any pathology which interferes with the perception of satisfactory sexual health. Varied conditions include absent sexual organs, hermaphrodite and other genetic malformations, or trauma such as amputation or lacerations. Examples of conditions which may be treated by specialists in this field include: Female Vaginismus Genito-pelvic pain-penetration disorder Vulvodynia Imperforate hymen Vaginal septum Vaginitis Endometriosis Atrophic vaginitis Vaginal yeast infection Pelvic floor dysfunction Male Premature ejaculation Delayed ejaculation Erectile dysfunction Retrograde ejaculation Anejaculation Non-exclusive Lack or loss of sexual desire (Libido) Hypoactive sexual desire disorder Lack of sexual enjoyment Sexual arousal disorder Failure of sexual response Anorgasmia Hypersexuality Dyspareunia Substance or medication induced sexual dysfunction Painful orgasm Chronic pelvic pain Sexually transmitted infection Hypogonadism Sexuality issues Pelvic floor dysfunction Treatment Once a diagnosis of sexual dysfunction has been made, treatment is often integrative and individualized. Sexual medicine experts aim to discover both the physical and psychologic factors that are the cause of an individual's sexual dysfunction. Male sexual dysfunction The most common male sexual dysfunction disorders are erectile dysfunction (ED), low libido, and ejaculatory dysfunction. Once etiology and cardiovascular risk factors for ED have been identified, lifestyle or non-pharmacological therapy can be initiated to mitigate risk factors. As of 2018, the American Urological Association (AUA) ED guidelines recommend shared medical decision-making between patient and provider over first-, second-. and third-line therapies. However, phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil (Viagra) and tadalafil (Cialis), are often recommended due to their favorable efficacy and side effect profile and work by increasing the lifespan of the vasodilator nitric oxide in the corpus cavernosum. Alternative treatments for ED are the use of vacuum-assisted erection devices, intracavernosal injection or intraurethral administration of alprostadil (prostaglandin E1), and surgery if necessary. Treatment for decreased libido is often directed towards the cause of the low libido. Low levels of hormones such as testosterone, serum prolactin, TSH, and estradiol can be associated with low libido, and thus hormone replacement therapy is often used to restore the levels of these hormones in the body. Low libido can also be secondary to use of medications such as selective serotonin reuptake inhibitors (SSRIs), and so reduction of dose of the SSRI is used to improve libido. Additionally, low libido due to psychological causes is often approached with psychotherapy. Similarly, treatment of ejaculatory dysfunction such as premature ejaculation is dependent on the etiology. SSRIs, topical anesthetics, and psychotherapy are commonly used to treat premature ejaculation.