What are the main causes of female sexual dysfunction. How can hormonal imbalances affect sexual health in women. What treatments are available for addressing sexual dysfunction in females.

Understanding Female Sexual Dysfunction: An Overview

Female sexual dysfunction (FSD) is a complex and multifaceted issue that affects many women worldwide. It encompasses a range of persistent problems related to sexual desire, arousal, orgasm, and pain during sexual activity. Understanding the various aspects of FSD is crucial for proper diagnosis and treatment.

FSD can manifest in several ways, including:

• Physical changes or conditions impacting intimacy
• Pain during sexual activity
• Low or absent sexual desire (hypoactive sexual desire disorder)
• Reduced or excessive genital arousal
• Difficulty or inability to achieve orgasm (female orgasmic disorder)
• Overall decreased satisfaction with sexual function

These issues can significantly impact a woman’s quality of life, relationships, and overall well-being. It’s important to note that FSD is not simply a matter of physical symptoms but often involves complex interactions between physical, psychological, and social factors.

Common Causes of Female Sexual Dysfunction

Female sexual dysfunction can arise from a variety of underlying causes. Some of the most common factors contributing to FSD include:

• Pregnancy and childbirth
• Surgical procedures
• Cancer and its treatments
• Diabetes
• Menopausal changes
• Anxiety and depression
• Trauma (physical or psychological)
• Certain medications

Can medical conditions affect sexual function in women? Yes, various medical conditions can significantly impact sexual function. For instance, hormonal imbalances, cardiovascular diseases, and neurological disorders can all contribute to sexual dysfunction. Additionally, chronic conditions like endometriosis or pelvic inflammatory disease may cause pain during intercourse, leading to sexual aversion or difficulties.

Vaginal, Urinary, and Bowel Dysfunction: Impact on Sexual Health

Dysfunction in the vaginal, urinary, and bowel systems can significantly affect a woman’s sexual health and overall quality of life. These issues can include:

1. Vaginal dryness and decreased lubrication
2. Vaginismus (involuntary spasms of vaginal muscles)
3. Pelvic organ prolapse
4. Urinary incontinence
5. Bowel dysfunction (e.g., constipation or fecal incontinence)

How does vaginal dryness affect sexual function? Vaginal dryness can lead to discomfort or pain during intercourse, which may result in decreased sexual desire and satisfaction. This condition is often associated with hormonal changes, particularly during menopause, but can also occur due to certain medications or medical treatments.

Addressing Pelvic Floor Disorders

Pelvic floor disorders, such as pelvic organ prolapse, can significantly impact sexual function. These conditions may cause discomfort, pain, or embarrassment during sexual activity. Treatment options for pelvic floor disorders include:

• Pelvic floor physical therapy
• Kegel exercises
• Biofeedback therapy
• Pessaries (for prolapse)
• Surgical interventions (in severe cases)

Pain-Related Sexual Dysfunction: Causes and Management

Pain during or after sexual activity is a common form of sexual dysfunction that can have various causes. Some pain-related conditions include:

• Dyspareunia (painful intercourse)
• Vulvodynia (chronic vulvar pain)
• Vulvar inflammatory conditions (e.g., lichen sclerosus)
• Post-traumatic pain (due to surgery, injury, or childbirth)
• Noncoital sexual pain (genital pain occurring outside of intercourse)

Is vulvodynia a common cause of sexual pain in women? Vulvodynia is indeed a relatively common condition, affecting up to 16% of women at some point in their lives. It can cause significant discomfort and pain during sexual activity, leading to sexual avoidance and relationship strain. Treatment for vulvodynia may include topical medications, pelvic floor physical therapy, and in some cases, nerve blocks or surgical interventions.

Managing Sexual Pain

Addressing pain-related sexual dysfunction often requires a multidisciplinary approach. Treatment strategies may include:

• Topical or oral pain medications
• Pelvic floor physical therapy
• Cognitive-behavioral therapy
• Lifestyle modifications
• Lubricants and moisturizers
• Hormone therapy (when appropriate)

Hormonal Imbalances and Their Effect on Female Sexual Health

Hormonal imbalances can have a significant impact on female sexual function. One of the most common hormone-related issues affecting sexual health is the genitourinary syndrome of menopause (GSM), which results from decreased levels of estrogen and other hormones during menopause.

