women's sexual problems: FSD diagnosis
Diagnosing FSD appropriately involves a comprehensive medical and psychosexual history, a physical exam which includes a genital exam and laboratory investigations.
The medical history for FSD diagnosis should involve the sexual partner if possible. Certainly the treatment plan will be more successful if the partner is actively involved. It should include a detailed investigation into symptoms, duration, relationships, the level of distress the symptoms are causing, clarification of current medications and the past medical history, including trauma and past psychiatric history.
Physical Exam for FSD
A comprehensive head-to-toe physical exam for FSD is extremely intimate in nature and is usually performed on the second office visit, once a rapport is established. It is extremely important to thoroughly screen for chronic disease before making the diagnosis of FSD. Diseases such as depression, neurological disorders, metabolic syndrome, cardiovascular disease, diabetes mellitus, genitourinary disorders, endocrine dysfunctions and chronic pain can all have FSD as a symptom. Therefore, careful screening for these diseases must be done because successful treatment of the underlying disease process will better facilitate the treatment of the FSD.
Laboratory Tests for FSD
Diagnostic testing will vary according to the clinical manifestations presented. A good baseline of testing that we use in our practice includes a complete blood count (CBC), hormone levels of testosterone, thyroid, estrogen and prolactin, DHEA, fasting glucose and cholesterol levels and a comprehensive metabolic profile.
References: See Bibliography
August 2006
Posted August 2008
Last Updated November 2009
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