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Female Sexual Dysfunction

Persistent, recurrent problems with sexual response or desire — that distress you or strain your relationship with your partner — are known medically as female sexual dysfunction.

Many women experience problems with sexual function at some point in their lives. Female sexual dysfunction can occur at all stages of life, and it may be ongoing or happen only once in a while.

You may experience more than one type of female sexual dysfunction. Types include:

  • Low sexual desire. You have diminished libido, or lack of sex drive.
  • Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

Sexual response involves a complex interaction of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any of these components can affect sexual drive, arousal or satisfaction. Fortunately, female sexual dysfunction is treatable.

Female sexual dysfunction can happen at any age. Sexual problems often develop when your hormones are in flux — for example, after having a baby or during menopause. Sexual concerns may also occur with major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease.

Your problems might be classified as female sexual dysfunction if you experience one or more of the following — and you’re distressed about it:

  • Your desire to have sex is low or absent.
  • You can’t maintain arousal during sexual activity, or you don’t become aroused despite a desire to have sex.
  • You can’t experience an orgasm.
  • You have pain during sexual contact.

Several factors contribute to sexual dissatisfaction or dysfunction. These factors tend to be interrelated.

  • Physical. Examples of physical conditions that may contribute to sexual problems include arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems, and neurological disorders such as multiple sclerosis. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sex drive 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. The folds of skin that cover your genital area (labia) become thinner, exposing more of the clitoris. This increased exposure sometimes reduces the sensitivity of the clitoris.

    The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active, causing a need for more stimulation to relax and lubricate before intercourse. These factors can lead to painful intercourse (dyspareunia), and it may take longer to experience orgasm.

    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. The worries of pregnancy and demands of being a new mother may have similar effects. Longstanding 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 may contribute.

    Emotional distress can be both a cause and a result of sexual dysfunction. Regardless of where the cycle began, you usually need to address relationship issues for treatment to be effective.

Some factors may increase your risk of sexual dysfunction:

  • Depression or anxiety
  • Heart and blood vessel disease
  • Neurological conditions, such as spinal cord injury or multiple sclerosis
  • Liver or kidney failure
  • Certain medications, such as antidepressants or high blood pressure medications
  • Emotional or psychological stress, especially with regard to your relationship with your partner
  • A history of sexual abuse