Physicians should make taking a sexual history an integral part of medical assessment as sexual symptoms can be a sign of serious underlying disease, according to the first paper in a Series which begins in this week’s issue of The Lancet.
Even though many diseases and their treatments impair sexual function, medical publications often omit sexual issues, and data on sexual function are uncommon in some medical specialties. The Series of three papers review the accumulating data on the comorbidity of sexual and other medical disorders.
Increased scientific understanding of the physiology of sexual response could help identify the pathophysiology of sexual dysfunction from disease and medical interventions, and also help improve or prevent some dysfunctions. Rosemary Basson (British Columbia Centre for Sexual Medicine, Vancouver General Hospital, Vancouver, Canada) and Willibrord Weijmar Schultz (University Medical Centre Groningen, University of Groningen, Netherlands) outline the many common general medical disorders that have negative effects on sexual motivation and desire, arousal, orgasm, ejaculation, and freedom from pain during sex. They also discuss how chronic disease interferes indirectly with sexual function by altering relationships and self-image, causing fatigue, pain, disfigurement, and dependency. Two very common dysfunctions—vascular erectile dysfunction and dyspareunia from vulvar vestibulitis syndrome—are also addressed in detail. The other two forthcoming articles in the Series review the sexual repercussions of endocrine and neurological disorders.
The authors conclude: “Both an increased understanding of sexual physiology and a wider acceptance that sexuality is often an important part of life might encourage physicians to routinely consider risk factors for sexual dysfunctions, to assess and manage those dysfunctions, and to avoid iatrogenesis.”
Embargo: 6:30pm ET Thursday February 1, 2007 in North America.
See accompanying Comment
Professor Rosemary Basson, British Columbia Centre for Sexual Medicine, Vancouver General Hospital, Vancouver, Canada. Tel) +1 604 875 8254 bassonrees@telus.net and Rosemary.Basson@vch.ca
Journal
The Lancet