Symptoms of GSM may include:

• Vaginal burning and irritation
• Dryness and discomfort during intercourse
• Urinary problems
• Decreased libido

How do hormonal changes during menopause affect sexual function? Menopausal hormonal changes can lead to various sexual health issues. Decreased estrogen levels can cause vaginal atrophy, resulting in dryness, irritation, and pain during intercourse. Additionally, changes in testosterone levels may contribute to reduced libido and difficulty achieving orgasm.

Addressing Hormonal Imbalances

Treatment options for hormone-related sexual dysfunction may include:

• Hormone replacement therapy (HRT)
• Topical estrogen creams or suppositories
• Non-hormonal vaginal moisturizers and lubricants
• Lifestyle modifications (e.g., diet, exercise, stress management)
• Alternative therapies (e.g., herbal supplements, acupuncture)

Hypoactive Sexual Desire Disorder: Understanding and Treatment

Hypoactive sexual desire disorder (HSDD) is characterized by a persistent lack of sexual interest that causes distress. This condition can significantly impact relationships and overall quality of life. HSDD can have various underlying causes, including hormonal imbalances, psychological factors, and certain medical conditions.

What are the primary symptoms of hypoactive sexual desire disorder? The main symptoms of HSDD include:

• Lack of interest in sexual activity
• Absence of sexual thoughts or fantasies
• Reduced responsiveness to sexual cues
• Distress or interpersonal difficulties due to low sexual desire

Treating Hypoactive Sexual Desire Disorder

Addressing HSDD often requires a comprehensive approach that may include:

• Psychological counseling or sex therapy
• Hormone therapy (when appropriate)
• Medications specifically approved for HSDD (e.g., flibanserin)
• Lifestyle modifications
• Relationship counseling

Psychological Factors Contributing to Female Sexual Dysfunction

While physical factors play a significant role in female sexual dysfunction, psychological and emotional aspects are equally important. Some common psychological factors that can contribute to FSD include:

• Stress and anxiety
• Depression
• Body image issues
• Past trauma or abuse
• Relationship problems
• Cultural or religious beliefs about sexuality

How does stress affect female sexual function? Stress can have a significant impact on sexual function in women. It can lead to decreased libido, difficulty becoming aroused, and problems achieving orgasm. Chronic stress may also contribute to physical symptoms such as vaginal dryness or pain during intercourse.

Addressing Psychological Aspects of Sexual Dysfunction

Treatment approaches for psychological factors contributing to FSD may include:

• Individual psychotherapy
• Cognitive-behavioral therapy (CBT)
• Mindfulness-based therapies
• Couples counseling
• Sex therapy
• Stress management techniques

Innovative Treatments and Future Directions in Female Sexual Health

As research in female sexual health continues to advance, new and innovative treatments are emerging to address various aspects of sexual dysfunction. Some promising areas of development include:

• Novel pharmacological treatments
• Regenerative medicine approaches (e.g., platelet-rich plasma therapy)
• Neuromodulation techniques
• Advanced hormone therapies
• Personalized medicine approaches

What are some emerging treatments for female sexual dysfunction? Some innovative treatments currently being explored include:

• DHEA vaginal suppositories for vaginal atrophy
• Bremelanotide for HSDD
• Transcutaneous electrical nerve stimulation (TENS) for pelvic pain
• Stem cell therapies for tissue regeneration
• Virtual reality-assisted therapies for psychological aspects of FSD

These emerging treatments offer hope for improved outcomes and more personalized approaches to addressing female sexual dysfunction. As research continues, it’s likely that new and more effective interventions will become available, providing women with a broader range of options for managing sexual health concerns.

In conclusion, female sexual dysfunction is a complex and multifaceted issue that can significantly impact a woman’s quality of life. By understanding the various causes, types, and available treatments, healthcare providers can offer more comprehensive and effective care to women experiencing sexual health concerns. As research in this field continues to advance, it’s crucial for both patients and healthcare professionals to stay informed about new developments and treatment options to ensure the best possible outcomes for women’s sexual health and overall well-being.

Causes and Types of Female Sexual Dysfunction

Causes and Types of Female Sexual Dysfunction | BIDMC of Boston








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Female sexual dysfunction is when a woman experiences persistent issues related to:

• Physical changes or conditions that impact intimacy
• Having pain during sex activity
• Hypoactive (low) sexual desire disorder — having low or absent desire for sexual intimacy that causes distress
• Having reduced or excessive arousal of genital organs
• Female orgasmic disorder — having reduced or absent orgasm during sexual activity that causes distress
• Having decreased overall satisfaction with sexual function

Common underlying causes can include pregnancy, surgery, cancer, diabetes, menopausal changes, anxiety, depression, trauma, and even medications. There are a number of conditions that can result, all of which can lead to problems with sexual function.

