Week 14 Sexuality

• Sexual Health Assessment


  1. Gather Information

  2. Physical Examination

  3. Psychological Assessment
• Sexual Health Diagnosis


  1. Identify Problems

  2. Consider Whole Person
• Sexual Health Planning


  Collaborative Planning
• Sexual Health Interventions


  1. Education

  2. Support

  3. Medical Interventions
• Sexual Health Monitoring


  Progress
• Menopause


  Decline in ovarian production of estrogen and progesterone due to natural depletion of ovarian follicles
• Menopausal Symptoms


  • Vasomotor Symptoms
  • Psychological Symptoms
  • Urogenital Symptoms
  • Somatic Symptoms
  • Osteoporosis
• Menopause Interventions


  1. Encourage healthy lifestyle

  2. Educate on symptom tracking

  3. Stress importance of screening

  4. Hormone Replacement Therapy (HRT)
• Estrogen


  Regulates transcription of target genes, crucial for maintaining female reproductive tissues, secondary sexual characteristics, and bone density
• Estrogen Indications


  • Hormone Replacement Therapy (HRT) for menopausal symptoms
  • Prevention of osteoporosis in postmenopausal women
  • Contraception (in combination with progestin)
  • Treatment of certain cancers and gender dysphoria
• Estrogen Side Effects


  • Increased risk of thromboembolic events
  • Breast tenderness or enlargement
  • Nausea and headaches
  • Increased risk of breast and uterine cancer
• Estrogen Client Education


  1. Instruct to report signs of blood clots

  2. Discuss importance of regular examinations

  3. Educate about potential mood swings and weight changes
• Estrogen Contraindications

  • Excessive vaginal bleeding
  • Breast cancer
  • Stroke
  • Heavy smokers
  • Liver disease
  • History of clotting disorders and heart disease
• Black Cohosh


  Commonly used herbal supplement that may alleviate some menopausal symptoms, though scientific evidence is mixed
• Erectile Dysfunction


  Persistent difficulty achieving or maintaining an erection sufficient for sexual intercourse
• Causes of Erectile Dysfunction


  • Vascular Causes
  • Neurological Causes
  • Hormonal Causes
  • Psychological Causes
• Erectile Dysfunction Lifestyle Modifications

  Emphasize importance of exercise, weight management, smoking cessation, and moderated alcohol consumption
• Erectile Dysfunction Psychological Impact


  Educate about the commonality of the condition and the potential psychological toll, encouraging open communication with partners
• Erectile Dysfunction Interventions


  1. Recommend psychological counseling or couples therapy

  2. Advise routine screenings for underlying conditions

  3. Recommend pelvic floor exercises
• Phosphodiesterase-5 (PDE5) Inhibitors


  Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) - improve blood flow by relaxing smooth muscle cells
• PDE5 Inhibitor Indications


  • Treatment of erectile dysfunction (ED)
  • Management of pulmonary arterial hypertension
  • Sometimes used for Raynaud's phenomenon
• PDE5 Inhibitor Side Effects


  • Headaches, dizziness, and flushing
  • Dyspepsia and nasal congestion
  • Vision changes
  • Rarely, priapism
• PDE5 Inhibitor Client Education


  1. Advise to take as needed before sexual activity or as directed

  2. Warn about potential interactions with nitrate medications and alpha-blockers

  3. Instruct to seek immediate medical attention if erection lasts longer than 4 hours

  4. Discuss possibility of visual disturbances
• Gender Identity


  A person's deeply-felt internal experience of gender, which may or may not correspond with the sex they were assigned at birth
• Gender Expression


  The ways in which a person externally communicates their gender identity to others through behavior, clothing, haircut, voice, and other forms of presentation
• Gender Dysphoria


  A clinical term used to describe a psychological distress that results from a discrepancy between a person's gender identity and their sex assigned at birth
• Transgender


  An umbrella term for persons whose gender identity differs from the sex they were assigned at birth
• Promotion of Inclusivity


  1. Collect data on patient's sexual history, current sexual behaviors, and concerns

  2. Perform or refer for appropriate physical exams

  3. Evaluate emotional and psychological aspects of patient's sexual health

  4. Provide education tailored to patient's needs

  5. Offer emotional support and counseling, or refer to specialized services

  6. Administer treatments or medications as prescribed and monitor for side effects
• Gender Inclusive Language


  • Upper body
  • Erogenous or erectile tissue
  • External genital area
  • Internal reproductive organs
  • Assigned female/male
  • Dead name
  • Pronouns
  • A person with...
  • A person who has...
  • Avoid sir/ma'am
  • Use "partner" or "spouse"
• Sexually Transmitted Diseases


  • Syphilis
  • Chlamydia
  • Gonorrhea
  • Genital herpes
  • Genital warts
  • Trichomoniasis
• Syphilis


  Caused by the bacterium Treponema pallidum, with primary, secondary, latent, and tertiary stages that can affect the heart and CNS
• Syphilis prevalence fluctuates regionally, with cases increasing in urban areas and among men who have sex with men
• Syphilis Interventions


  Screening of at-risk populations, partner notification, and treatment tracking
• Syphilis Education


  Safe sex practices, importance of early treatment
• Penicillin G remains the treatment of choice for syphilis
• Chlamydia


  Caused by the bacterium Chlamydia trachomatis, often asymptomatic but may include genital discharge, burning during urination, and pelvic pain
• Chlamydia is the most reported STI in many countries, especially prevalent in young adults
• Chlamydia Interventions


  Screening in sexually active young adults and pregnant women, expedited partner therapy
• Chlamydia Education


  Condom use, regular screening due to the asymptomatic nature, complete the antibiotic course
• Chlamydia is treated with Azithromycin or Doxycycline