Introduction

Sexual dysfunction is most likely the cause when having sex with a partner is not pleasurable. The most common problems are:

1. Inhibited sexual desire
2. Inability to become aroused
3. Anorgasmia (lack of orgasm)
4. Painful intercourse

The Importance of Screening

Health screening is the most successful method which can help you and your doctor to identify health problems early. It is the same thing that applies to sexual dysfunction in elderly. The importance of screening which can be identified is:

1. To improve quality of life (social life)
2. Improving sexual quality of life
3. To prevent transmitted of Sexual Transmitted Disease

When do you need to see a doctor for sexual dysfunction?

1. Cause distress to you and your partner
2. Not being in the mood for sex
3. Lead to negative impact in your relationship
4. Experience of pain during sexual intercourse

List of screening for sexual dysfunction:

1. Pap Smear

Pap smear examination is to detect the cancerous or pre-cancerous condition of the cervix. A woman should be screen once she is exposed to sexual activity and needs to be repeated annually. If after three or more consecutive results are normal, it will be performed less frequently as advice by your doctor.

Procedure

It is a simple procedure whereby your doctor/nurse uses a small brush and gently scrapes the inside of your cervix to obtain cells. The cells are prepared on a slide and sent to a laboratory to look for cancerous and pre-cancerous changes.

2. Clinical Breast Examination

This examination is to detect any breast tumor.

Procedure

The doctor will examine both breasts looking for abnormal physical finding such as skin changes, puckering, dimpling, redness and swelling. He also will examine both your armpit to look for any abnormal swelling.

3. Urine Test

This test is done to detect any urinary tract infection.

• Urine Full Microscopic examination.

This test is to detect any abnormalities in the urine such as any urine infection or any abnormalities in the urinary tract.

• Urine Culture & Sensitivity

To detect any specific bacteria in the urine which cause urinary tract infection.

4. Pelvic Examination

Pelvic examination like any other examination is required to detect an abnormality in the pelvic region. The entire body and genitalia should be examined. This examination is important to rule out gynecologic causes such as Bartholin gland cysts, cancer, cystocele or rectocele, uterine fibroids and uterine prolapse.

5. Mental  Health screening

To evaluate of possible contributing factors such as:

• anxiety
• depression
• past sexual abuse
• alcohol
• drug abuse

This screening will help your doctor to understand the cause of the problem and make appropriate treatment recommendation for you.

6. Cardiovascular Disease (CVD) screening

The purpose of these tests is to rule out any medical problem which might relate to sexual dysfunction. Obesity can cause insulin resistance and is associated with a high risk of hypertension, diabetes, elevated triglycerides and premature heart disease.

• Fasting serum lipid

To measure cholesterol level

This screening is to determine high blood cholesterol, which can lead to heart disease. A fasting lipid profile is the most accurate type of cholesterol screening; it measures HDL and LDL cholesterol and triglyceride levels.

• Fasting blood sugar

Measure blood sugar to detect Diabetes Mellitus.

The doctor will advise you not to consume anything rather than water for at least 8 hours prior to the blood test. Early in the morning doctor will take a sample of your blood and send to the laboratory for analysis. The blood test was done early in the morning because it is more accurate to screen for Diabetes rather than in the afternoon.

• Renal profile

Rule out kidney problem.

A sample of your blood (non-fasting blood ) will be taken and send to the laboratory for  analysis.

• Electrocardiogram

For heart-related cause example Myocardial Infarction.

This is a non-invasive procedure which records the electrical activity of the heart.  This test is to detect any abnormal heart activity which is due to abnormal cardiac rhythm and heart disease such as ischaemic heart disease.

7. Hormonal screening

Hormones play an important role in regulating sexual function in women. The decrease of any of these hormones may lead to sexual dysfunction.

• Thyroid function test

To perform this test only need a sample of blood ( non-fasting blood ).

• Hypothyroidism

This disease is due to thyroid hormone deficiency. It is a common cause of sexual dysfunction and infertility in our society. Symptoms such as depression, fatigue, sleepiness, weight gain and constipation occur in moderate to severe hypothyroidism.

• Hyperthyroidism

This disease is due to an over-production of thyroid hormone. The patient will have symptoms such as weight loss, nervousness, restlessness, insomnia, racing heartbeat and decreased stamina which can lead to sexual dysfunction and infertility.

• Follicle-stimulating hormone (FSH)

FSH hormone is hormone released by the pituitary gland and responsible for regulation of the human reproductive system.  A sample of blood is needed to perform this test.

• If high FSH levels occur during the reproductive years, it is abnormal. Conditions with high FSH levels include Premature menopause associated with subfertility and/or infertility
• Diminished secretion of FSH can result in failure of gonadal function (hypogonadism) can lead to  Polycystic Ovarian Syndrome

All these conditions will contribute to sexual dysfunction later.

• Estrogen

Decrease level of estrogen is related to aging and menopause. Estrogen deficiency cause women to suffer from :

• decrease vaginal lubrication (vaginal dryness and dyspareunia)
• decreased genital sensation(decreased libido)
• Testosterone

Decrease level of testosterone will contribute to:

• the decline in sexual arousal
• decreased
• decline orgasm
• Prolactin

Increased Prolactin level will cause infertility and sexual dysfunction specifically reduced libido.

8. Sexually Transmitted Disease screening

It is important to screen for the sexual transmitted disease because some of the diseases are asymptomatic. Sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, genital herpes, and HIV can be detected  by STD screenings.

• Cervical Swab

To rule out Gonorrhea infection.

Gonorrhea can cause infertility. It is also a common cause pelvic inflammatory disease which leads to pain during sexual intercourse.

• HIV screening

Human Immunodeficiency Virus (HIV) is a virus that causes AIDS. Healthy HIV carrier will have no symptoms for years. AIDs symptoms include extreme fatigue, swollen lymph glands, persistent diarrhea, dry cough and rapid weight loss .

• The venereal disease research laboratory (VDRL) test

This test is to detect whether or not you have syphilis.

• Hepatitis screening

This test is to assess your hepatitis status.

Your doctor will take a sample of blood to check for antigens and antibodies. This will be able to determine whether you have been infected with viral hepatitis.

References

1. Gerontology for The Health Care Professional  2nd Edition Jones And Bartlett
2. Phillips NA. Female sexual dysfunction: Evaluation and treatment. Am Fam Physician 2000;62:127-136, 141-142.
3. womenshealth.gov/publications/our…/screening-tests-for-women.pdf
4. National Women’s Health Resource Center Inc. (NWHRC)
5. health.howstuffworks.com/…/women/…/screening-guidelines-for-women…