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. This inability also may be related to anxiety or inadequate stimulation. In addition, researchers are investigating how blood flow problems affecting the vagina and clitoris may contribute to arousal problems.
- Lack of orgasm (anorgasmia). This is the absence of sexual climax (orgasm). It can be caused by a woman's sexual inhibition, inexperience, lack of knowledge, and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to anorgasmia include insufficient stimulation, certain medications, and chronic diseases.
- Painful intercourse. Pain during intercourse can be caused by a number of problems, including endometriosis, a pelvic mass, ovarian cyst, vaginosis, poor lubrication, the presence of scar tissue from surgery, or an STD. 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.
Diagnosing Sexual Dysfunction in Women
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 per-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.
Causes of Sexual Dysfunction in Women
Four major causes for sexual problems include medications, gynecologic conditions, hormone changes and marital and family relationships.
- Medications: Many common medications such as antidepressants, oral contraceptives, blood pressure medications and allergy medications could affect sexual desire and the ability to have an orgasm.
- Gynecologic Conditions: Certain gynecologic conditions also affect sexual functioning.
- Disorders of the bladder, urethra, and uterus can cause problems with intercourse.
- In addition, chronic vaginal infections can lead to painful intercourse. If left untreated many women are unable to have penetration of any kind in the future. Many women have had vaginal infections that resulted in painful intercourse. While cured of the infection, the pain remains.
How Does Menopause Affect a Female Sexual Dysfunction?
The loss of estrogen following menopause can lead to changes in a woman's sexual functioning. Emotional changes that often accompany menopause can add to a woman's loss of interest in sex and/or ability to become aroused. Hormone replacement therapy (HRT) or vaginal lubricants may improve certain conditions, such as loss of vaginal lubrication and genital sensation, which can create problems with sexual function in women. Also, an oral drug taken once a day, ospemifene (Osphena), makes vaginal tissue thicker and less fragile.
It should be noted that some postmenopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety over getting pregnant. In addition, postmenopausal woman often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.
Can Female Sexual Dysfunction Be Cured?
The success of treatment for female sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition. Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.
How Do Hormones Affect Female Sexual Dysfunction?
Hormones play an important role in regulating sexual function in women. With the decrease in the female hormone estrogen that is related to aging and menopause, many women experience some changes in sexual function as they age, including poor vaginal lubrication and decreased genital sensation. Research suggests that low levels of the male 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 drugs like Viagra, to treat sexual problems in women.
When Should I Call my Doctor About Sexual Dysfunction?
Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship. If you experience any of these problems, make an appointment with Comprehensive Women's health for an evaluation and treatment.