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Female Sexual Dysfunction

Female sexual dysfunction is a chronic disturbance in the sexual response cycle.

The sexual response cycle consists of three stages: desire, arousal, and orgasm. It relies on mental stimulation, nerve signals, hormones, and blood flow. Sexual dysfunction can arise if any of these processes are disturbed.

Sexual dysfunctions include:

Hypoactive sexual desire disorder - low sexual desire. Causes include conditions or medications that interfere with nerve signals, such as:

  • Hormone deficiencies
  • Neuropsychiatric disorders

Sexual aversion disorder - strong desire to avoid sexual activity. Caused primarily by psychological factors stemming from traumatic experiences, such as:

  • Childhood sexual abuse
  • Painful sexual experiences
  • Feelings of shame and guilt

Female sexual arousal disorder - inability to attain or maintain a physical response to sexual arousal. Physical causes include conditions and medications that interfere with nerve signals or blood flow, such as:

  • Diabetes
  • Arteriosclerosis
  • Medications, including many blood pressure and psychiatric drugs

Female orgasmic disorder - inability to achieve orgasm or delayed orgasm. Physical causes include:

  • Surgery
  • Hormone deficiencies
  • Certain medications, including antidepressants

Dyspareunia - pain during sexual intercourse. Physical causes include:

  • Insufficient vaginal lubrication
  • Inflammation of the bladder (cystitis)
  • Endometriosis
  • Vaginal or pelvic infections

Vaginismus - painful spasms of the muscles of the vagina preventing intercourse. Physical causes include:

  • Vaginal scarring from previous injuries, surgeries, or childbirth
  • Vaginal irritation or inflammation from douches, spermicides, or latex condoms
  • Vaginal infection

Psychological causes -

  • Sexual guilt.
  • Grief
  • Trauma
  • Depression
  • Interpersonal conflict with a sexual partner
Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition.

Medical conditions and diseases:

  • Arteriosclerosis
  • Autoimmune disorders
  • Cancer
  • Diabetes
  • High blood pressure
  • Endocrine disorders
  • Nerve disorders (i.e., multiple sclerosis, peripheral neuropathy, stroke)
  • Sexually transmitted diseases
  • Skin disorders (i.e., eczema, contact dermatitis)
  • Spinal cord injury
  • Urinary tract infections

Gynecologic disorders, procedures, and changes:

  • Bladder or uterine prolapse
  • Hysterectomy
  • Oophorectomy (removal of one or both of the ovaries)
  • Mastectomy
  • Endometriosis
  • Uterine fibroids
  • Vaginitis
  • Complications of gynecologic surgery
  • Pregnancy and post-partum period
  • Lactation
  • Menopause


  • Antidepressants
  • Antipsychotics
  • Antiepileptics
  • Antihistamines
  • Antihypertensives and other cardiac medications
  • Anabolic steroids
  • Antianxiolytics
  • Narcotics
  • Alcohol
  • Oral contraceptives
  • Smoking
  • Cancer chemotherapy

Psychological and social conditions:

  • Life stressors
  • Anxiety or depression
  • Grief
  • Guilt
  • Rape
  • Interpersonal conflict with a sexual partner
  • Sexual identity conflicts
Symptoms of sexual dysfunction include:
  • Loss of desire
  • Lack of lubrication
  • Lack of clitoral/vaginal sensation
  • Delayed orgasm
  • Pain during intercourse
  • Involuntary vaginal contraction that inhibits penetration
Your doctor will ask about your symptoms, medical history and the medications you take. Your doctor will also conduct a gynecologic exam.

Tests may include:

  • Swabs of vaginal fluid to evaluate for infection or bacterial imbalance
  • Cervical swabs to test for sexually transmitted diseases (STDs)
  • Urine tests
  • Blood tests

If psychological issues are involved, the doctor may refer you to a:

  • Psychiatrist
  • Psychologist
  • Sex therapist
Treatment depends on whether the cause of the sexual dysfunction is correctable. If not, the doctor may recommend behavioral techniques to enhance sexual desire and decrease discomfort.

Treatments may include:

Eros - a "clitoris pump" that uses a suction cup and hand-held vacuum device to increase blood flow to the clitoris

Estrogen Replacement Therapy (ERT) - to increase libido, improve clitoral sensation, and decrease pain during intercourse for women in menopause. For women with other estrogen-depleting conditions, topical estrogen cream and Estring can also help with vaginal irritation, pain, or dryness.

Testosterone - used most effectively in menopausal women to increase libido and clitoral sensitivity

Lubricants - vaginal lubricants to relieve dyspareunia, vaginal dryness, and irritation. These are available over the counter.

Vaginal Dilators - inserted into the vagina for 15 minutes, twice daily, to treat vaginismus

Pelvic Exercises - Kegel exercises and techniques to relax the vaginal muscles and relieve orgasmic disorders and vaginismus

You can't avoid all the risk factors for female sexual dysfunction. However, the steps below will help you avoid certain risk factors.
  • If a medical condition is the cause, follow the treatment.
  • If medications are the problem, ask your doctor about changing the medication or the regimen.
  • Eat a healthful diet, one that is low in saturated fat and rich in whole grains, fruits, and vegetables.
  • Avoid emotional stress.
  • If interpersonal conflict is the cause, try relationship counseling.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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