1) What do we mean by “Sex medicine”?
When I say sex and medicine, I mean the clinical field that combines biological, psychological and social approaches to diagnose and treat sexual health problems — from difficulties with desire, arousal and orgasm to painful sex or erectile problems. Sexual health is more than the absence of disease; the World Health Organization describes it as a state of physical, emotional, mental and social well-being in relation to sexuality.
The medical specialty (often called sexual medicine) brings together gynecology, urology, endocrinology, psychiatry, and specialist psychosexual therapy so care is tailored, safe and evidence-based. Professional societies like the International Society for Sexual Medicine help set standards for diagnosis and management.
2) Why an integrated approach matters
Sexual problems rarely have a single cause. For example, erectile function depends on blood flow, hormones, nerve function, mental state and relationship context. Treating one factor (say, prescribing a medicine) without addressing others (communication, stress, underlying disease) often leaves the problem unresolved. Integrated care — combining medical, behavioral and relationship strategies — produces the best outcomes in most cases. Clinical guidance for common problems (like erectile dysfunction) recommends starting with a full assessment and offering PDE-5 inhibitors when appropriate, alongside lifestyle and psychosocial interventions.
3) Common conditions seen in sexual medicine
- Erectile dysfunction (ED) — difficulties achieving or maintaining an erection suitable for sexual activity(sex and medicine). Oral PDE-5 inhibitors (sildenafil, tadalafil, etc.) are first-line medical treatments for most men.
- Premature ejaculation (PE) — ejaculation that often occurs within about one minute of penetration and causes distress; behavioral and pharmacologic options exist.
- Female sexual interest/arousal disorder (FSIAD) — reduced interest or arousal that causes distress; it is common and underdiagnosed. Diagnosis follows standard criteria and requires attention to medical, psychological and relational contributors.
- Painful intercourse (dyspareunia, vulvodynia) — can be due to infection, hormonal changes (e.g., menopause), pelvic floor dysfunction or neurological causes. Pelvic physio, topical treatments and counseling are often parts of treatment.
- Low sexual desire in women — a complex condition with biological and psychosocial contributors; some drug and hormone options exist but benefit is often modest and must be balanced with safety considerations.
4) How sexual problems are assessed
A good assessment typically includes:
- A sensitive sexual history for sex and medicine (what changed, when, frequency, partner factors).
- Medical review (medications, chronic illnesses, vascular or neurological disease).
- Screening questionnaires when helpful (clinician selects appropriate tools).
- Physical exam and targeted investigations (hormone tests, pelvic exam, penile Doppler only when indicated).
- Consideration of mental health, trauma history, relationship context and medication side effects (many antidepressants, antipsychotics and antihypertensives can affect sexual function).
Assessment is collaborative and non-judgmental; patients should expect confidentiality and a clear plan.
5) Evidence-based treatments (what works)
Medical treatments
- PDE-5 inhibitors (sildenafil, tadalafil, etc.) are a well-established treatment for erectile dysfunction and remain first line when there are no contraindications. Guidance on prescribing frequency and choice is detailed in primary-care and specialist guidelines.
- Hormonal therapy (including testosterone) for women is targeted and limited. Meta-analyses show testosterone may modestly improve sexual desire in some postmenopausal women with HSDD/FSIAD, but long-term safety data are limited and careful monitoring is necessary. Prescribing trends and concern about overuse have been reported; hormone therapy is not a universal solution.
- Drugs for female HSDD: a few agents (for example, bremelanotide/Vyleesi and flibanserin/Addyi) have regulatory approval in some countries for specific populations, but benefits are modest and side effects and access vary. Shared decision making is essential.
Behavioral and psychological treatments
- Sex therapy and cognitive-behavioral approaches are core parts of treating many sexual problems (relationship issues, performance anxiety, and for many female sexual problems). These interventions are often recommended alongside or instead of medical therapy.
Device and procedural options
- Vacuum devices, intracavernosal injections, penile implants — options for ED when oral meds fail or are contraindicated.
- Pelvic floor therapy and topical/local treatments for women with pain disorders.
Lifestyle and risk factor modification
Exercise, weight control, smoking cessation, optimizing diabetes and cardiovascular risk all improve sexual function in many people and should be part of every treatment plan. (Lifestyle changes are often under-emphasized but are high-value interventions.)
6) Helpful enhancements — practical tips for patients
- Talk early: bring the issue up with your clinician — sexual problems are common and treatable.
- Medication review: ask if any of your current medicines might affect sexual function.
- Try a combined plan: a short course of medical therapy often works best when combined with couples’ communication or sex therapy.
- Set realistic expectations: especially for some female sexual-desire medicines — benefits may be modest.
- If pain is present: avoid painful activity, seek evaluation, and consider pelvic-floor physiotherapy.
- Safety first: never start hormonal or off-label therapies without appropriate testing and follow-up.
7) How Female Sexual Health by Dr. Kusuma approaches care
At Female Sexual Health by Dr. Kusuma (Androcare-Swetha Scans, 67-A, Journalist Colony, Road No. 70, Jubilee Hills, Hyderabad-500033; website: femalesexualhealth.in), we follow an integrated, evidence-based pathway:
- Private, structured assessment with medical history and focused physical exam.
- Shared decision making that explains medical, psychological and lifestyle options.
- Personalized treatment plans (medical + therapy + physiotherapy/referral where needed).
- Follow-up with outcomes and monitoring for safety when medications or hormones are used.
If you want to book an appointment or a teleconsult, visit femalesexualhealth.in or call the clinic directly (clinic phone details are on the website).
8) FAQ
Q: When should I see a specialist for sexual problems?
Q: Are sexual problems normal after childbirth or menopause?
Q: Is testosterone safe for women with low desire?
Q: Can antidepressants cause sexual problems?
Q: Are there non-drug options that really work?
Q: What is the difference between “sex medicine” and general practice?
Final note
Talking about sex and medicine isn’t always easy, but your concerns deserve private, evidence-based care that treats the whole person — body, mind and relationship. If you’re in Hyderabad, Female Sexual Health by Dr. Kusuma at Androcare-Swetha Scans is set up to offer confidential, specialist assessments and a clear treatment plan. Visit femalesexualhealth.in to learn more or book an appointment.
Author & review box
Author: Dr. Kusuma — Founder, Female Sexual Health; 10 years’ clinical experience in sexual and reproductive health and outpatient sexual medicine.
Clinical review: Content reviewed by the Female Sexual Health clinical team (multidisciplinary clinicians) to ensure accuracy and clinical safety.
Clinic address: Androcare-Swetha Scans, 67-A, Journalist Colony, Road No 70, Jubilee Hills, Hyderabad-500033.
Website: femalesexualhealth.in
Disclaimer: This article provides general information only and does not replace a medical consultation. For personalized advice, testing or prescriptions, please see a clinician.
