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Female sexual dysfunction

Sexual problems in women, known as female sexual dysfunction, affect as many as half of all women at some stage in their lives, especially as they get older.

Women's sexual problems include loss of desire or arousal, problems with orgasm and pain during sex.

Female sexual dysfunction can be caused by physical and psychological problems.

What causes sexual dysfunction?

Sexual dysfunction can be a result of:

  • Physical causes. Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause, and chronic diseases such as kidney disease or liver failure, alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
  • Psychological causes. These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma.

How does sexual dysfunction affect women?

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. The inability to become aroused may also 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 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 cysts, vaginitis, poor lubrication, the presence of scar tissue from surgery, or a sexually transmitted infection. 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.

How is female sexual dysfunction diagnosed?

The doctor will probably begin with a thorough evaluation of symptoms and a physical examination. The doctor may perform a pelvic examination to evaluate the health of the reproductive organs and a cervical screening ( smear test) to detect changes in the cells of the cervix (to check for cancer or a pre- cancerous condition). He or she may arrange 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 (fear, anxiety, past sexual trauma/abuse, relationship problems, alcohol or drug abuse, etc.) will help the doctor understand the underlying causes of the problem and make appropriate recommendations for treatment.

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