During a consultation, your doctor will use various techniques in his assesment of the symptom: Low libido. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: to determine if libido problems have existed since the onset of adult sexual function (lifelong) or may have been preceded by a period of unimpaired function (acquired). This differentiation is ultimately needed to give proper therapeutic direction.
Why: gradual onset may suggest an organic cause (i.e. due to medical problems) while sudden onset often suggests a psychological cause (i.e. depression, bereavement, stress, fatigue, performance anxiety, anger and relationship problems).
Why: must determine if the low libido exists under all (generalized) or just some (situational) sexual circumstances. Generally a problem that appears only sometimes (e.g. with one sexual partner but not with another) can be thought of as arising from psychosocial origins.
Why: to determine if there are any deleterious consequences of the low libido. There is no "right" or "normal" number of times you should want to make love. Desire can wax and wane with circumstances and at different periods in a relationship. Low sexual desire doesn't have to be a problem at all - unless there is a discrepancy with the desire level of your partner.
Why: worries about a sexual problem can become an important perpetuating factor.
Why: Sexual function involves a partner and thus any sexual dysfunction is also partner related.
Why: problems in a relationship can cause sexual dysfunction. e.g. are you and your partner sexually attracted to each other?, how often do you argue with your partner?, do you talk things over with your partner?, how is your love for your partner?
Why: this is one of the key factors for causing sexual problems. Stress lowers the levels of some body chemicals and thus may have the effect of reducing sexual desire and reducing the ability to perform when you do try.
Why: e.g. Menopause may be associated with a reduced libido.
Why: Any medical condition that causes fatique or tiredness may potentially cause low libido e.g. glandular fever, flu.
Why: some medications are associated with a reduced sexual desire including clomipramine, fluphenazine, methadone, guanethidine, chlorthalidone, guanedrel, methyldopa, spironolactone, fluoxetine, danazol, digoxin, ethinyl estradiol, ketoconazole and niacin.
Why: e.g. hemochromatosis, depression, bipolar affective disorder.
Why: e.g. marijuana may reduce libido.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: e.g. Vaginismus causes strong, involuntary tightening of the vaginal muscles which can make penetration extremely painful and impossible and therefore reduce sexual interest.
Why: Vaginal lubrication is, from a functional point of view, the equivalent of erections in a man in that both are evidence of sexual arousal.
Why: Are you able to achieve orgasm from sexual intercourse or other activities such as masturbation, manual or oral stimulation?
Why: e.g. palpitations, hot flushes, night sweats, lethargy, dry vagina, dry skin, emotional changes, reduced sexual drive.
Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping (usually early morning waking), fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt. If you are depressed it is common to have problems with reduced libido due to the physical and emotional state of your body when you are depressed. Treating the depression may alleviate the libido problems as well.
Why: e.g. weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, psychosis, insomnia, frequent urination, excessive thirst - Cushing's syndrome may also present with depression.
Why: e.g. fatigue, painful joints, impotence, bronze discoloration of skin, poor libido.
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