Sexual Health

It's hard to watch TV these days without seeing ads for medicines claiming to treat male sexual dysfunction. Although drugs like these have inspired many people to discuss sexual concerns with their doctor, some conditions cannot be treated with just a prescription. Thankfully, the field of sexual health has made great progress using various treatment options.

"Our patients are very grateful to learn our sexual health clinic has a multidisciplinary team that treats all aspects of sexual dysfunction - physical and psychological," says Peter Garske, MD, a sexual health specialist at Park Nicollet Clinic-Creekside.

"Our team is pretty impressive. It includes a licensed clinical psychologist who specializes in sexual health; a medical doctor with advanced training in sexual medicine; a physical therapist; and a certified nurse practitioner, urologist, gynecologist and urogynecologist. We're one of the state's largest clinics focusing on sexual health - and one of few in the nation with a multidisciplinary approach," Dr. Garske says.

"Comprehensive care is important, because these conditions usually are complex," explains Tricia Zubert, a certified nurse practitioner at Park Nicollet Clinic-Creekside. "They're often caused by low hormone levels, chronic illnesses or surgery. But, many are caused by depression, anxiety or stress, or the medications that treat them." Sexual health concerns also can be the result of a troubled relationship, past abuse or chemical dependency. Cultural issues, such as religion, sexual taboos or a lack of sexual education also may play a role.

What patients can expect

Most patients are referred to the clinic by their primary care doctor or are self-referred. Others are referred by their gynecologist, urologist or oncologist. "Usually, new patients see our psychologist first," Zubert explains. "Even if we have a patient's past medical history, it is important for us to get to know the person as a whole. Sexual health concerns often have an emotional component simply because of the relationships involved." After meeting with the psychologist, patients undergo a complete medical evaluation, including a physical exam, lab work and any other recommended testing.

Common conditions among men

Many men come to the clinic to be evaluated and treated for erectile dysfunction, which can be caused by conditions affecting the blood vessels, including hypertension, high cholesterol, diabetes, obesity and tobacco use. "Erectile dysfunction also can be caused by medications, psychological disorders and relationship concerns, and we need to address all the underlying causes," Dr. Garske says. Erectile dysfunction can also be a signal of underlying cardiovascular disease, and should be carefully assessed.

Some men come to the clinic to be treated for ejaculation concerns or structural disorders of the penis, as well as penile rehabilitation after prostate surgery. Others are treated for low testosterone (hypogonadism), which often affects men who have diabetes or other chronic illnesses. "Up to 5 million men suffer from low testosterone, yet only 5 percent of them seek therapy," Dr. Garske says.

Common conditions among women

Some of the more common sexual health concerns among women include low libido or sexual desire, problems with arousal and lubrication, difficulty or inability to achieve orgasm and pelvic pain issues, including painful intercourse. As with men, women often have underlying health problems related to their sexual health issues.

The science of female sexual health is a relatively new medical discipline. In the past 10 years, the ability to diagnose and help women with sexual problems has markedly improved as more research has been dedicated to this previously underserved area. "In treating these conditions, we look at our patients' hormone levels, their psychological health, the quality of their relationships and their attitudes toward sex," Zubert explains. Depending on the cause, treatment can involve adjusting hormones, physical therapy, psychotherapy, medication or surgery.

It's estimated that 30 percent of the adult population - men and women - have some kind of sexual health problem. "When sexual health suffers, it can have a global effect on patients' physical and emotional health - and their relationships," Dr. Garske says. "It's very important for more people to know that clinics like ours exist."