Female sexual dysfunction refers to recurrent problems during any phase of the sexual response cycle (excitement, plateau, orgasm, resolution) that causes distress or negatively affects your relationship with your partner. This condition affects 43% of women of all ages and is most common in those aged 45-64.
The following factors tend to be related:
Conditions that may cause problems with sexual function include diabetes, heart disease, cancer, neurological disorders (depression, anxiety, history of sexual abuse), arthritis, fatigue, headaches, urinary or bowel difficulties, alcoholism, and drug abuse. The side effects of certain medications, including antidepressant drugs, blood pressure medications, and chemotherapy drugs, can affect sex drive and functioning.
During menopause in particular, estrogen levels decrease, which can cause changes to occur in your genital tissues and your sexual responsiveness. Intercourse may become painful (dyspareunia), and/or it may take longer for you to achieve an orgasm.
Untreated emotional and psychological issues need to be addressed for treatment to be effective. Factors that affect sexual functioning may include anxiety, depression, stress, sexual abuse in the past, self-perception during and after pregnancy, and conflict with you partner.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include medical conditions or diseases, hormonal changes, side effects of medications, and psychological and social conditions.
Symptoms of sexual dysfunction include experiencing personal distress because of one or more of the following:
Defining sexual dysfunction is largely dependent on your own view of sexual difficulties and your relationship with your partner.
Your doctor will ask about your symptoms, medical history, sexual history, and the medications you take. Your doctor will also conduct a gynecologic exam. You may also have a psychological evaluation.
Your bodily fluids may be tested. This can be done using:
Because many factors can lead to the disorder, both medical and nonmedical treatments may be recommended.
Medical treatments address the underlying conditions, and include the following:
Other treatments to improve sexual health and decreased desire include:
You can't avoid all the risk factors for female sexual dysfunction. However, the steps below will help you avoid certain risk factors.
American Academy of Family Physicians
American Congress of Obstetricians and Gynecologists
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
American Congress of Obstetricians and Gynecologists. Female sexual dysfunction. Practice Bulletin. 2011;119.
Berman JR, Adhikari SP, Goldstein I. Anatomy and physiology of female sexual function and dysfunction. European Urology. 2000;38:20-29.
Berman JR, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology. 1999;54(3):385-391.
Dennerstein L. How changing methods affect our understanding of female sexual function and dysfunction J Sex Med. 2010;7(7):299-300.
Female sexual dysfunction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 12, 2013. Accessed January 7, 2013.
Phillips NA. Female sexual dysfunction: evaluation and treatment. Am Fam Physician. 2000;62(1).
9/16/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Huang A, Yaffe K, Vittinghoff E, et al. The effect of ultralow-dose transdermal estradiol on sexual function in postmenopausal women. Am J Obstet Gynecol. 2008;198:265.e1-7.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Shifren JL, Monz BU, Russo PA, Segreti A, Johannes CB. Sexual problems and distress in United States women: prevalence and correlates. Obstet Gynecol. 2008;112:970-978.
Last reviewed December 2013 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.