Overview

Persistent, recurrent problems with sexual response, desire, orgasm or pain — that distress you or strain your relationship with your partner — are known medically as female sexual dysfunction.

Many women experience problems with sexual function at some point. Female sexual dysfunction can occur at any stage of life. It can be lifelong or be acquired later in life. It can occur only in certain sexual situations or in all sexual situations.

Sexual response involves a complex interplay of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.

Symptoms

Your symptoms will depend on the type or types of female sexual dysfunction you have:

  • Low sexual desire. This most common of female sexual dysfunctions involves a lack of sexual interest and willingness to be sexual.
  • Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

When to see a doctor

If sexual problems affect your relationship or worry you, make an appointment with your doctor for evaluation.

Causes

Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.

Factors, often interrelated, that contribute to sexual dissatisfaction or dysfunction include:

  • Physical. Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sexual desire and your body's ability to experience orgasm.
  • Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in needing more time to build arousal and reach orgasm, as well as less genital sensation.

    The vaginal lining also becomes thinner and less elastic, particularly if you're not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.

    Your body's hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.

  • Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.

    Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness, as well. Cultural and religious issues and problems with body image also can contribute.

Risk factors

Some factors may increase your risk of sexual dysfunction:

  • Depression or anxiety
  • Heart and blood vessel disease
  • Neurological conditions, such as spinal cord injury or multiple sclerosis
  • Liver or kidney failure
  • Certain medications, such as antidepressants or high blood pressure medications
  • Emotional or psychological stress, especially with regard to your relationship with your partner
  • A history of sexual abuse
March 05, 2016
References
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  2. Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home. Accessed July 4, 2015.
  3. McCool ME, et al. Prevalence and predictors of female sexual dysfunction: A protocol for a systematic review. Systematic Reviews. 2014;3:1.
  4. Fact sheet: Female sexual dysfunction. Hormone Health Network. http://www.hormone.org/questions-and-answers/2012/female-sexual-dysfunction. Accessed July 4, 2015.
  5. Effective treatments for sexual problems. The North American Menopause Society. http://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems. Accessed July 10, 2015.
  6. Overview of female sexual function and dysfunction. Merck Manual Professional Version. https://www.merckmanuals.com/professional/gynecology-and-obstetrics/sexual-dysfunction-in-women/overview-of-female-sexual-function-and-dysfunction. Accessed July 10, 2015.
  7. Khamba B, et al. The efficacy of treatment of sexual dysfunction secondary to antidepressants. The Journal of Alternative and Complementary Medicine. 2013;19:862.
  8. Laughlin-Tommaso, SK (expert opinion). Mayo Clinic, Rochester, Minn. July 16, 2015.
  9. FDA approves first treatment for sexual desire disorder. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm. Accessed Aug. 18, 2015.
  10. Addyi (prescribing information). Raleigh, N.C.: Sprout Pharmaceuticals Inc.; 2015. http://www.addyi.com/wp-content/uploads/2015/08/addyi-pi-8-18-15-FINAL2.pdf. Accessed Aug. 18, 2015.
  11. Jaspers L, et al. Efficacy and safety of flibanserin for the treatment of hypoactive sexual desire disorder in women. JAMA Internal Medicine. In press. Accessed March 2, 2016.

Female sexual dysfunction