A medical term for sexual problems in women that worries you or your partner is called female sexual dysfunction. Problems often involve sexual desire, response, orgasm, or pain during sexual intercourse.
Generally, approximately all people have sexual problems at some point but a few people may experience them throughout their lives. This condition may happen at any age and only in some cases or all the time during sexual activity.
Furthermore, sexual response is complex and involves multiple factors including how your body works, your feelings and beliefs, life events, lifestyle choices, and how you relate to your partner. Even problems in one of the previous areas may negatively affect desire, arousal, and satisfaction. Therefore, treatment for female sexual dysfunction involves multiple approaches.
Symptoms
The symptoms usually appear according to the sexual dysfunction type you experience. Check below some symptoms:
- Reduced sexual drive is the most common sexual dysfunction in women. It involves not wanting and lack of interest in sex.
- Sexual arousal disorder (it involves hard to stay aroused during sexual activity despite you want it)
- Orgasmic disorder (cannot have an orgasm even with enough sexual arousal)
- Sexual pain disorder (in other words, pain during sexual intercourse)
It is recommended to visit a doctor if sexual problems cause relationship problems or worry you.
Causes
Sexual dysfunction issues commonly begin when hormones change and it usually occurs after birth or during menopause. Serious health conditions also may cause this condition. These include heart disease, diabetes, cancer, and others. Check below some factors that contribute to sexual dysfunction in women:
- Physical – This includes health conditions that lead to sexual dysfunction. For example cancer, kidney failure, diabetes, multiple sclerosis, heart and bladder disease, and others. Additionally, certain medicines also may reduce your desire to have sex. These include high blood pressure, depression, allergy, and cancer medications.
- Hormonal – Changes in the genital tissues usually occur in women who have gone through menopause and Estrogen levels are reduced. Therefore, it affects how you respond to sex. Moreover, reduced Estrogen levels decrease blood flow to the pelvic region causing less feeling in your genitals and needing more time to become aroused and reach orgasm.In addition, the vaginal lining also becomes less stretchy and thinner. People who do not have sex may make this worse. As a result, it may lead to painful sexual intercourse (also called dyspareunia). Decreased sexual desire also is common in postmenopausal women. Vaginal dryness and shifts of hormones after pregnancy also may affect the desire for sex.
- Psychological and social – Some mental disorders (including anxiety and depression may cause sexual dysfunction or contribute to it. However, problems with your partner may negatively affect your sex life.
Risk Factors
The following factors may increase your risk of developing sexual dysfunctions. For example:
- Mental disorders (such as depression, anxiety, and others)
- Heart disease
- Cancer
- Diabetes
- Neurological disorders (including multiple sclerosis, spinal cord injury, and others)
- Gynecological conditions (such as infections)
- Medications (these include depression medicines, antihypertensives, and others)
- Psychological and emotional stress
- Medical history of sexual abuse
- Lack of privacy
Diagnosis
Doctors will discuss their medical history and gender identity with the patients and ask some questions about symptoms. Moreover, they may also perform a pelvic examination and blood tests to help confirm the condition.
- Pelvic examination – During this procedure, your doctor will check for physical changes including pain or scarring of the genital tissues.
- Blood tests – These tests are done to check for diseases that may be a part of sexual dysfunction.
Treatment
This condition becomes a problem only if it bothers you or your partner. People who do not have problems due to this condition, do not need treatment. However, in most cases, sexual dysfunction negatively affects your relationship with your partner.
There are different causes of sexual dysfunction. Thus, treatment options also differ among people depending on the cause, severity, age, and other factors. Moreover, it is important to know what you want from sex and how your body responds to it.
Nonmedical Treatment
Check below some treatment options usually recommended by doctors:
- Talk and listen – You should discuss openly with your partner to have a good sex life.
- Live healthy – Healthy lifestyle habits may also help improve sex life. For instance, limit or avoid alcoholic beverages, regularly exercise and adopt a healthy diet full of fresh vegetables, fruits, and whole grains. Discuss with your doctor about ways to manage stress.
