Table of Contents
Common Questions
Chat with CodyMD
Cody's Chat with Patient
Cody's AI Summary
Top 3 AI Diagnosis List
Review by Dr Albert DiPiero
Resource Center
Testimonials
Share this Case Study
Case Study
Meet your host
Albert DiPiero, MD MPH FACP
I am a co-founder and the Chief Medical Officer at CodyMD and your host for this edition of Cody Grand Rounds. I have been a practicing physician and faculty member at medical schools for over 26 years.
About The AI Doctor Case Study
CodyMD is a partnership between Human Doctors and AI Doctors. Cody is an AI Doctor who helps thousands of people every day. At each Cody Grand Rounds, I select a real case and review it with Cody, the AI Doctor.
Each case is based on a real patient but has been modified to maintain privacy and to emphasize certain teaching points.
Common Questions
What causes painful sex in women?
What is vulvodynia, and how does it affect sexual health?
Can anxiety and depression contribute to sexual dissatisfaction?
What are common treatments for vaginal dryness?
How can spending quality time with a partner improve sexual satisfaction?
What is dyspareunia?
How does hormonal imbalance affect sexual health?
Chat with CodyMD
Click the button below to initiate a conversation with CodyMD, your AI Doctor.
Cody's Chat with Patient
Below is a conversation transcript between the patient and our AI Doctor CodyMd.
Cody, the AI Doctor
So you want to focus on your concerns regarding unsatisfying sex today, is that correct?
Patient
Yes.
Cody, the AI Doctor
Thanks for confirming! Good to meet you! My goal is to provide you with an accurate assessment and plan. Let's talk about your concerns regarding unsatisfying sex. Can you describe specific aspects of your sexual experiences that you find unsatisfying? For example, is it related to physical pleasure, emotional connection, or communication with your partner?
Patient
Painful sex and lack of pleasure.
Cody, the AI Doctor
Painful sex, also known as dyspareunia, can be caused by various factors including physical issues, emotional stress, or lack of arousal. When did you first start experiencing unsatisfying sex? For example, did it begin 6 months ago or perhaps 1 year ago?
Patient
About 1 year ago.
Cody, the AI Doctor
It's not uncommon for sexual dissatisfaction to develop over time, and it can be influenced by changes in relationship dynamics, stress levels, or even hormonal changes. Have you ever been diagnosed with a mental health condition by a health professional? For example, conditions like anxiety, depression, or PTSD?
Patient
No, no diagnosis, but I suspect anxiety and depression.
Cody, the AI Doctor
Ah, I see. In what year were you born? And what is your sex?
Patient
I'm 35 years old, female.
Cody, the AI Doctor
At 35, many individuals experience shifts in their sexual desires and satisfaction due to various factors such as stress, hormonal changes, or relationship dynamics. How would you describe the frequency of your unsatisfying sexual experiences? For example, are they happening more often now than they did a few months ago, or do they seem to occur at random times?
Patient
Yes, definitely more often now.
Cody, the AI Doctor
On a scale of 1 to 10, how severe would you rate your feelings of anxiety or depression in relation to your unsatisfying sexual experiences, where 1 is no problem and 10 is very severe?
Patient
About a 6.
Cody, the AI Doctor
A rating of 6 indicates a moderate level of anxiety or depression, which can significantly impact sexual satisfaction. Have you noticed any specific situations or activities that help improve your sexual experiences? For example, does spending quality time with your partner or engaging in relaxation techniques like yoga or deep breathing make a difference?
Patient
Quality time helps. I also feel dry and that causes pain.
Cody's AI Summary
- You are a 35-year-old woman who has been experiencing painful sex and lack of pleasure for about a year now.
- You suspect anxiety and depression are contributing factors.
- Your feelings of anxiety or depression are moderate, rated 6 out of 10.
- You have noticed that unsatisfying sexual experiences occur more often now.
- Spending quality time with your partner helps improve your sexual experiences.
- You also experience dryness, which contributes to the pain during sex.
Top 3 AI Diagnosis List
Based on the information and conversations with Cody, we have prepared a top 3 AI Diagnosis List.
1. Vulvodynia( 40 % probability)
A chronic pain condition affecting the vulvar area, often leading to painful intercourse.
2. Dyspareunia(30 % probability)
A condition characterized by recurrent pain during sexual intercourse, which can be caused by various physical or psychological factors.
3. Hormonal Imbalance(30 % probability)
An imbalance in hormones that can lead to vaginal dryness and discomfort during sex.
Review by Dr Albert DiPiero
Dr. Albert DiPiero
The history provided suggests a significant issue with sexual dissatisfaction characterized by painful sex (dyspareunia) and lack of pleasure. The patient also suspects anxiety and depression, which can further exacerbate her symptoms. The three main diagnoses — Vulvodynia, Dyspareunia, and Hormonal Imbalance — each hold merit given the patient's history. But the ultimate solution likely requires a multifactorial approach directed at structure, hormones, and mental health.
1. Vulvodynia(50% probability)
Vulvodynia is a common cause of chronic pain in the vulvar area and fits well with the symptom of painful intercourse.
2. Dyspareunia(30% probability)
This condition also fits the bill but often has multiple contributing factors—both physical and psychological.
3. Hormonal Imbalance(20% probability)
While hormonal imbalances, especially those that occur around peri-menopause, could be a factor, they are less likely given the patient's age, unless other signs of hormonal issues are present.
Next Steps for Evaluation
Gynecological Examination: A thorough physical examination is necessary to rule out any local pathology, such as infections or dermatological conditions, which could be causing pain.
Hormonal Profile: Checking levels of estrogen and other relevant hormones can help identify any imbalances contributing to vaginal dryness.
Mental Health Evaluation: Given the patient's self-reported anxiety and depression, a referral to a mental health professional could be beneficial.
Behavioral Therapies: Approaches such as cognitive-behavioral therapy (CBT) may address the psychological components of her concerns.
Treatments
Lubricants and Moisturizers: For immediate relief of dryness, over-the-counter lubricants can be used.
Hormonal Treatment: If hormonal imbalances are confirmed, local or systemic hormonal treatments may help.
Pain Management: Topical treatments might provide relief if vulvodynia is diagnosed.
Psychological Support: Counseling and therapy to manage anxiety and depression could significantly improve overall well-being and sexual satisfaction.
Conclusion: The case highlights common issues in female sexual health, such as painful sex and lack of pleasure, exacerbated by psychological factors like anxiety and depression. A multidisciplinary approach involving gynecological, hormonal, and psychological evaluations is essential for a comprehensive treatment plan.
Resource Center
Testimonials
CodyMD is a very precise and accessible app. My consultation with CodymMD is commendable and I highly recommend it for others to try CodyMD especially for assessment and consultation purposes.
TrustPilot Review
Dr Cody spot on, better than most Human Drs. Also far more pleasant. Try him, he could better help you understand your issues. He will give you good info for your Drs visit as well.
TrustPilot Review
It gave me the best response possible and suggested simple self care treatment options which I'm in favor with. It has a to the point interface and brief answer for better understanding.
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