Sexual Dysfunction

What is sexual dysfunction?

Problems with:

  • Motivation, or desire
  • Arousal
  • Orgasm

What types of dysfunction are there in the sexual life of women?

Sexual dysfunction in women can come in many forms and be caused by many things. It can happen before, during, or after sex. The most common issues related to sexual dysfunction are:

  • Anorgasmia – An orgasmic disorder or inability to have an orgasm.
  • Hypoactive Sexual Desire Disorder – Low libido or lack of sexual desire
  • Sexual Arousal Disorder – Difficulty becoming sexually aroused

 

What is the prevalence of sexual dysfunction among women?

About 30%-40% of women suffer from sexual dysfunction. The most common complaint is a lack of sexual desire. While problems with sex tend to be more common as women get older, they can also affect women at all stages of their lives. Sexual dysfunction can be either temporary or chronic (long-lasting).

SYMPTOMS & CAUSES

What causes female sexual dysfunction?

There are several physical causes for sexual dysfunction in women:

  • Blood flow disorders – Some research suggests that there may be vascular (blood vessel) disorders. These conditions may cause blood to stop flowing to certain parts of the body. For sexual arousal, blood flow to the vagina, clitoris, and labia must be increased.
  • Some medications and treatments – Antidepressants can reduce your sexual drive and your ability to have a sexual moment. Sexual side effects are more common with selective serotonin-reuptake inhibitors (SSRIs). Theses medications can alter hormone levels and cause problems.
  • Endometriosis and ovarian cysts – Can cause pain during sex.
  • Vaginismus – Vaginal muscle spasm is an unconscious reaction to the fear of oncoming vaginal penetration. Vaginismus often causes pain during sexual activity, and it can even make inserting tampons, gynecologic exams, or intercourse impossible.
  • Hormonal Changes– Hormone imbalances can cause vaginal dryness and atrophy making sex unpleasant. Low estrogen levels can cause a decrease in feeling in the genitals. Hormone levels can be affected by surgery, pregnancy, and menopause.
  • Specific Health Conditions- There are a variety of conditions that can impact your ability to have sex. These include diabetes and arthritis. Multiple sclerosis is another. Alcohol abuse and drug addiction can also hinder a healthy sexual experience.

There may be psychological reasons for sexual dysfunction in women:

  • Depression – A lack of interest or enjoyment in the activities you enjoy, such as sex, may lead to depression. Sexual dysfunction can also be caused by low self-esteem or feelings of hopelessness.
  • Stress – Habitual stress can cause you to lose focus and make it difficult to enjoy sex. Studies have shown that stress can cause an increase in cortisol levels. This may reduce sex drive.
  • Previous sexual or physical abuse – Trauma and abuse can cause anxiety or fear of intimacy. These feelings may make it difficult for you to have sex.
  • Relationship problems – Some women might be unhappy with their partner, or may feel bored while having sex. Sexual dysfunction can also result from other strains in the relationship.

 

DIAGNOSIS and TESTS

How is Sexual Dysfunction in women diagnosed?

Talk to your healthcare provider if you are experiencing sexual dysfunction. Your provider will be able to conduct a comprehensive evaluation of your physical and psychological factors related to sex.

A complete health history will be taken by your healthcare provider. Sexual dysfunction may be caused by past surgeries such as a hysterectomy and oophorectomy. Also, a physical exam can rule out any gynecologic problems. A pelvic exam and a cervical smear may be performed by your provider. You will also be evaluated for your medications.

Sometimes, additional tests like imaging may be required. These tests are used by your provider to detect tumors, cysts, or other abnormalities. Hormone imbalances can be diagnosed by blood tests. To check for infection, a vaginal culture may be taken.

You can also have your healthcare provider look into possible psychological causes. You can talk openly about the sexual difficulties you are experiencing. Do not be afraid to express your worries and fears. Your provider might recommend that you talk to a counselor or mental health professional in certain cases.

TREATMENT AND MANAGEMENT

What is the treatment for sexual dysfunction in women?

A plan for treating sexual dysfunction can be created by women and their healthcare team. Before you can choose therapies, it is important to fully understand the psychological and physical causes.

These treatments include:

  • Sexual Stimulation Techniques: Talk to your partner about the different ways you can increase desire and arousal. You might consider changing your sexual routine. Also, you might consider trying erotic materials (sexual stimulators, videos, or books), masturbation or massage.
  • Counseling: Talking to a mental health professional might be helpful. To have sex that is enjoyable and satisfying, you can overcome emotional or psychological blocks. You can choose to have individual counseling or couple’s counseling.
  • Hormone Therapy: Depending on your symptoms, your provider might recommend topical creams or vaginally administered hormones or hormones that are applied to the skin.
  • Medication: Flibanserin, Addyi(r), and bremelanotide(Vyleesi ™), are the only approved medications to treat hypoactive sexual drive disorder (low sex drive). This type of treatment is only available to women who are pregnant. Your provider might discuss with you other medications that may be used “off-label” to treat sexual dysfunction.
  • Intercourse pain management: There area variety of ways to reduce intercourse pain. Before you have sex, you can try different sexual positions and vaginal lubricants. You may be able to talk to your provider about vaginal dilation.

PREVENTION

What can I do to prevent sexual dysfunction?

Although there are no single ways to prevent sexual dysfunction, these steps can help you reduce your chances.

  • Avoid excessive alcohol and drugs
  • A balanced diet is important
  • Exercising regularly
  • A healthy weight is important
  • If you have trouble communicating with your partner or are having mood swings, seek help from your doctor

Before you start any new medication or undergo certain procedures, speak to your healthcare provider.

OUTLOOK/PROGNOSIS

Is sexual dysfunction a permanent condition?

Some women may experience sexual dysfunction that disappears on its own. Sometimes, it may only occur after childbirth or when hormonal changes are occurring. Others may require ongoing treatment for sexual dysfunction. Many people with sexual dysfunction need the help of multiple health care professionals, such as counselors and physical therapists.

What should I do if my female partner is having problems with her sexual function?

Many women have occasional sexual issues. If it becomes a problem that bothers you, or becomes a regular problem, it is time to seek help. Talk to your healthcare provider for evaluation and treatment.

Many women find sexual dysfunction frustrating and challenging. It’s not something you should be ashamed or embarrassed by. It’s possible to get to the root cause of the problem by talking openly with your partner, your healthcare provider, and other family members. There are many treatments available to treat the psychological and physical causes of sexual dysfunction. With the right treatment, most women can have healthy and enjoyable sex.

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Iowa Women's Health Center

IWHC is an advanced women's health clinic located in Cedar Rapids, IA. We service all women through central Iowa and in neighboring states for progressive gynecological care. We provide the latest and least invasive medicine throughout Linn County.

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Iowa Women’s Health Center is interested in talking to you about your decision when choosing which medical options are best for you.  IWHC is an advanced women’s health clinic located in Cedar Rapids, IA. We service all women through central Iowa and in neighboring states for progressive and advanced gynecological care.

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