Cyclic Depression Sleep Intent Guilt Energy Concentration poor Appetite Psychomotor Suicide SIGECAPS 5+ for >2 weeks—depression episode PMS = 5-10 days out of the cycle before the cycle Somatic Symptoms Headache Abdominal pain GI Etc Diagnosis made by Diary Rule out hyperthyroid (TSH test) Alcoholism Depression Questionare -, history of alcohol not prominent Treatment: Fluoxetine (prozac)—SSRI Alprazolam (Zanex) Reasons for surgery with fibroids: Severe symptoms Anemia Organ damage Suspiscios for cancer—almost never—sarcoma Post menopausal fibroid Rapidly growing fibroid other treatments: Surgery Lupron Myomectomy—never do unless patient wants to retain fertility Uterine Artery (UA) embolization Sexual response Cycle: Female: Libido Excitement Orgasm Plateau Resolution male is the same except instead of plateau has refractory Libido is most common problem, poor prognosis No interest in sex (aversion disorder) Depression, drugs (alcohol, SSRI, Illicit), relationships (domestic violence) Excitement: Lubrication—pain with intercourse, no lubrication Infection—herpes, yeast, HPV, warts Scarring Meds—Anticholinergic—anything that causes dry mouth will cause dry vagina Orgasm: anorgasmic Primary—never had—directed masturbation is treatment Secondary
Cyclic Depression Sleep Intent Guilt Energy Concentration poor Appetite Psychomotor Suicide SIGECAPS 5+ for >2 weeks—depression episode PMS = 5-10 days out of the cycle before the cycle Somatic Symptoms Headache Abdominal pain GI Etc Diagnosis made by Diary Rule out hyperthyroid (TSH test) Alcoholism Depression Questionare -, history of alcohol not prominent Treatment: Fluoxetine (prozac)—SSRI Alprazolam (Zanex) Reasons for surgery with fibroids: Severe symptoms Anemia Organ damage Suspiscios for cancer—almost never—sarcoma Post menopausal fibroid Rapidly growing fibroid other treatments: Surgery Lupron Myomectomy—never do unless patient wants to retain fertility Uterine Artery (UA) embolization Sexual response Cycle: Female: Libido Excitement Orgasm Plateau Resolution male is the same except instead of plateau has refractory Libido is most common problem, poor prognosis No interest in sex (aversion disorder) Depression, drugs (alcohol, SSRI, Illicit), relationships (domestic violence) Excitement: Lubrication—pain with intercourse, no lubrication Infection—herpes, yeast, HPV, warts Scarring Meds—Anticholinergic—anything that causes dry mouth will cause dry vagina Orgasm: anorgasmic Primary—never had—directed masturbation is treatment Secondary
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