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Female Sexual Dysfunction | Female sexual problems

Causes & Treatment & Types of Female Sexual Dysfunction

Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illnesses, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.

Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:

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Physical. Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease, and bladder problems, can lead to sexual dysfunction. 

Certain medications, including some antidepressants, blood pressure medications, antihistamines, and chemotherapy drugs, can decrease your sexual desire and your body’s ability to experience orgasm.

Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. 

A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm.

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The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.

Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.

Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and the demands of being a new mother may have similar effects.

Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.

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How Is Female Sexual Dysfunction Diagnosed?
To diagnose female sexual dysfunction, the doctor likely will begin with a physical exam and a thorough evaluation of symptoms. The doctor may perform a pelvic exam to evaluate the health of the reproductive organs and a Pap smear to detect changes in the cells of the cervix (to check for cancer or a pre-cancerous condition). He or she may order other tests to rule out any medical problems that may be contributing to the woman’s sexual dysfunction.

An evaluation of your attitudes regarding sex, as well as other possible contributing factors (such as fear, anxiety, past sexual trauma/abuse, relationship problems, or alcohol or drug abuse), will help the doctor understand the underlying cause of the problem and make appropriate treatment recommendations.

Sexual dysfunction is a common problem among both men and women. It can be caused by physical problems and medical conditions, such as heart disease and hormone imbalances, or by psychological problems, like anxiety, depression and the effects of past trauma.

There are four types of sexual dysfunction:

Desire disorders

These disorders affect sexual desire and interest in sex, are also known as libido disorders or low libido. Low estrogen and testosterone levels can cause decreased libido, as can hormonal changes, medical conditions (like diabetes and heart disease), relationship problems, sexual inhibitions, fatigue, fear, depression, and anxiety, among other things.

Arousal disorders

These disorders make it difficult or impossible to become physically aroused during sexual activity, can occur in both men and women. The most common type in men is erectile dysfunction. When a person has arousal disorder, he or she may be interested in sexual activity, but be unable to get any physical satisfaction from it.

Orgasm disorders

These involve the absence of orgasm or delayed orgasm, are a common problem with women, but they can also occur in men. Pain during sexual activity, stress, fatigue, hormonal changes and reduced libido can all lead to delayed or absent orgasm.

Pain disorders

These involve pain during intercourse, can affect both men and women. In women, pain may be caused by vaginal dryness, vaginismus (a condition that affects the vaginal muscles), urinary tract infections (UTIs), hormonal changes during menopause, and other conditions. In men, pain may be caused by Peyronie’s disease (physical damage to the penis), infections like UTIs, prostatitis and yeast infections, genital herpes and skin conditions.

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What Causes Female Sexual Dysfunction?

There are a variety of physical and mental factors that can contribute to the onset of FSD.

PHYSICAL FACTORS:

Vaginal atrophy

Trauma

Infections such as a urinary tract infection

Chronic conditions (eg. Endometriosis, Vulvodynia, pelvic pain)

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Increasing age

Pregnancy

Cardiovascular

disease

Diabetes

Cancer survivors

MENTAL FACTORS:

Depression and use of anti-depressants

Anxiety

Guilt and/or shame

Past sexual trauma or abuse

Poor interpersonal relationship with partner

Body image issues
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How does sexual dysfunction affect women?
The most common problems related to sexual dysfunction in women include:

Inhibited sexual desire
This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes, medical conditions, and treatments (for example cancer and chemotherapy), depression, pregnancy, stress, and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.

Inability to become aroused
For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. The inability to become aroused also may be related to anxiety or inadequate stimulation. In addition, researchers are investigating how blood flow disorders affecting the vagina and clitoris may contribute to arousal problems.

Lack of orgasm (anorgasmia)
Delay or absence of sexual climax (orgasm). It can be caused by sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or past sexual trauma or abuse. Other factors contributing to anorgasmia include insufficient stimulation, certain medications, and chronic diseases.

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Painful intercourse
Pain during intercourse (dyspareunia) can be caused by a number of problems, including endometriosis, pelvic mass, ovarian cysts, inflammation of the vagina (vaginitis), poor lubrication, the presence of scar tissue from surgery and a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.

How is female sexual dysfunction diagnosed?
The doctor likely will begin with a thorough history of the problem and any associated symptoms followed by a physical exam. The doctor may perform a pelvic examination to evaluate the health of the reproductive organs and a Pap test to detect changes in the cells of the cervix (to check for cancer or a pre-cancerous condition). He or she may order other diagnostic tests to rule out any medical problems that may be contributing to the dysfunction.

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An evaluation of the person’s attitudes regarding sex, as well as other possible contributing factors (fear, anxiety, past sexual trauma/abuse, relationship problems, alcohol or drug abuse, etc.), will help the doctor understand the underlying cause of the problem and make appropriate recommendations for treatment.

How is female sexual dysfunction treated?
The ideal approach to treating female sexual dysfunction involves a team effort between the patient, health care providers, and trained therapists. Most types of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Other treatment strategies focus on the following:

Minimizing pain
Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. The use of vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

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How do hormones affect sexual function?
Hormones play an important role in regulating sexual function in women. With the decrease in the hormone estrogen that is related to aging and menopause, many women experience some changes in sexual function as they age. Decreased vaginal lubrication and altered genital sensation are problems associated with changes in estrogen levels. Further, research suggests that low levels of the hormone testosterone also contribute to a decline in sexual arousal, genital sensation, and orgasm. Researchers still are investigating the benefits of hormones and other medications, including sildenafil (Viagra), to treat sexual dysfunction in women.

Want to learn more about exercise & women’s health?

20 to 30 minutes of high intensity exercise approximately half an hour before sexual interaction has been shown to increase sexual arousal in FSD. This is attributed to the increase in the sympathetic nervous system activity.

Exercise causes a reduction in anxiety and increases blood flow and oxygen to the brain.

Yoga, meditation and breathing exercises to help to relax the muscles and the mind are also beneficial.

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