This is a corrected version of the article that appeared in print. This version of the article includes supplemental content. A more recent article on sexual dysfunction in women is available. Decreased desire is the most common complaint. Normal versus abnormal sexual functioning in women is poorly understood, although the concept of normal female sexual function continues to develop. A complete history combined with a physical examination is warranted for the evaluation of women with sexual complaints or concerns.
Overview of Sexual Dysfunction in Women
Sexual Problems in Women | Dyspareunia | MedlinePlus
Sexual dysfunction includes painful intercourse, painful contraction spasm of the vaginal muscles, and problems with sexual desire, arousal, or orgasm that cause distress. Depression or anxiety, other psychologic factors, disorders, and drugs can contribute to sexual dysfunction, as can the woman's situation, including relationship difficulties. To identify a problem, doctors often talk to both partners separately and together, and a pelvic examination is often necessary when the woman has pain or problems with orgasm. Improving the relationship, communicating more clearly and openly, and arranging the best circumstances for sexual activities can often help, regardless of the cause of sexual dysfunction. Cognitive-behavioral therapy, mindfulness, or a combination of the two, can also help, as can psychotherapy. If the problems are severe enough to cause distress, they may be considered sexual dysfunction. Sexual dysfunction can be described and diagnosed in terms of specific problems, such as lack of interest or desire, difficulty becoming aroused or reaching orgasm, pain during sexual activity, involuntary tightening of the muscles around the vagina, or persistent and unwanted physical genital arousal.
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Diagnosis and Treatment of Female Sexual Dysfunction
FSD is more typical as women age and is a progressive and widespread condition. Common symptoms associated with FSD include diminished vaginal lubrication, pain and discomfort upon intercourse, decreased sense of arousal and difficulty in achieving orgasm. Only a small percentage of women seek medical attention. In comparison to the overwhelming research and treatment for erectile dysfunction in males, specifically with the development of phosphodiesterase type 5 inhibitors, significantly less has been explored regarding FSD and treatment is primarily limited to psychological therapy. Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men.
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These problems may have physical or psychological causes. Physical causes may include conditions like diabetes, heart disease, nerve disorders, or hormone problems. Some drugs can also affect desire and function. Psychological causes may include work-related stress and anxiety. They may also include depression or concerns about marriage or relationship problems.