Management of common disorders in psychosexual medicine

Abstract

Key content Over 20% of women attending gynaecology clinics have psychosexual dysfunction and yet training for medical students, trainees, and consultants is inadequate and in some regions non‐existent. Common problems include sexual pain disorders, protracted pelvic or vulval pain, hypoactive sexual desire disorder and repeated requests for gynaecological surgery where no pathology has been found. National provision of specialist psychosexual clinics is patchy and yet the Tomorrow's Specialist report from the RCOG includes psychosexual services as a service expected by patients. Learning objectives This article outlines the management of psychosexual dysfunction in the gynaecology outpatient department (GOPD). After reading we would expect clinicians to have a basic understanding allowing the majority of such cases to be managed in the GOPD. The principles of psychosexual medicine are that the patient is the expert but clinicians can allow them to see their problems more clearly through enhanced consultation skills. Ethical issues There are very few trained doctors and specialists in psychosexual medicine despite it being a commonly requested service.