Persistent, recurrent problems with s*xual response or desire — that distress you or strain your relationship with your partner — are known medically as female s*xual dysfunction.
Many women experience problems with s*xual function at some point in their lives. Female s*xual dysfunction can occur at all stages of life, and it may be ongoing or happen only once in a while.
You may experience more than one type of female s*xual dysfunction. Types include:
Low s*xual desire. You have diminished libido, or lack of s*x drive.
s*xual arousal disorder. Your desire for s*x might be intact, but you have difficulty or are unable to become aroused or maintain arousal during s*xual activity.
Orgasmic disorder. You have persistent or recurrent difficulty in achieving climax after sufficient s*xual arousal and ongoing stimulation.
s*xual pain disorder. You have pain associated with s*xual stimulation or vaginal contact.
s*xual response involves a complex interaction of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any of these components can affect s*xual drive, arousal or satisfaction. Fortunately, female s*xual dysfunction is treatable.
Female s*xual dysfunction can happen at any age. s*xual problems often develop when your hormones are in flux — for example, after having a baby or during menopause. s*xual concerns may also occur with major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease.
Your problems might be classified as female s*xual dysfunction if you experience one or more of the following — and you’re distressed about it:
Your desire to have s*x is low or absent.
You can’t maintain arousal during s*xual activity, or you don’t become aroused despite a desire to have s*x.
You can’t experience an climax.
You have pain during s*xual contact.
When to see a doctor
If s*xual problems affect your relationship or disrupt your peace of mind, make an appointment with your doctor for evaluation.
Several factors contribute to s*xual dissatisfaction or dysfunction. These factors tend to be interrelated.
Physical. Examples of physical conditions that may contribute to s*xual problems include arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems, and neurological disorders such as multiple sclerosis. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your s*x drive and your body’s ability to experience climax.
Hormonal. Lower estrogen levels after menopause may lead to changes in your private part tissues and s*xual responsiveness. The folds of skin that cover your private part area (labia) become thinner, exposing more of the clitoris. This increased exposure sometimes reduces the sensitivity of the clitoris.
The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active, causing a need for more stimulation to relax and lubricate before intercourse. These factors can lead to painful intercourse (dyspareunia), and it may take longer to experience climax.
Your body’s hormone levels also shift after giving birth and during chest-feeding, which can lead to vaginal dryness and can affect your desire to have s*x.
Psychological and social. Untreated anxiety or depression can cause or contribute to s*xual dysfunction, as can long-term stress. The worries of pregnancy and demands of being a new mother may have similar effects. Longstanding conflicts with your partner — about s*x or other aspects of your relationship — can diminish your s*xual responsiveness as well. Cultural and religious issues and problems with body image also may contribute.
Emotional distress can be both a cause and a result of s*xual dysfunction. Regardless of where the cycle began, you usually need to address relationship issues for treatment to be effective.
Treatments and Drugs
1. Nonmedical treatment for female s*xual dysfunction. To treat s*xual dysfunction, your doctor might recommend that you start with nonmedical strategies:
Talk and listen. Open, honest communication with your partner makes a world of difference in your s*xual satisfaction. Even if you’re not used to talking about your likes and dislikes, learning to do so and providing feedback in a nonthreatening way sets the stage for greater intimacy.
Practice healthy lifestyle habits. Go easy on alcohol — drinking too much can blunt your s*xual responsiveness. Stop smoking — smoking restricts blood flow to your s*xual organs, decreasing s*xual arousal. Be physically active — regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy your s*xual experience.
Seek counseling. Talk with a counselor or therapist who specializes in s*xual and relationship problems. Therapy often includes education about how to optimize your body’s s*xual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.
Use a lubricant. A vaginal lubricant may be helpful during intercourse if you experience vaginal dryness or pain during s*x.
Try a device. Arousal improves with stimulation of the clitoris. Use a vibrator to provide clitoral stimulation. Although some women find clitoral vacuum suction devices helpful for enhancing s*xual arousal, those devices can be cumbersome.
2. Medical treatment for female s*xual dysfunction. Effective treatment for s*xual dysfunction often requires addressing an underlying medical condition or hormonal change.
To treat s*xual dysfunction tied to an underlying medical condition, your doctor might recommend that you:
Adjust or change medication that has s*xual side effects
Treat a thyroid problem or other hormonal condition
Optimize treatment for depression or anxiety
Try strategies for relieving pelvic pain or other pain problems
Treating female s*xual dysfunction linked to a hormonal cause might include:
Estrogen therapy. Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits s*xual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone plays a role in healthy s*xual function in women as well as men, although women have much lower amounts of testosterone. Androgen therapy for s*xual dysfunction is controversial, however. Some studies show a benefit for women who have low testosterone levels and develop s*xual dysfunction; other studies show little or no benefit.
The risks of hormone therapy may vary, depending on whether estrogen is given alone or with a progestin, your age, the dose and type of hormone, and health issues such as your risks of heart and blood vessel disease and cancer. Talk with your doctor about benefits and risks. In some cases, hormonal therapy might require close monitoring by your doctor.
To boost your s*xual health, practice these healthy lifestyle habits:
Avoid excessive alcohol. Drinking too much blunts s*xual responsiveness.
Don’t smoke. Cigarette smoking restricts blood flow throughout your body. Less blood reaches your s*xual organs, which means you could experience decreased s*xual arousal and orgasmic response.
Be physically active. Regular aerobic exercise increases your stamina, improves your body image and elevates your mood. This can help you feel more romantic, more often.
Make time for leisure and relaxation. Learn ways to decrease stress, and allow yourself to relax amid the stresses of your daily life. Being relaxed can enhance your ability to focus on your s*xual experiences and may help you attain more satisfying arousal and climax.