Vaginal, Urinary, and Bowel Dysfunction

• Vaginal dryness resulting in decreased lubrication in and around the vagina
• Vaginismus, when vaginal muscles spasm when something is entering it, like a tampon
• Pelvic organ prolapse, when the vaginal and surrounding organs bulge, which can be often result from childbirth, hormonal changes, and other medical or lifestyle conditions
• Urinary incontinence (leakage)
• Bowel dysfunction, such as constipation or fecal incontinence (leakage)

Pain

• Painful intercourse (dyspareunia)
• Vulvodynia, when there is chronic pain affecting the labia, clitoris and vaginal opening
• Vulvar inflammatory conditions such as lichen sclerosus, a chronic condition that causes thin, white patches of skin in the genital area
• Vaginal burning
• Pain after trauma to pelvis, due to surgery, personal trauma, injury, or childbirth
• Noncoital sexual pain, or genital pain that occurs at times other than sexual intercourse

Hormonal Concerns

• Genitourinary syndrome of menopause (GSM), menopause symptoms that come from having lower levels estrogens and other hormones in the body. Symptoms include:
• Burning and irritation in the vagina
• Dryness, discomfort, or pain with intercourse
• Urinary problems
• Hormonal imbalance disorders, related to sex hormones
• Hypoactive (low interest) sexual desire disorder, a low level of interest in sex that leads to distress.
• Hyperactive sexual desire disorder, or high interest in sex that leads to distress.
• Female orgasmic disorder, when there is an inability to achieve orgasm that causes distress.
• Sexual arousal disorder, a lack or absence of sexual fantasies, desire for sexual activity, and/or inability to maintain sexual arousal response that causes distress.

Female Sexual Dysfunction

Written by Kathleen Fordyce

Medically Reviewed by Neha Pathak, MD on September 20, 2021

• Medical or Physical Conditions
• Mental and Emotional Issues
• Medications, Drugs, and Alcohol
• Treatments and Other Help

Sexual dysfunction is a common problem among women. Almost half of all women have persistent problems with sex, such as little or no sex drive, trouble reaching an orgasm, or pain during intercourse.

Satisfying sex involves your body, mind, health, beliefs, and your feelings toward your partner, among other factors. Here are some possible causes behind problems in your sex life.

Heart disease, diabetes, thyroid disease, nerve conditions such as multiple sclerosis, and even simple fatigue can make sex uncomfortable or painful. They can make it hard for you to get aroused or climax during sex.

Scarring from surgery or radiation treatment in your vaginal opening or in other parts of your genital area also can change your sexual experience. So can infections such as genital herpes.

Other possible causes include hormonal imbalance or physical changes related to:

• Pregnancy (you may have sex less often or find it uncomfortable, especially during the third trimester)
• Childbirth (your genitals may be less sensitive, you may have had a difficult delivery)
• Breastfeeding (low estrogen levels may lead to vaginal dryness, you may lack energy for sex)
• Menopause (vaginal dryness, lack of libido)

The right mood and a healthy, respectful connection with your partner play an important role in sexual intimacy. But there may be factors that leave you feeling self-conscious, fearful, or uninterested. Reasons may include:

• Depression
• Anxiety
• Stress
• Past sexual abuse
• Low self-esteem

Drinking can make orgasm longer to achieve or feel less intense. Tobacco smoking and long-term use of heroin and other illegal drugs also can lead to sexual problems.

Some medications can make sex less pleasurable, dampen sex drive, or cause vaginal discomfort. Types of medications include:

• High blood pressure drugs
• Antidepressants
• Antipsychotic medications
• Epilepsy drugs
• Certain cancer drugs
• Medication for urinary tract infection
• Steroids

See your doctor right away if you suddenly have pain or unusual syptoms during sex, like a headache, or if you think you’ve been exposed to a sexually transmitted disease. 

For other kinds of sexual dysfunction, a range of therapies can help. Your doctor will ask about your symptoms, check your health, order blood screens or other tests, and rule out other possible causes.

