What is sexual medicine?
Sexual medicine is a branch of medicine that focuses on the care of sexual health and conditions which impact sexual pleasure and, consequently, mental wellness. Sexual medicine can include aspects of reproductive care and sexually transmitted infections, but generally focuses on the functions and variations of the sex organs as they relate to sexual pleasure as experienced by people of any gender.
When is it important to visit a sexual medicine specialist instead of a general provider who might be able to treat a sexual medicine condition?
If you have symptoms that impact your sexual pleasure and your medical provider seems uncomfortable, dismissive, or lacks knowledge about what you are experiencing, you might want to consider making an appointment with a sexual medicine specialist.
Who practices sexual medicine?
Some sexual medicine healthcare providers are physicians (and their team members, like physician assistants and nurses) such as gynecologists, urogynecologists, urologists, andrologists, pelvic floor therapists, vulvovaginal clinicians, and sex therapists and counselors. Other healthcare providers may also have sexual medicine training and provide some services related to sexual health.
These providers may come from the fields of primary care (family medicine), allergy and immunology, endocrinology, gastroenterology, genetics, neurology, obstetrics, occupational therapy, oncology, pain management, physical therapy, proctology, reproductive medicine, speech language pathology, and many more.
What conditions are often under the care of a sexual medicine specialist?
When most people think of seeking out help from a sexual medicine specialist, the first consideration most think of is the treatment of erectile dysfunction. While that might be the most well-known reason to see a sexual medicine specialist, there are many more!
- Anatomy: congenital variations, fistulas, incontinence, inguinal-scrotal hernia, prolapse of the pelvic or rectal organs, and support for intersex individuals to make their own choices about their bodies
- Orgasm: anejaculation, anorgasmia, dysorgasmia, hyperorgasmia, painful ejaculation, postorgasmic illness syndrome, premature ejaculation, retrograde ejaculation
- Painful sex: chronic pelvic pain syndrome, clitorodynia, dyspareunia, hard flaccid syndrome, interstitial cystitis, pelvic floor dysfunction, persistent genital arousal disorder, priapism, pudendal neuralgia, sexual headache, vaginismus, vestibulodynia/vulvar vestibulitis, vulvodynia
- Skin: anal tear or fissure, aphthous ulcers, hemorrhoids, lichen planus, lichen sclerosus, lichen simplex chronicus, Peyronie’s disease, plasma cell vulvitis, skin tags, vulvar atrophy and tears, vulvitis/vulvar itching
- Variance of arousal and/or desire: erectile dysfunction, hypoactive sexual desire, hyperactive sexual desire, inability to become aroused, sexual anhedonia, substance or medication induced sexual dysfunction such as post-SSRI sexual dysfunction
What are some other conditions that might be under the care of certain types of healthcare providers who have sexual medicine backgrounds?
- Allergies: latex, semen, silicone, and other ingredients in personal lubrication products and sex toys
- Cancers: anal, bladder, cervical, fallopian tube, ovarian, penile, prostate, testicular, uterine, vaginal, vulvar, vulvar intraepithelial neoplasia
- Hormones: hypoandrogenism, hypogonadism, hypopituitarism, infertility, menopause, polycystic ovarian syndrome
- Infections: bacterial vaginosis, cervicitis, chronic candidiasis, herpes and post-herpetic neuralgia, human papillomavirus, pelvic inflammatory disease, prostatitis, urinary tract infection, vaginitis, yeast infection, other sexual and non-sexual infections of the genitourinary system
- Plastic surgery: gender-affirming surgery in cases of female genital mutilation and others requiring bottom surgery
- Psychosocial: affirmation of intersex gender identity, body image; exploration of gender identity; exploration of sexual identity; feelings of anxiety, fear, or shame related to sex; improving communication between you and your partner(s); inherited attitudes about sex (often cultural, familial, religious, and societal); living with STIs; living with sexual variations or other chronic conditions that impact sex; mismatched sexual desire; relationship issues related to sex in or out of a relationship; sexual trauma; skin hunger
- Reproductive: amenorrhea, dysmenorrhea, endometriosis, menorrhagia, metrorrhagia
Why should sex educators be informed about sexual medicine?
Sex educators should be informed about sexual medicine to improve our knowledge about anatomy and sex, in all its many variations – many of which are not taught to family doctors and certainly not to high school sex education students. This means people who experience variation may not know where to seek support! A sex educator might be the first person they ask.
Sex educators should have a basic understanding of the many variations in sexual anatomy and sexual functions, as well as medical conditions that can impact sex. This helps empower sex educators for when people confide in us when they are asking for help, support, guidance, or resources.
Sex educators: Don’t forget that we are not here to diagnose and treat, but to provide education, emotional support, guidance to outside resources, and referrals to appropriate sexual medicine providers if requested.
Hot tip: Sexual medicine providers are the ultimate sex educators! If you’re a sex educator, follow some of your sexual medicine colleagues’ social accounts to learn more about sex ed than any standard curriculum or basic training program for sex educators will provide.