Female Sexual Dysfunction
Cynthia M. Johnson, MA
Female sexual dysfunction refers to recurrent problems during any phase of the sexual response cycle (excitement, plateau, orgasm, resolution) that causes distress or negatively affects your relationship with your partner.
The following factors tend to be related:
Physical causes of female sexual dysfunction include:
During menopause in particular, estrogen levels decrease, which can cause changes to occur in your genital tissues and your sexual responsiveness. Intercourse may become painful (
dyspareunia), and/or it may take longer for you to achieve an orgasm.
Untreated emotional and psychological issues need to be addressed for treatment to be effective. Factors that affect sexual functioning may include:
- Sexual abuse in the past
- Self-perception during and after pregnancy
- Conflict with your partner
Factors from different body systems may play a part in female sexual dysfunction.
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Risk Factors TOP
This condition is most common in those aged 45-64.
Factors that may increase your risk of sexual dysfunction include:
- Medical conditions or diseases
- Hormonal changes
- Certain medications
- Psychological and social conditions
Symptoms of sexual dysfunction include experiencing personal distress because of one or more of the following:
- Low sexual desire—You have a lack of interest in sex and have poor libido.
- Inability to become aroused—Although your desire to have sex may exist, you are unable to become physically aroused or to maintain arousal during sex. This may be due to insufficient vaginal lubrication, anxiety, or lack of clitoral/vaginal sensation.
- Orgasmic disorder—You consistently have difficulty achieving sexual climax, or are unable to do so.
Pain during intercourse—You experience pain during sexual stimulation and/or penetration.
is an involuntary, painful vaginal contraction that inhibits penetration.
Defining sexual dysfunction is largely dependent on your own view of sexual difficulties and your relationship with your partner.
You will be asked about your symptoms, medical history, sexual history, and the medications you take. A gynecologic exam will be done. You may also have a psychological evaluation.
Your bodily fluids may be tested. This can be done using:
- Swabs of vaginal fluid
- Cervical swabs
- Urine tests
Because many factors can lead to the disorder, both medical and nonmedical treatments may be recommended.
Medical treatments address the underlying conditions, and include the following:
- Changing medication that may have sexual side effects
- Treating depression and anxiety
- Using vaginal lubricants to relieve dyspareunia, vaginal dryness, and irritation
- Estrogen supplementation, such as the low-dose estradiol skin patch or topical estrogen or low dose oral medication, can help with vaginal pain and dryness.
- Androgen therapy, including the use of testosterone, is controversial for the treatment of decreased sex drive/libido. The treatment is not approved by the United States Food and Drug Administration (FDA) at this time and is only to be used under medical supervision.
Other treatments to improve sexual health and decreased desire include:
- Working with a sex therapist
- Making lifestyle changes to improve your overall health through things like diet and exercise
Strengthening your pelvic muscles by doing
You can't avoid all the risk factors for female sexual dysfunction. However, avoiding emotional stress may help.
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Last reviewed November 2018 by Beverly Siegal, MD, FACOG
Last Updated: 12/20/2014