- Seek counseling – Do not be ashamed to discuss your problem with a counselor or therapist. These healthcare providers may help you learn multiple techniques about your body and ways to be closer to your partner.
- Use a lubricant or vaginal moisturizer – These products can be used anytime to reduce vaginal dryness or painful sexual intercourse.
- Stay sexually active – This can reduce vaginal discomfort and improve blood flow to the pelvic region.
Medical Treatment
Sexual dysfunction treatment frequently includes medications that help treat a disease or hormonal change. Check below some medicines usually recommended by doctors for female sexual dysfunction:
- Vaginal Estrogen – This medicine comes in different forms including cream, tablet, or ring. It helps reduce vaginal dryness and some urinary symptoms and lessen pain during sexual intercourse.
- Ospemifene – This medicine is taken orally and it belongs to a group of medicines called selective Estrogen receptor modulators (SERMs). It helps lessen pain during sex but should not be used in people with breast cancer or who are at higher risk of developing breast cancer.
- Testosterone therapy – This hormone plays an important role in healthy sexual function in men as well as in women. However, there are no Testosterone treatments approved for female sexual dysfunction due to how it works and how safe it is. Discuss with your healthcare professional about the benefits and risks associated with Testosterone therapy in women.
- Flibanserin – THis medication is approved by the FDA (Food and Drug Administration) to treat low sex drive before menopause. Previously, this medicine was used as an antidepressant. Taking the medication daily may boost sex drive but if you do not notice any improvements after 8 weeks, you should stop using it. Potential adverse reactions include nausea, fainting, hypotension (low blood pressure), sleepiness, dizziness, and others. Do not drink alcohol while using this medicine because negative effects may worsen.
- Bremelanotide – It is also approved by the FDA to treat reduced sexual desire in premenopausal females. It is usually injected under the skin in the abdomen or thigh before sexual activity. Nausea, headaches, flushing, vomiting, and irritation of the skin at the injection site are the most common adverse reactions to this medicine.
- Prasterone – This medication is a suppository of Dehydroepiandrosterone (DHEA), which is a human-made hormone in the vagina. It is effective in the treatment of vaginal dryness and painful sexual intercourse.
Possible Treatments
The following treatment options require more research. For example:
- Tibolone – This medicine is usually used in Europe but in the U.S. it is not approved due to increased risk of breast cancer and stroke.
- Phosphodiesterase inhibitors – This group of medications is effective in treating erectile dysfunction (ED) in men. However, it does not work so well in women with sexual dysfunction.Sildenafil is one medication that may be useful for some people with sexual dysfunction for those who administer a group of antidepressants (such as selective reuptake inhibitors or SSRIs). However, Sildenafil should not be used if you use Nitroglycerin for chest pain.
In addition, sexual dysfunction in women is complex and medications may not work until you resolve other emotional or social factors.
Frequently Asked Questions
What are the most common symptoms of sexual dysfunction in women?
- Involuntary painful contractions (spasms) of the muscles around the vagina
- Low libido (lack of interest in sex)
- Arousal or orgasm problems
Discuss with your healthcare professional if any of the previous symptoms occur.
What are the main causes of female sexual dysfunction?
These include:
- Estrogen deficiency
- Multiple sclerosis
- Endometriosis
- Sexually transmitted infections (STIs)
- Hormonal imbalances
- Substance use disorder
- Breast cancer
- Neurological disorders
- Antidepressants
- Atrophic vaginitis
- Thyroid disease
- Pregnancy
The list above does not contain all possible causes. For more details, discuss it with your healthcare professional.
What is the best treatment for female sexual dysfunction?
The treatment for this condition usually involves multiple options. For example:
- Psychotherapy (such as cognitive behavioral therapy or CBT, mindfulness-based CBT, behavior therapy, and others)
- Hormonal therapy
- Lifestyle changes (such as eating a well-balanced diet, limiting alcoholic drinks, regular physical exercise, and others)
If you have additional questions, ask your healthcare provider.
