From the Research
The most appropriate next step in management for a 20-year-old woman with unsatisfying sexual experiences with her partner is to encourage the patient to discuss her concerns with her partner. This approach is supported by the most recent and highest quality study, which emphasizes the importance of addressing the multifactorial nature of sexual satisfaction, including physical, emotional, and relational components 1.
Key Considerations
- A comprehensive sexual health assessment and counseling should be recommended, beginning with a detailed medical and psychosocial history to identify potential physical, psychological, or relationship factors contributing to her sexual dissatisfaction.
- The clinician should create a comfortable, non-judgmental environment where the patient can openly discuss her concerns, expectations, and experiences.
- Communication counseling is essential, encouraging her to discuss her needs and preferences with her partner.
- Education about sexual anatomy, response cycles, and techniques may be beneficial, as many young adults lack comprehensive sexual education.
- If psychological factors such as anxiety, depression, or past trauma are identified, referral to a mental health professional with expertise in sexual health would be appropriate.
- Physical causes should be ruled out through appropriate examination and testing if indicated by her history.
- No medications are typically indicated as first-line treatment for general sexual dissatisfaction without specific diagnosed conditions, as supported by studies such as 2 and 3.
Additional Recommendations
- The patient may benefit from techniques such as the stop-start technique or the use of a personal lubricant, but these should be recommended in the context of a comprehensive assessment and counseling.
- The use of a vibrator or other sexual aids may also be considered, but this should be discussed in the context of the patient's specific needs and preferences.
- It is essential to prioritize the patient's comfort and autonomy in discussing her sexual health and to provide her with evidence-based information and support.