How Do You Treat Sexual Dysfunction in Women?

Female sexual dysfunction treatment depends on the underlying cause.

Sexual dysfunction is recurrent or persistent problems with sexual response, desire, orgasm or pain that can potentially create a strain in relationships. Sexual dysfunction can occur in men and women. Female sexual dysfunction may include problems with sexual desire, arousal, attaining an orgasm, painful spasms of the vaginal muscles causing contraction of the vagina and painful intercourse. Sexual dysfunction in women is fairly common. Around 43% of women experience sexual dysfunction at some point in their lives. Some may have difficulties throughout their lives.  Sexual dysfunction can occur at any stage of life. It may either occur in only some specific sexual situations or in all sexual situations.

Female sexual dysfunction may be due to multiple reasons. Treatment of sexual dysfunction involves addressing the underlying cause, which may be due to a medical, psychological or hormonal condition. Treatment of sexual dysfunction involves more than one approach and is a team effort of multiple healthcare professionals.

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

• Motivation or desire: Motivation or desire is required to engage in a sexual activity or 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 it has 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 an 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 disease, kidney failure, multiple sclerosis and bladder problems can lead to sexual dysfunction. Certain medications such as antidepressants, blood pressure medications, antihistamines and chemotherapy drugs can affect sexual function.
• Hormonal: Decline in estrogen levels after menopause can lead to changes in the genital tissues such as dryness, decreased elasticity and decreased sensation that can cause pain during intercourse. Sexual desire may also decrease after menopause. Decrease in estrogen leads to decreased blood flow to the genitals. Women also have hormonal imbalance after childbirth and while breastfeeding that can cause sexual dysfunction.
• Psychological and/or social: Untreated psychological conditions such as anxiety, post-traumatic stress disorder (PTSD), history of sexual abuse, stress, insecurity, body image issues and depression can cause sexual dysfunction. Having problems with other aspects of the relationship and cultural and religious beliefs may also contribute to sexual dysfunction.

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

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

Non-medical treatment options 

• Communication: 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
  • Performing regular physical activity
  • Consuming a healthy, balanced diet 
• Vaginal lubricants: A vaginal lubricant can reduce dryness, pain and discomfort during intercourse.
• Using a device: Arousal may be stimulated by using a vibrator over the clitoris to stimulate it.

Medical treatment for female sexual dysfunction

Certain medications can cause sexual dysfunction. The doctor may prescribe an alternate 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. Additionally, there are 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.
• Addyi (flibanserin) and Vyleesi (bremelanotide): These are the two Food and Drug Administration (FDA)-approved medications for hypoactive sexual drive in women. These may be taken after discussion with the physician. They cause chemical changes in the brain and thus lead to arousal.
• 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, post-traumatic stress disorder (PTSD), depression and other psychological conditions may be prescribed by the doctor.