Understanding Female Sexual Dysfunction

Sexual Health can be a difficult subject for people to talk about, and for those with sexual dysfunction, it can be even more challenging.

It is estimated that roughly 31% of men and 43% of women will experience sexual dysfunction. While male erectile disorders are often spoken about, female sexual dysfunction (FSD) is not commonly discussed despite its high prevalence.

In this post, we’ll explore the different types of FSD, common causes, and available treatment options.

Types of Female Sexual Dysfunction

FSD encompasses various symptoms, but it is typically broken into the following four categories.

1) Desire Disorders
Disorders of sexual desire are the most common type of female sexual dysfunction, impacting around 30% of women. Those with desire disorders often report decreased or lack of desire for sexual activity or fantasies. Despite being common, this issue is often underreported.

2) Arousal Disorders
Disorders surrounding arousal are the second most common sexual concern. This can include a lack of lubrication or sensation in the genitals, or the physical response to sexual stimulation without any mental awareness of sexual pleasure.

3) Orgasmic Disorders
Orgasmic disorders may include the delay or absence of an orgasm, or decreased intensity of orgasm, despite adequate sexual stimulation. It is estimated that orgasmic dysfunction impacts 20-40% of women.

4) Sexual Pain Conditions
Sexual pain conditions, also known as Genito-Pelvic Pain/Penetration Disorder (GPPD), describe pelvic pain that can occur during and/or following sexual activity. This pain may be superficial or deep, and it may have occurred since the first attempt at sexual activity or developed over time. Some people may report an inability to have penetrative sex, which is called vaginismus.

Causes of Female Sexual Dysfunction

Anyone can experience sexual dysfunction, but certain life events make women or those assigned female at birth (AFAB) more likely to develop sexual health issues.

These include the postpartum period and menopause, due to the hormonal changes that can impact sexual health

Medical conditions that can cause or contribute to FSD include:

• Diabetes
• Hypertension (high blood pressure)
• Endometriosis
• Chronic pain conditions (e.g., arthritis, fibromyalgia)
• Neurological disorders (e.g., multiple sclerosis, spinal cord injuries)
• Gynecological conditions (e.g., vulvodynia, vestibulitis, uterine fibroids)
• Hormonal imbalances (e.g., thyroid disorders, polycystic ovary syndrome)
• Cancer and cancer treatments (e.g., chemotherapy, radiation, surgery)
• Cardiovascular disease
• Pelvic floor disorders

Psychological factors can also have a measurable impact on sexual function. This includes:

• Stress
• Anxiety
• Depression
• Body image issues
• History of sexual abuse or trauma
• Relationship difficulties
• Poor self-esteem
• Past negative sexual experiences
• Concerns about sexual performance
• Feelings of guilt or shame around sexuality

Relationship problems, communication issues, and societal pressures can further exacerbate FSD

Treatment Options for FSD

Fortunately, there are numerous treatment options available to address FSD and improve sexual well-being. A multidisciplinary team approach is often necessary, as sexual health involves the whole person and treatment options vary patient to patient.

Medication and Hormone Therapy
For some cases of FSD, treatment may involve resolving an imbalance in hormones. For desire disorders, medications like flibanserin or bremelanotide may be prescribed to increase sexual desire.
Similarly, for arousal disorders topical estrogen creams or vaginal suppositories can help improve vaginal lubrication and sensation.

Hormone replacement therapy (HRT) can also be beneficial for women experiencing sexual dysfunction related to hormonal changes, such as those going through menopause.

Psychotherapy and Counseling
Therapies aimed at improving sexual self-image, enhancing intimacy, and developing coping strategies for sexual difficulties is another powerful treatment option.

This might include cognitive-behavioral therapy (CBT), sex therapy, or couples counseling with the goal of addressing psychological and interpersonal factors contributing to FSD, such as anxiety, depression, trauma, and communication issues.

Pelvic Floor Therapy
For sexual pain conditions like GPPD, pelvic floor physical therapy can help address underlying pelvic floor muscle dysfunction, reducing pain and improving sexual function.

Techniques may include internal and external manual therapy, biofeedback, and exercises to strengthen and relax the pelvic floor muscles.

Lifestyle and Behavioral Modifications
Sometimes the changes necessary have nothing to do with sex and everything to do with lifestyle. Regular exercise, stress management techniques, and addressing any underlying medical conditions can positively impact sexual function. The use of personal lubricants, moisturizers, and vibrators can also be helpful in addressing arousal and pain-related concerns.

Combination Therapies
In many cases, a combination of the above-mentioned treatments will be the most effective approach.
This could involve a combination of medication, therapy, and lifestyle interventions to address the multifaceted nature of FSD.

Closing Thoughts

Sexual dysfunction can be very distressing, but it’s important to remember that you’re not alone.

By understanding the different types of FSD, their causes, and the available treatment options, you can take the first step toward improving your sexual well-being.

Don’t hesitate to reach out to a healthcare provider trained in sexual medicine to get the support and care you deserve.

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