Sexual dysfunction includes desire, arousal, orgasmic and sex pain disorders.primary care physicians must assume a proactive role in the diagnosis and treatment of these disorders.

Patient history and physical examination techniques, normal sexual responses and the factors that influence these responses and the application of medical and gynecologic treatments to sexual issues are very important.

Physical examination of the genitalia was performed during an evaluation of women with sexual health problems. Cephalad displacement of the right and left labia minora enables full retraction of the clitoral prepuce and complete exposure of the glans clitoris, under normal circumstances. We defined clitoral examination as abnormal when the cephalad force resulted in varying degrees of incomplete foreskin retraction and limited exposure of the glans clitoris.

We show our rechnique of circumcision in the case of clitoris phimosis. Under local anesthesia we reduce the prepuce with the cut and we have the exposure of clitoris.

No major complications occurs no loss of sensitivity. The patient has a normal intercourse after two weeks.

Clitoral phimosis, a previously undiagnosed physical finding, was identified in 22% of the women. Other than its link to sexual pain, the clinical significance of this finding, in particular the relation to diminished sensitivity and impaired orgasmic.