Female sexual dysfunction
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In the field of medicine, the term “sexual dysfunction” refers to persistent and recurrent problems related to sexual responsiveness, desire, orgasm, or pain that cause distress or create difficulties in one’s relationship with their partner.
Numerous women experience challenges with their sexual function at various points in their lives, and for some, these struggles persist. Female sexual dysfunction can occur at any stage of life, impacting every sexual situations or only specific situations.
About 30% to 40% of women experience sexual dysfunction. The main grievance is a lack of desire. Sex issues can afflict women at any stage of life, but they tend to get worse as women get older. Sexual dysfunction can be short-lived or persistent (chronic).
A complex interaction of physiology, emotions, experiences, beliefs, lifestyle, and relationships goes into a sexual response. Any component disruption can impact sexual desire, arousal, or satisfaction, and treatment frequently combines multiple strategies.
Symptoms
Depending on the sort of sexual dysfunction you’re dealing with, there are different symptoms:
- Decreased sexual desire. The most prevalent female sexual dysfunction involves a lack of desire for and willingness to engage in sexual activity.
- Sexual arousal disorder. Even though you may still have a strong desire for sex, you may find it difficult to arouse yourself or find it difficult to maintain arousal throughout sexual activity.
- Sexual pain disorder (Dyspareunia). When you are stimulated sexually or have vaginal contact, you experience pain.
- Orgasmic disorder (Anorgasmia). Even after sexual arousal and continuing stimulation, you frequently struggle to experience orgasm.
Make an appointment with your doctor for an evaluation if sexual issues impact your relationship or cause you anxiety.
Causes
When your hormones are fluctuating, such as after giving birth or throughout menopause, sexual issues can arise. Sexual dysfunction can also be a result of serious illnesses including cancer, diabetes, or heart and blood vessel (cardiovascular) disease.
The following factors, many of which are connected, can lead to sexual dysfunction or dissatisfaction:
- Physical. Sexual dysfunction can be brought on by a wide variety of illnesses, such as cancer, kidney failure, multiple sclerosis, heart disease, and bladder issues. Your sexual desire and your body’s capacity for orgasm can be decreased by a number of medications, including several antidepressants, blood pressure meds, antihistamines, and chemotherapy therapies.
- Hormonal. Following menopause, lower estrogen levels can lead to changes in genital tissues and sexual receptivity. The decrease in estrogen can result in reduced blood flow to the pelvic area, potentially affecting genital sensation and causing a lengthened time to reach orgasm.
Moreover, if sexual activity is not engaged in, the vaginal lining may become thinner and less elastic, particularly due to lower estrogen levels. Dyspareunia, a condition characterized by painful sexual intercourse, can be a consequence of these factors. As hormone levels decline, sexual desire may also decrease.
After giving birth and during nursing, your body’s hormone levels change, which can cause vaginal dryness and alter your desire for sex.
- Psychological and social. Sexual dysfunction can result from or be exacerbated by untreated anxiety, depression, chronic stress, and a history of sexual abuse. Pregnancy anxieties and new mother demands could have similar impacts.
Ongoing conflicts with your partner regarding sexual or other matters can also impact your sexual receptivity. Additionally, factors such as body image concerns, cultural and religious influences, and various other factors may also contribute to changes in sexual receptivity.
Risk factors
Several elements could raise your risk of experiencing sexual dysfunction:
- Anxiety
- Depression
- Disease of the blood vessels and heart
- Neurological disorders including multiple sclerosis and spinal cord damage
- Gynecological disorders like vulvovaginal atrophy, lichen sclerosus, or infections
- A few drugs, like antidepressants or drugs for high blood pressure
- Psychological or emotional stress
- Past experiences with sexual assault
Diagnosis
To diagnose female sexual problems, your healthcare provider may undertake the following steps:
- Discuss your sexual and medical history. Although it may make you uncomfortable, your sexuality is an important aspect of your overall health. The greater your chances are of finding a successful treatment method, the more honest you can be about your sexual history and present issues.
- Perform a pelvic exam. During the examination, your doctor looks for any physical causes that can impair your ability to enjoy sexual activity, such as genital tissue thinness, a loss of skin flexibility, scars, or pain.
- Order blood tests. In order to screen for underlying medical issues that can contribute to sexual dysfunction, your doctor may advise blood testing.
Your doctor may also suggest seeking the assistance of a therapist or counselor who specializes in relationship and sexuality issues.
