed choice
- Manage sexual disorders in the context of medical conditions, including mental health conditions
- Plan and arrange appropriate investigations
- Recognise need to counsel individuals and partners
- Recognise patients’ attitudes and values
- Take sexual function history
- Treat in a holistic way that recognises biopsychosocial aspects of sexual dysfunction in people
- Use appropriate models, such as Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT), for brief interventions
- Benefits to general health and relationships for normal sexual functioning
- Impact of dysfunctional relationships on sexual function
- Participate as a team member in managing patients’ dysfunction
- Recognise own limitations in management of sexual function, and refer where appropriate
- Recognise the length of time people can take to present with sexual difficulties and be proactive in enquiring about issues in sexual histories
- Treatment strategies for psychosocial effects and drivers of pain
