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Female sexual dysfunction



Female Sexual dysfunction is an age-related, progressive and highly prevalent problem affecting nearly 30-50 percent of women globally.

Sexual activity incorporates interpersonal relationships, each partner bringing unique attitudes, needs and responses into the coupling. A breakdown in any of these areas may lead to sexual dysfunction.

The American Psychological Association (APA) classifies female sexual problems as :-

a). Mental disorders - loss of sexual desire or arousal,

b). Discomfort during intercourse,

c). Diminished blood flow to the vagina,

d). Trauma-related aversion to sex,

e). Inability to achieve orgasm.


If you don't want to have sex or it never feels good, you might have a sexual problem. The best person to decide if you have a sexual problem is you hence awareness of the problem is important.


1). Hypoactive sexual disorder:

Hypoactive sexual desire disorder is characterized by an absence of libido or the intrinsic lack of desire to have sexual relationship. Persistent or recurring deficiency (or absence) of sexual fantasies/thoughts and sexual activity may sometimes cause personal distress.

2). Sexual aversion disorder:

Sexual aversion disorder is characterized by an aversion to or avoidance or dismissal of sexual contact with a sexual partner .

It is generally a psychological or emotional problem that can be due to various other underlying long standing emotional problems , (for e.g -physical or sexual abuse or childhood trauma).

3). Female sexual arousal disorder:

Female sexual arousal disorder When you don't feel a sexual response in your body or you start to respond but can't keep it up.

Some disorders of arousal include, lack of or diminished vaginal lubrication, decreased clitoral and labial sensation, decreased clitoral and labial engorgement or lack of vaginal smooth muscle relaxation. These conditions may occur secondary to psychological factors, however often there is a medical/physiologic basis such as diminished vaginal/clitoral blood flow, previous injury or fracture to pelvic bones, pelvic surgery or sometimes due to certain medications.

4). Female orgasmic disorder:

Female orgasmic disorder is defined as the delay or absence of orgasm after "normal" arousal.

This may be a primary (never achieved orgasm) or secondary condition, as a result of surgery, trauma, or hormone deficiencies. Primary orgasm can be secondary to emotional trauma or sexual abuse, however medical/physical factors can certainly contribute to the problem.

5). Dyspareunia

Dyspareunia is a medical term that indicates genital pain before, during, or after intercourse. In some women, the muscles in the outer part of the vagina tighten when they start to have sex leading to the discomfort.

Dyspareunia can also develop secondary to medical problems such as vestibulitis (inflammation of a gland), vaginal atrophy or dryness of vagina or vaginal infection. Dyspareunia can also be either physiologically or psychologically based, or a combination of the two.

6). Vaginismus:

Vaginismus is another medical term that indicates recurrent or persistent involuntary spasm of the musculature of the outer third the vagina and this interferes with vaginal penetration.

Vaginismus usually develops as a conditioned response to painful penetration, or secondary to psychological/emotional factors.


The causes of female sexual dysfunction are poorly defined. The reason for this is perhaps because sexual intercourse or stimulation is an act that involves many systems to function in harmony for it to reach the stage of orgasm. To simplify its understanding it is best divided depending on the system that predominates in the dysfunction. Sometimes there may be multiple factors leading to the dysfunction Below are few of the causes that can case sexual dysfunction. The most common are listed first:



>Depression -
An unhappy relationship or abuse (now or in the past) can also cause sexual problems.

>Emotional problems; distraction.


>Negative body perception.

The stresses of everyday life can affect your ability to have sex. Being tired from a busy job or caring for young children may make you feel less desire to have sex.

>You may have less sexual desire during pregnancy, right after childbirth or when you are breast-feeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex.


>Vaginal atrophy

>Vascular causes

>High blood pressure

>High cholesterol levels



>Heart disease

>Urinary incontinence

>Spinal cord injury


These are not undertaken commonly. However more recently a few investigations are available.

1). Vagnial pH testing
2). Vaginal photoplethysmography


There are three primary types of treatment for female sexual dysfunction:

When blood flow, hormone levels, and sexual anatomy are normal - Education on female anatomy, arousal and response can help;

When there is hormonal dysfunction (especially in post menopausal women) - Hormone replacement therapy can be considered and is found to be helpful.

When there is a vascular or Blood flow problem - Vascular treatment may be required.


(A):- Education:

Educating both women and men on how to talk about and respond to a woman's psychological and physical stimulatory needs can only happen if both partners recognize that there is a problem.
Behavioral and sex therapists note the need for partners to examine the actual act of having sex, including foreplay, intercourse, and talking about sex.
Sex therapists and psychologists may assist in improving communication between partners.

(B):- Hormone Replacement Therapy:[HRT]

With aging and menopause, and the decreasing estrogen levels, a majority of women experience some degree of change in sexual function. Common sexual complaints include loss of desire, decreased frequency of sexual activity, painful intercourse, diminished sexual responsiveness, difficulty achieving orgasm, and decreased genital sensation.

Hormones play a significant role in regulating female sexual function. In animal models, estrogen administration results in expanded touch receptor zones, suggesting that estrogen effects sensation. In post-menopausal women, estrogen replacement restores clitoral and vaginal vibration and sensation to levels close to those of pre-menopausal women. Estrogens also have protective effects which result in increased blood flow to the vagina and clitoris. This helps to maintain female sexual response over time.

(C:- Eros Therapy:

The Eros Therapy is an FDA-approved device for the treatment of female sexual dysfunction. This small handheld device is used 3 to 4 times per week to increase blood flow to the clitoris and external genitalia, which improves clitoral and genital sensitivity, lubrication, and the ability to experience orgasm. It may take several weeks of conditioning before experiencing the benefits of this therapy.


-.Sildenafil (Viagra®)
-.Phentolamine (Vasomax)


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