Treatment
It is important to remember that sexual dysfunction becomes a concern only if it bothers you personally. If you are not bothered by it, treatment may not be necessary. The treatment approach for female sexual dysfunction varies due to the diverse range of symptoms and underlying causes. It is crucial to communicate your concerns and have a clear understanding of your body’s typical sexual response. Your individual goals for your sexual life also play a significant role in selecting an appropriate treatment and assessing its effectiveness. In many cases, a comprehensive treatment approach that addresses medical, interpersonal, and emotional aspects proves beneficial for women dealing with sexual concerns.
Non-medical treatment
Your healthcare provider may recommend starting with the following methods to address sexual dysfunction:
- Communicate with your partner. Your sexual enjoyment is drastically affected by your partner’s open communication. Even if you’re not used to discussing your preferences, making an effort to do so and offering feedback in an unthreatening manner might pave the road for closer closeness.
- Live a healthy lifestyle. Drink in moderation; excessive alcohol consumption can impair sexual responsiveness. Be physically active; consistent exercise can improve your endurance and mood, which will heighten love sentiments. Learn stress-reduction techniques to help you concentrate on and enjoy sexual activities.
- Undergo counseling. Consider seeking guidance from a therapist or counselor who specializes in sexual and relationship issues. Therapy often involves learning techniques to enhance your body’s sexual response, improving intimacy with your partner, and receiving recommendations for couples exercises or suggested reading materials.
- Utilize lubricants. If you experience vaginal dryness or soreness during sex, a vaginal lubricant may be useful.
- Use a device. The clitoris can be stimulated to increase arousal. To stimulate the clitoral area, use a vibrator.
Medical treatment
It is frequently necessary to treat an underlying medical problem or hormonal alteration in order to effectively treat sexual dysfunction. A medicine you’re already taking may need to be changed, or your doctor may recommend a different one.
Treatment options for female sex issues could include:
- Estrogen therapy. A vaginal ring, cream, or tablet are all forms of localized estrogen therapy. By boosting vaginal blood flow, promoting lubrication, and strengthening vaginal tone and flexibility, this therapy enhances sexual function.
The hazards associated with hormone therapy can change depending on your age, your risk of developing other diseases like cancer and heart and blood vessel disease, the type and dosage of hormones, and whether estrogen is administered alone or in combination with a progestin.
Discuss the advantages and disadvantages with your doctor. Hormonal therapy may occasionally need cautious observation by your doctor.
- Ospemifene. This drug selectively modifies estrogen receptors. It eases vulvovaginal atrophy sufferers’ pain during sexual activity.
- Androgen therapy. Testosterone is one of the androgens. Despite the fact that women have far lower levels of testosterone than males do, testosterone plays a role in optimal sexual function in both sexes.
The use of androgen treatment to treat sexual dysfunction is debatable. Some research indicate a benefit for females who experience sexual dysfunction due to low testosterone levels, while other studies indicate little to no benefit.
- Flibanserin (Addyi). The Food and Drug Administration (FDA) has given the antidepressant flibanserin permission to be used as a treatment for premenopausal women who have poor sexual desire.
For women experiencing low sex drive that causes distress, the use of Addyi, a daily medication, may be beneficial in increasing sexual desire. However, it’s important to note that Addyi carries potential significant side effects, including low blood pressure, sleepiness, nausea, fatigue, dizziness, and fainting, particularly when combined with alcohol. If there is no improvement in sex drive after eight weeks of medication use, experts recommend discontinuing its use.
- Bremelanotide. Another medication for reduced sexual desire in premenopausal women with FDA approval is called bremelanotide. You administer this drug to yourself by giving an little injection into your abdomen or thigh before a planned sexual activity.
Some women report feeling nauseous, which is more frequent after the first injection but usually goes away with the second. Other adverse reactions include vomiting, flushing, headaches, and a skin response at the injection site.
Potential therapies that require additional study
Further research is needed before these medications can be recommended for the treatment of female sexual dysfunction.
- Tibolone. In Australia and Europe, postmenopausal osteoporosis is treated with the synthetic steroid medication tibolone. Tibolone has not been given FDA approval for usage in the United States due to worries about increased risk of breast cancer and stroke in women using the medicine.
- Phosphodiesterase inhibitors. This class of pharmaceuticals has shown to be effective in treating male erectile dysfunction, but they are not nearly as effective in treating female sexual dysfunction. Studies examining how well these medications work for women have produced mixed results.
For some women who experience sexual dysfunction as a result of taking selective serotonin reuptake inhibitors (SSRIs), a family of medications used to treat depression, sildenafil (Revatio, Viagra) may prove helpful. If you use nitroglycerin to treat angina, a kind of chest pain brought on by decreased blood flow to the heart, don’t take sildenafil.
Even the most effective drugs may not effectively treat complex issues related to female sexual dysfunction if underlying emotional or social factors are not addressed simultaneously.
