Hand-Crafted Healthcare Education
ISSWSH 2019 State of the Art Session 3
It Takes Two to Tango
In 1970, Masters & Johnson established that “There is no such thing as an uninvolved partner in a marriage or relationship where sexual dysfunction exists.”
At ISSWSH in 2019, Stanley Althof, Ph.D. and Sheryl Kingsberg, Ph.D. presented the State-of-The-Art Session entitled "It Takes Two to Tango." Drs. Althof and Kingsberg reviewed the dynamic and reciprocal relationship of one partner’s sexual function, sexual satisfaction, physical and mental health to the other partner’s sexual health and satisfaction.
Then in an ISSWSH first, Drs. Althof and Kingsberg invited attendees to 'join them’ for a series of recorded office visits with standardized patients as they uncovered how partners in a long-term relationship often play a role in precipitating and maintaining dysfunction.
Through a series of virtual office visits, Drs. Althof and Kingsberg demonstrated how and why clinicians need to consider the impact of one partner’s sexual dysfunction on the other partner and how modern treatment planning can consider and successfully engage both partners.
It Takes Two to Tango: Session Introduction
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Get to know our two patients, Laura and Carl...
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Introduction to Office Vist 1 with Dr. Kingsberg
About 6 weeks ago...
Laura was having her annual gynecologic exam.
She told her GYN that the hot flashes were gone but that she was experiencing increasing vaginal dryness and some itching for the past year and after reading about ‘vaginal atrophy’ (vulvovaginal atrophy or VVA) and she recommended an over the counter lubricant for a couple of weeks but stopped due to ineffectiveness and the mess.
When asked if she was experiencing pain during intercourse Laura responded that the last couple of times, many months ago, were difficult and that she couldn’t really say about lately as she and Carl hadn’t had sex for months.
She said she hasn’t had much interest in sex at all for about a year. When the gynecologist asked if they were intimate in other ways and were just avoiding intercourse Laura responded that she didn’t have much desire for any physical contact and that it appeared that Carl was feeling the same way.
The gynecologist referred Laura to another specialist, a sexual health expert, as she suspected there was more to what was going on than VVA alone.
Dr. Kingsberg Office Visit 1- Part 1
Dr. Kingsberg Office Visit 1- Part 2
Dr. Kingsberg Office Visit 1- Part 3
Dr. Kingsberg Office Visit 1- Part 4
Introduction to Office Vist 1 with Dr. Althof
About 5 months ago...
During a routine visit with his Internist to check blood pressure and renew his medications Carl mentioned that he’s been feeling a bit down because of low sexual interest he attributed to ‘a bit of ED’ that started about a year ago. He described very little interest in sex and even avoiding intimacy.
Carl had no other complaints at the time and his physical exam was normal. His internist explained that it was not uncommon for men to begin to experience erectile dysfunction at his age and that blood pressure medicines can cause ED.
At the time of Carl’s visit he and Laura hadn’t had sex in a couple of months. Lab tests revealed that Carl’s testosterone levels were within the normal range. Physical exam did not reveal any other urological problems. He was given a diagnosis of erectile dysfunction and prescribed Viagra.
The doctor assured Carl that the pills work like a charm for most patients and soon things would be working well again. Carl tried one Viagra to see how it worked (it worked well), that’s the one pill from the prescription that he’d wind up taking for a while.
Dr. Althof Office Visit 1- Part 1
Dr. Althof Office Visit 1- Part 2
Introduction to Office Vist 2 with Dr. Kingsberg
First Couples Visit
Prior to this first couples visit with Dr. Kingsberg Laura’s gynecologist prescribed a new low-dose estrogen insert for the VVA, which she told her was part of a broader condition called genitourinary syndrome of menopause or GSM.
Laura’s been taking the medication as prescribed for about three weeks and reports that it’s clearly working. She has much less discomfort and doesn't feel dry at all.
Dr. Kingsberg Office Visit 2
Part 1
Dr. Kingsberg Office Visit 2
Part 2
Dr. Kingsberg Office Visit 2
Part 3
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Introduction to Office Vist 3 with Dr. Kingsberg
First Couples Follow-up Visit
Dr. Kingsberg Office Visit 3 Part 1
Dr. Kingsberg Office Visit 3 Part 2
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