What are the main causes of female sexual dysfunction. How can different types of female sexual dysfunction be identified. Which treatment options are available for women experiencing sexual health issues.

Understanding Female Sexual Dysfunction: An Overview

Female sexual dysfunction (FSD) encompasses a range of persistent issues that can significantly impact a woman’s sexual health and overall well-being. These problems may manifest in various ways, affecting different aspects of sexual function and intimacy. To better understand this complex topic, it’s essential to explore the various facets of FSD and its potential causes.

What exactly constitutes female sexual dysfunction? FSD typically involves ongoing difficulties related to:

• Sexual desire
• Arousal
• Orgasm
• Pain during sexual activity
• Overall sexual satisfaction

These issues can lead to distress and strain in relationships, affecting a woman’s quality of life and self-esteem.

Common Causes of Female Sexual Dysfunction

The origins of female sexual dysfunction are often multifaceted, involving a combination of physical, psychological, and relationship factors. Some of the most common causes include:

• Hormonal changes (e.g., menopause, pregnancy, postpartum)
• Medical conditions (e.g., diabetes, cancer, cardiovascular disease)
• Surgical procedures (particularly those affecting the pelvic area)
• Medications (including antidepressants and blood pressure medications)
• Psychological factors (anxiety, depression, stress, past trauma)
• Relationship issues (communication problems, lack of intimacy)

Why do these factors contribute to sexual dysfunction? Each can disrupt the delicate balance of physical and emotional elements necessary for healthy sexual function. For instance, hormonal changes can lead to vaginal dryness and discomfort, while psychological stress can dampen desire and arousal.

Types of Female Sexual Dysfunction

Female sexual dysfunction manifests in several distinct forms, each with its own set of symptoms and challenges. Understanding these different types is crucial for proper diagnosis and treatment.

1. Hypoactive Sexual Desire Disorder (HSDD)

HSDD is characterized by a persistent lack of sexual desire that causes distress. Women with HSDD may experience little to no interest in sexual activity, leading to relationship strain and personal frustration.

2. Female Sexual Arousal Disorder (FSAD)

FSAD involves difficulty becoming or staying physically aroused during sexual activity. This can manifest as inadequate vaginal lubrication or lack of genital swelling and sensitivity.

3. Female Orgasmic Disorder

This condition is marked by difficulty achieving orgasm, despite adequate stimulation and arousal. Some women may experience delayed or absent orgasms, while others may find their orgasms less intense than before.

4. Genito-Pelvic Pain/Penetration Disorder

This disorder encompasses various pain-related issues, including:

• Dyspareunia (pain during intercourse)
• Vaginismus (involuntary muscle spasms that make penetration difficult or impossible)
• Vulvodynia (chronic pain or discomfort around the vaginal opening)

These conditions can make sexual activity uncomfortable or even unbearable for some women.

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

Sexual health is closely intertwined with overall pelvic health. Various conditions affecting the vagina, urinary system, and bowels can contribute to sexual dysfunction.

Vaginal Dryness and Atrophy

What causes vaginal dryness? This common issue often results from hormonal changes, particularly during menopause. Reduced estrogen levels can lead to thinning of the vaginal walls and decreased natural lubrication, making intercourse uncomfortable or painful.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the muscles and tissues supporting the pelvic organs (uterus, bladder, rectum) weaken, causing these organs to descend. This can lead to discomfort during intercourse and affect body image, potentially impacting sexual desire and satisfaction.

Urinary and Fecal Incontinence

Incontinence issues can significantly impact a woman’s confidence and comfort during sexual activity. Fear of leakage may lead to avoidance of intimacy, while the underlying pelvic floor weakness can affect sexual sensation and function.

Pain Disorders and Their Impact on Sexual Function

Pain during or after sexual activity can be a significant barrier to a fulfilling sex life. Several pain-related conditions can contribute to female sexual dysfunction:

Dyspareunia

Dyspareunia refers to persistent or recurrent pain during sexual intercourse. This pain can occur at the vaginal entrance, deep within the pelvis, or both. What causes dyspareunia? Common culprits include vaginal dryness, infections, hormonal changes, and underlying pelvic conditions.

Vulvodynia

Vulvodynia is characterized by chronic pain or discomfort in the vulvar area without an identifiable cause. This condition can make any form of genital contact, including intercourse, extremely uncomfortable or painful.

Post-Surgical and Trauma-Related Pain

Women who have undergone pelvic surgery or experienced trauma to the pelvic area may develop chronic pain that interferes with sexual function. This can be due to nerve damage, scar tissue formation, or other complications.

Hormonal Imbalances and Sexual Dysfunction

Hormones play a crucial role in female sexual function, influencing everything from desire to physical arousal. Imbalances in key hormones can lead to various sexual health issues.

