How Common Is Female Sexual Dysfunction?

Normal sexual function and response involve the mind and body. A woman can have problems at any stage of sexual function

• Motivation or desire: This is required to engage in sexual activity or to continue it. Sexual desire could be triggered by thoughts, words, sights or touch and varies with each woman.
• Arousal: Arousal is the sexual excitement that is felt and involves a physical element. The blood flow increases to the genital area, the vaginal wall starts to swell and vaginal secretions increase.
• Orgasm: Orgasm is the peak of sexual excitement. There is increased muscle tension throughout the body and the muscles around the vagina start contracting rhythmically.
• Resolution: This occurs following orgasm or sexual activity. There is widespread muscular relaxation throughout the body and a feeling of well-being.

Sexual dysfunction can occur due to various physical, hormonal and psychological causes or a combination of multiple factors. Factors contributing to sexual dysfunction include

• Physical: Several medical conditions and major illnesses, such as cancer, chronic pain, severe arthritis, physical injuries, diabetes, heart diseases, kidney failure, multiple sclerosis and bladder problems can lead to sexual dysfunction. Certain medications, such as antidepressants, blood pressure medications, antihistamines or chemotherapy drugs, can affect sexual function.
• Hormonal: Decline in estrogen levels after menopause can lead to changes in the genital tissues, such as dryness and decreased elasticity, which can cause pain during intercourse. Sexual desire may also decrease after menopause. A decrease in estrogen leads to decreased blood flow to the genitals. Women also have hormonal imbalance after childbirth and while breastfeeding, which can cause sexual dysfunction.
• Psychological and/or social: Untreated psychological conditions like anxiety, post-traumatic stress disorder (PTSD), history of sexual abuse, stress, insecurity, body image issues or depression can cause or aggravate sexual dysfunction. Having problems with other aspects of the relationship, such as cultural and religious beliefs, may also contribute to sexual dysfunction.

Sexual dysfunction requires treatment only if one is bothered by it. If it is not bothersome, it doesn’t require treatment because it doesn’t affect the health of the body.

Treatment varies depending on the symptoms and causes of sexual dysfunction. Most women require a combined treatment approach that treats medical, psychological and relationship problems that contribute to sexual dysfunction.

Nonmedical treatment options

• Communicating openly with the partner about sexual preferences or resolving conflicts can solve most relationship problems that may be contributing to sexual dysfunction.
• Counseling: Consulting with a licensed therapist or psychiatrist can help treat psychological and emotional problems or relationship problems contributing to sexual dysfunction.
• Lifestyle modifications: Lifestyle modifications include
  • Reducing alcohol consumption
  • Getting regular physical activity
  • Eating a healthy, balanced diet
• Vaginal lubricants: Vaginal lubricants can reduce dryness, pain and discomfort during intercourse.
• Using a device: Stimulate arousal by using a vibrator over the clitoris.

Medical treatment for female sexual dysfunction

Certain medications can cause sexual dysfunction. The doctor may prescribe an alternative medicine or adjust the dose of such medications. Sexual dysfunction caused due to hormones and other medical illnesses may require medical treatment, which includes

• Hormone therapy: Localized estrogen therapy is administered in the form of creams, vaginal rings or tablets. This improves vaginal dryness, tone and elasticity and increases blood flow locally. There are also medications that modulate estrogen receptors, reducing pain during sex. Hormone replacement therapy (HRT) can help reduce the symptoms of menopause throughout the body, including the genitals.
• Androgen therapy: Testosterone is an androgen that affects sexual function in women as well, but the use of testosterone to treat female dysfunction is still controversial.
• Treatment of psychological conditions: Medical treatment to manage stress, anxiety, PTSD, depression and other psychological conditions may be prescribed by the doctor.