Medical treatments may include:

• Drugs to raise low libido (desire for sex)
• Kegel exercises to strengthen pelvic muscles to help achieve better orgasm
• Anti-inflammatory drugs to take before intercourse to lower pain

Other advice to improve your intimate experience may include:

• More open communication between you and your partner,
• Making time for sex
• Improving intimacy with your partner
• Healthy habits, such as minimizing alcohol, getting exercise and eating a healthy diet
• Therapy or counseling to help you manage stress or anxiety, or work through feelings of fear or shame in regards to sex
• Vaginal lubricant for dryness or lessen pain during sex
• Vibrators and other tools to enhance arousal
• Techniques on how to reduce distractions and be more present during sex

Top Picks

Impotence – a woman’s view of the problem

Advertising will never show the painful disappointment and stress that a woman experiences if her partner has erectile dysfunction (ie impotence).

Women often hide their true feelings and experience hard unpleasant situations, although they do not show it – they either blame themselves for everything, suspecting the cause of sexual discord in their behavior, or they believe that they have lost attractiveness in the eyes of a partner. “It’s my fault!” – this is the first thought that rushes through the excited mind of a woman when her partner cannot achieve an erection. And meanwhile, this assumption has nothing to do with the truth!

The term erectile dysfunction in medicine is used to refer to the inability to achieve or maintain an erection during the entire intercourse. Almost all men sooner or later, at least once in their lives, face a similar problem. Erectile dysfunction can be the result of stress, depression, and sometimes it can be completely unreasonable. For some men, erection problems become permanent. In this case, impotence is diagnosed.

Although many women – as well as men – still consider impotence to be a purely sexual problem, in reality, the most common causes of impotence are undetected physical conditions such as diabetes, high cholesterol, or even early stage heart disease. Often impotence is a consequence or side effect of taking certain medications that are used in the treatment of these diseases, in particular, certain drugs for hypertension.

Unfortunately, ignorance about the real causes of male impotence often makes women feel guilty and causes confusion, panic, and sometimes even irritation and anger.

As a rule, faced with male impotence, women feel humiliated and offended and ask their partner a lot of questions. So, a woman may suspect that her lover has a mistress, or that he has lost sexual interest in her, and only worsens the already unenviable position of a man with offensive hints. In this situation, the man often interprets her questions – and the offensive tone in which they are given – as an attack and involuntarily withdraws.

In the end, this misunderstanding can turn into a real conflict, and the couple will stop full-fledged communication – and not only in bed. Naturally, this is unlikely to help solve the problem of impotence and may lead to a relationship crisis.

The only thing a woman should never do in such delicate circumstances is to remain silent and pretend that nothing happened. Silencing problems is a sure way to destroy relationships. The withdrawal of one partner causes alienation of the other, which can lead to disastrous consequences – at first the couple stops talking about sex, then stops talking altogether and imperceptibly finds themselves in the trap of their own caution or delicacy.

If dismissal and silence are a bad tactic, then too much persistence is unlikely to produce the desired result. No need to go to extremes. While many women flee the sinking ship, others take the opposite tack and try to take the helm into their own hands. They are sure that everything can be fixed if they make a little more effort to excite a partner. This tactic is not only ineffective, but also harmful, as it can worsen the situation.

So what should a woman do if a man cannot meet her expectations? According to experts, the most important thing is to remember that male impotence has nothing to do with a woman. And in no case should you attribute the male “puncture” to your account!

Do not feel rejected and betrayed. It’s not about you at all. Having overcome this psychological barrier, acknowledge the existence of the problem and openly discuss it with your partner.

“It’s best to discuss sexual issues outside the bedroom – not immediately after a failed intimacy attempt, but several days or even weeks later,” advises Jennifer Downey, MD, psychiatrist at the New York State Psychiatric Institute and professor at Columbia University. Downey also encourages women to talk to their partner about possible medical conditions that may be causing impotence, and to subtly suggest that they see a doctor.

According to Downey, the more serious a woman is about this conversation, the more likely she is to influence a man and gain his trust.

“The problem of impotence should be treated like any other relationship problem, i. Discuss it calmly and frankly,” says Downey.

Depending on the cause of male impotence, treatment can be quick (eg taking Viagra) or long-term (eg treating hypertension). It is possible that a lot of time will have to be spent just to convince a man to see a doctor.

The main thing is to never tell a man that his impotence doesn’t matter to you and that you “love him like that.”

Instead, experts recommend using the opportunity for sexual experimentation and finding ways to maintain intimacy, even if an erection is not yet possible.

