Female sexual dysfunction
If you have persistent, recurrent problems with sexual response or desire — and if these problems are making you distressed or straining your relationship with your partner — what you’re experiencing is known medically as female sexual dysfunction.
Female sexual dysfunction isn’t uncommon — many women experience problems with sexual function at some point in their lives. Female sexual dysfunction can be a lifelong problem, or it can happen later in life after you’ve experienced a period of satisfactory functioning.
Female sexual dysfunction has many possible symptoms and causes. Fortunately, they’re almost all treatable. Communicating your concerns and understanding your body and its normal response to sexual activity are important steps toward gaining sexual satisfaction.
You can develop female sexual dysfunction at any age, but sexual problems often happen when your hormones are in flux — for example, after having a baby or during menopause. Sexual concerns may also occur with major illness, such as cancer or cardiovascular disease.
Your problems might be classified as female sexual dysfunction if you experience one or more of the following and you’re distressed about it:
- Your desire to have sex is low or absent.
- You can’t maintain arousal during sexual activity, or you don’t become aroused despite a desire to have sex.
- You cannot experience an orgasm.
- You have pain during sexual contact.
When to see a doctor
If sexual problems are undermining your relationship or disrupting your peace of mind, make an appointment with your doctor for evaluation.
Several factors may contribute to sexual dissatisfaction or dysfunction. These factors tend to be interrelated.
- Physical. Physical conditions that may cause or contribute to sexual problems include arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems, and neurological disorders such as multiple sclerosis. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sex drive and your body’s ability to experience orgasm.
Hormonal. Lower estrogen levels after the menopausal transition may lead to changes in your genital tissues and your sexual responsiveness. The folds of skin that cover your genital region (labia) become thinner, exposing more of the clitoris. This increased exposure sometimes reduces the sensitivity of the clitoris, or may cause an unpleasant tingling or prickling sensation.
In addition, the vaginal lining becomes thinner and less elastic, particularly if you’re not sexually active. At the same time, the vagina requires more stimulation to relax and lubricate before intercourse. These factors can lead to painful intercourse (dyspareunia), and experiencing orgasm may take longer.
Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.
Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress. The worries of pregnancy and demands of being a new mother may have similar effects. Longstanding conflicts with your partner — about sex or any other aspect of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with your own body image also may contribute.
Emotional distress can be both a cause and a result of sexual dysfunction. Regardless of where the cycle began, you usually need to address relationship issues for treatment to be effective.
Some factors may increase your risk of sexual dysfunction:
- Depression or anxiety
- Cardiovascular disease
- Neurologic conditions, such as spinal cord injury or multiple sclerosis
- Liver or kidney failure
- Certain medications, such as antidepressants or high blood pressure medications
- Emotional or psychological stress, especially with regard to your relationship with your partner
- A history of sexual abuse
Preparing for your appointment
If you’re experiencing ongoing sexual difficulties, such as low desire or lack of arousal, and it’s causing you distress, make an appointment with your doctor. You may feel embarrassed to talk about sex with your doctor, but this topic is perfectly appropriate. Your doctor knows that a satisfying sex life is very important to a woman’s well-being at every age and stage of life.
You may have a treatable, underlying condition, or your may benefit from lifestyle changes, therapy or a combination of treatments. Your regular doctor may diagnose and treat the problem or refer you to a specialist who can.
Here’s some information to help you prepare for your appointment, and what to expect from your doctor.
Information to gather in advance
- Your symptoms. Take note of any sexual difficulties you’re having, including when and how often you usually experience them.
- Your sexual history. Your doctor likely will ask about your relationships and experiences since you first became sexually active. He or she also may ask about any history of sexual trauma or abuse.
- Your medical history. Write down any medical conditions with which you’ve been diagnosed, including mental health conditions. Also note the names and strengths of all medications you’re currently taking or have recently taken, including prescription and over-the-counter drugs.
- Questions to ask your doctor. Creating a list of questions in advance can help you make the most of your time with your doctor.
Basic questions to ask your doctor
The list below suggests questions to raise with your doctor about your sexual difficulties. Don’t hesitate to ask more questions during your appointment if you don’t understand something.
- What may be causing my sexual difficulties?
- Do I need any medical tests?
- What treatment approach do you recommend?
- If you’re prescribing medication, are there any possible side effects?
- How much improvement can I reasonably expect with treatment?
- Are there any lifestyle changes or self-care steps that may help me?
- Do you recommend therapy?
- Should my partner be involved in treatment?
- Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend visiting?
What to expect from your doctor
Your doctor may ask a number of very personal questions and may want to include your partner in the interview. To help your doctor determine the cause of your problem and the best course of treatment, be ready to answer questions such as:
- What problems are you currently experiencing?
- How much do these problems bother you?
- How satisfied are you with your current relationship?
- When did you first become sexually active?
- Do you become aroused during sexual interactions with your partner?
- Are you able to experience orgasm?
- If you’ve had orgasms in the past, what were the circumstances?
- Do you experience any pain with intercourse?
- Are you using any form of birth control? If yes, what form?
- What medications are you taking, including prescription and over-the-counter drugs as well as vitamins and supplements?
- Do you use alcohol or recreational drugs? How much?
- Have you ever had surgery that involved your reproductive system?
- Have you been diagnosed with any other medical conditions, including mental health conditions?
- Have you ever been the victim of sexual violence?
What you can do in the meantime
Keep the lines of communication open with your partner. Be honest about your dissatisfaction or the problem you’re experiencing. Consider alternatives for intimacy and engage in sexual activities that are relaxing and rewarding for both of you. In this way, you can sustain your intimacy and ease the stress of the situation.
Dr. Veronique Fernandez-Salvador, the first female urologist in Lee County, is here to answer any questions or concerns you have regarding female sexual health. Please contact our office at 239-689-8800 for inquiries.