NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)
A patient presenting with performance anxiety or fear of sexual dysfunction requires a confidential, culturally sensitive medical and psychosexual assessment to differentiate performance anxiety from organic etiologies (cardiovascular disease, diabetes, hypogonadism, neurogenic disease, or medication adverse effects). Address performance anxiety through psychoeducation, reassurance regarding normal physiological variability, and basic lifestyle modifications. If organic disease is excluded and anxiety persists, refer for specialized psychosexual counseling or cognitive behavioral therapy. - Refer
Children follow the same pathway: recognise and refer. No primary-care medicine is implied.
No dose - referral pathway, no medicine given in primary care
A patient presenting with performance anxiety or fear of sexual dysfunction requires a confidential, culturally sensitive medical and psychosexual assessment to differentiate performance anxiety from organic etiologies (cardiovascular disease, diabetes, hypogonadism, neurogenic disease, or medication adverse effects). Address performance anxiety through psychoeducation, reassurance regarding normal physiological variability, and basic lifestyle modifications. If organic disease is excluded and anxiety persists, refer for specialized psychosexual counseling or cognitive behavioral therapy.
- No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
- RED FLAG - ED or sexual dysfunction may be the initial presentation of occult cardiovascular disease or diabetes.
- RED FLAG - The clinical features pointing to psychogenic etiology are sudden onset, high erectile variability, and the presence of morning erections or erections with masturbation.
- RED FLAG - Underlying depression, relationship distress or an anxiety disorder driving the concern, or an actual dysfunction emerging on closer questioning, which would move this to a different, treatable condition.