Many women are accustomed to the fact that the initiator of sexual intimacy is a man. Maybe it’s time to switch roles?

So, in no case do not stop emotional communication with a partner, even if you have to stop sexual relations for a while. And most importantly – listen to the voice of your heart.

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Causes of impotence (erectile dysfunction) | Articles MEDSI

Erectile dysfunction (impotence) is a serious problem for any man. It consists in the inability to maintain an erection level sufficient for a full-fledged sexual intercourse. According to statistics, today every 10th man suffers from impotence. The situation is complicated by the fact that the frequency of early development of erectile dysfunction is increasing. As a result, many young men may experience psychoneurotic disorders and even depression.

What to do? What are the causes of impotence? Can the problem be dealt with? Let’s figure it out!

The main causes of erectile dysfunction

For a long time, experts believed that the main causes of the pathology lie in the lack of testosterone. Studies conducted in the last few decades have shown that erectile dysfunction is usually the result of organic changes in the mechanism of erection and psychogenic factors.

Let’s see what causes impotence in men.

To do this, we highlight the main factors of its development:

• Psychogenic. Anxiety, stress and depression can lead to erectile dysfunction
• Neurogenic. The cause of impotence can be past injuries, injuries of the spine and its diseases, disorders at the level of the brain and spinal cord, hormonal deficiencies, diabetes mellitus, multiple sclerosis, etc.
• Arterial. Erectile dysfunction can be provoked by hypertension, smoking, increased levels of fats in the blood, etc.
• Medicinal. Possible violations when taking antidepressants, antihypertensive drugs, hormones.
• Curvature of the penis, etc.

Often, impotence has several causes at once. Congenital impotence is also diagnosed. It is also called primary. This pathology is characterized by a complete absence of erection throughout the patient’s life. Usually such a violation is the result of anomalies in the development of the penis and / or testicles.

Psychological impotence

Often impotence is the result of nervous disorders (psychosomatics). In such cases, the problem is especially acute. This is due to the fact that increased anxiety and other causes provoke erectile dysfunction. At the same time, impotence itself causes a state of depression in a man. It is extremely difficult to get out of the vicious circle, but one should definitely not give up.

Important! It must be understood that many men today face psychological erectile dysfunction (including at a young age). And at least once an unsuccessful sexual intercourse happened to almost everyone. Of course, in this case it is impossible to diagnose erectile dysfunction in men, but even one failure can make a representative of the stronger sex doubt their own sexual capabilities and provoke the development of pathology.

Psychological impotence can be caused by:

• Extreme fatigue
• Uncertainty before sexual intercourse
• Psychological trauma
• Loss of desire for sex and relationships with women in general

The main signs of psychological impotence

How to understand that a man is impotent and the cause of his problem lies in psychological factors?

In fact, everything is simple.

It is psychological impotence that can be suspected in the presence of an erection during sleep and in the morning after waking up, as well as in involuntary moments and with the ability to ejaculate during masturbation.

In any case, it should be understood that it is often very difficult to identify the causes of psychological and any other impotence. To cope with such a task is only possible for specialists. Moreover, doctors will determine not only how and why a man became impotent, but also decide what to do about it.

Treatment of impotence

Today, treatment is carried out using a range of different drugs and procedures. Men are offered hormonal therapy, sessions with psychologists and psychotherapists, correction of concomitant pathologies, etc.

Qualified andrologists individually select the tactics of assistance depending on:

We hope you now know why erectile dysfunction develops and why you should not give up, even if you or your sexual partner has been diagnosed with it. If you have any questions, we recommend that you contact the experts.

MEDSI-Dialine doctors are ready not only to consult and tell everything about impotence and its features, but also to provide assistance to every man. In the clinic, you can undergo the necessary examination, visit specialists of a narrow profile (if necessary) and receive recommendations for the treatment and prevention of a pathological condition. All procedures and consultations are carried out without queues, in a comfortable environment and in one place.

Author

The author of the article is Alexey Yurievich Sitnikov, urologist.

Sources:

• Pushkar D. Yu. et al. Epidemiological study of the prevalence of erectile dysfunction in the Russian Federation // Ural Medical Journal. – 2012. – No. 3. – S. 75-79
• Gamidov S.I., Dmitriev D.G., Ovchinnikov R.I. Erectile dysfunction in men // Consilium medicum. – 2003. – T. 5. – No. 12. – S. 736-742
• Pushkar D.