Genitourinary Syndrome of Menopause (GSM)

GSM, formerly known as vulvovaginal atrophy, is a collection of symptoms resulting from decreased estrogen levels during menopause. These symptoms can include:

• Vaginal dryness and irritation
• Painful intercourse
• Urinary tract issues
• Reduced sexual desire

How does GSM affect sexual function? The physical changes associated with GSM can make sexual activity uncomfortable or painful, while the accompanying symptoms can dampen desire and overall sexual satisfaction.

Other Hormonal Imbalances

Beyond menopause-related changes, imbalances in other hormones such as testosterone, progesterone, and thyroid hormones can also impact sexual function. These imbalances may result from various factors, including:

• Polycystic ovary syndrome (PCOS)
• Thyroid disorders
• Certain medications
• Stress and lifestyle factors

Addressing these underlying hormonal issues is often key to improving sexual health.

Psychological Factors Contributing to Sexual Dysfunction

While physical causes of sexual dysfunction are significant, psychological factors often play an equally important role. Mental health, emotional well-being, and relationship dynamics can all influence sexual function.

Anxiety and Depression

Mood disorders like anxiety and depression can significantly impact sexual desire, arousal, and satisfaction. These conditions may lead to:

• Reduced interest in sexual activity
• Difficulty becoming aroused
• Inability to achieve orgasm
• Overall dissatisfaction with sexual experiences

Moreover, some medications used to treat these conditions, particularly certain antidepressants, can have sexual side effects.

Stress and Fatigue

Chronic stress and fatigue can take a toll on sexual function. When the body is in a constant state of stress, it prioritizes survival functions over reproductive and sexual processes. This can lead to:

• Decreased libido
• Difficulty becoming aroused
• Trouble achieving orgasm
• Reduced overall sexual satisfaction

Managing stress and ensuring adequate rest are crucial for maintaining healthy sexual function.

Body Image and Self-Esteem Issues

A woman’s perception of her body and overall self-esteem can significantly impact her sexual experiences. Negative body image or low self-esteem may lead to:

• Avoidance of sexual situations
• Difficulty relaxing during intimate moments
• Reduced sexual confidence and satisfaction

Addressing these underlying psychological factors is often an important component of treating sexual dysfunction.

Diagnosis and Treatment Options for Female Sexual Dysfunction

Diagnosing and treating female sexual dysfunction often requires a multidisciplinary approach, addressing both physical and psychological factors. Here’s an overview of the diagnostic process and available treatment options:

Diagnostic Approaches

How is female sexual dysfunction diagnosed? The process typically involves:

• Comprehensive medical history, including sexual history
• Physical examination, focusing on the pelvic area
• Laboratory tests to check hormone levels and rule out underlying conditions
• Psychological evaluation to assess mental health and relationship factors

In some cases, specialized tests may be necessary to diagnose specific conditions contributing to sexual dysfunction.

Treatment Options

Treatment for female sexual dysfunction is often tailored to the specific underlying causes and may include a combination of approaches:

Medical Treatments

• Hormone therapy (e.g., estrogen for vaginal dryness)
• Medications to address specific symptoms (e.g., ospemifene for painful intercourse)
• Treatment of underlying medical conditions

Psychological Interventions

• Sex therapy or couples counseling
• Cognitive-behavioral therapy (CBT)
• Mindfulness-based approaches

Lifestyle Modifications

• Stress reduction techniques
• Regular exercise
• Improved sleep habits
• Dietary changes

Non-Pharmacological Treatments

• Pelvic floor physical therapy
• Vaginal dilators for vaginismus
• Lubricants and moisturizers for vaginal dryness

Which treatment approach is most effective? The answer varies depending on the specific type of sexual dysfunction and its underlying causes. Often, a combination of treatments yields the best results.

The Importance of Open Communication and Seeking Help

Addressing female sexual dysfunction requires open communication and a willingness to seek help. Many women feel embarrassed or ashamed to discuss sexual health issues, but it’s crucial to remember that these problems are common and treatable.

How can women overcome barriers to seeking help for sexual dysfunction? Here are some strategies:

• Educate yourself about sexual health and normalize discussions about sexual function
• Choose a healthcare provider you feel comfortable with and build a trusting relationship
• Communicate openly with your partner about your concerns and experiences
• Consider joining support groups or online communities for women with similar issues
• Remember that seeking help is a sign of strength, not weakness

By taking proactive steps to address sexual health concerns, women can improve their overall quality of life and strengthen their relationships.

Female sexual dysfunction is a complex issue with various causes and manifestations. By understanding the different types of sexual dysfunction, their potential causes, and available treatment options, women can take control of their sexual health and work towards more satisfying intimate experiences. Remember, sexual health is an important aspect of overall well-being, and there’s no shame in seeking help to address any concerns or issues that arise.

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.