Female Sexual Dysfunction

June 18th, 2008

Definition:
When you have problems with sex, doctors call it “sexual dysfunction.” Both men and women can have it. There are 4 kinds of sexual problems in women.

* Desire disorders - When you are not interested in having sex or have less desire for sex than you used to.
* Arousal disorders - When you don’t feel a sexual response in your body or you cannot stay sexually aroused.
* Orgasmic disorders - When you can’t have an orgasm or you have pain during orgasm.
* Sexual pain disorders - When you have pain during or after sex.

Symptoms:
The symptoms of sexual dysfunction can include lack of sexual desire, an inability to enjoy sex, insufficient vaginal lubrication, or, even if sexually aroused, a failure to achieve an orgasm.The female equivalent of impotence is known as Female Sexual Arousal Disorder (FSAD).

Your problems might be classified as female sexual dysfunction if you experience one or more of the following and you’re distressed about it:

* Your desire to have sex is low or absent.

*You can’t maintain arousal during sexual activity, or you don’t become aroused despite a desire to have sex.

*You cannot experience an orgasm.

*You have pain during sexual contact.

When men and women become sexually aroused, their genitals become engorged with blood.

In women this normally results in:

* Enlargement of the clitoris and surrounding tissues (comparable to a male erection)
* Secretion of vaginal lubrication
* Relaxation and widening of the vaginal opening to permit intercourse.

FSAD patients have the desire to have sex but their genital area fails to respond in the normal way, making sex painful or impossible.

Causes:
Inadequate sexual function in women is a complex problem that can have many different causes. It is estimated that up to 40% of women suffer from sexual dysfunction. This might be caused by physical illness, but is often linked to psychological factors.

Many things can cause problems in your sex life. Certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high blood pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction.

You may have less sexual desire during pregnancy, right after childbirth or when you are breastfeeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex due to a decrease in estrogen (a hormone in the body).

The stresses of everyday life can also affect your ability to have sex. Being tired from a busy job or caring for young children may affect your sexual desire. You may also be bored by a long-standing sexual routine.

How do you know if you have a problem?
Up to 70% of couples have a problem with sex at some time in their relationship. Most women will have sex that doesn’t feel good at some point in her life. This doesn’t necessarily mean you have a sexual problem.

If you don’t want to have sex or it never feels good, you might have a sexual problem. Discuss your concerns with your doctor. Remember that anything you tell your doctor is private and that your doctor can help you find a reason and possible treatment for your sexual dysfunction

FSAD can result from an underlying medical condition, such as high blood pressure or diabetes.

It can also be caused by irritations, infections and growths in the vaginal area, or reactions to contraceptive devices.

Medications used to treat high blood pressure, peptic ulcers, depression or anxiety and cancer may also cause problems.

Another factor is the physical, hormonal and emotional changes that occur during or after pregnancy or while breast feeding.

However, FSAD is usually linked to psychological causes. These can include:

* Inadequate or ineffective foreplay
* Depression
* Poor self-esteem
* Sexual abuse or incest
* Feelings of shame or guilt about sex
* Fear of pregnancy
* Stress and fatigue

Orgasm problems:

Women who suffer from Female Orgasmic Disorder (FOD) are unable to achieve orgasm despite being sufficiently aroused to have sex.

Women differ from men in that orgasm is a learned, not automatic, response. About five to ten percent of women never have an orgasm through any type of sexual activity - a condition called anorgasmia.

Anorgasmia is most often the result of sexual inexperience, performance anxiety, or past experiences, such as sexual trauma or a strict upbringing, that have led to an inhibition of sexual response.

Some women are able to enjoy sexual activity in spite of reaching orgasm only some or even none of the time. FOD is a problem only if it has a negative effect on the satisfaction of a woman or her partner.

Diagnosis:
You might be reluctant to consult your doctor about sexual concerns, but your sexuality is integral to your well-being — and it’s standard practice during general medical visits for doctors to ask about sexual health. The more forthcoming you can be about your sexual history and current problems, the better your chances of finding an effective approach to treating them.

You may need a pelvic exam, during which your doctor will check for any physical changes that may be diminishing your sexual enjoyment, such as thinning of your genital tissues, decreased skin elasticity, scarring or pain.

Your doctor may also refer you to a counselor or therapist specializing in sexual and relationship problems.

Female sexual dysfunction is generally divided into the following four categories, which are not mutually exclusive:

* Low sexual desire. You have diminished libido, or lack of sex drive.
* Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty 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.

Sexual response is a complex interaction of many components, including physiology, emotions, experiences, beliefs, lifestyle and relationships. If any one of these components is disrupted, sexual drive, arousal or satisfaction may be affected.

Treatment:

Natural Solutions:
If desire is the problem, try changing your usual routine. Try having sex at different times of the day, or try a different sexual position.

Arousal disorders can often be helped if you use a vaginal cream or sexual lubricant for dryness. If you have gone through menopause, talk to your doctor about taking estrogen or using an estrogen cream.

If you have a problem having an orgasm, you may not be getting enough foreplay or stimulation before actual intercourse begins. Extra stimulation (before you have sex with your partner) with a vibrator may be helpful. You might need rubbing or stimulation for up to an hour before having sex. Many women don’t have an orgasm during intercourse. If you want an orgasm with intercourse, you or your partner may want to gently stroke your clitoris. Masturbation may also be helpful, as it can help you learn what techniques work best for you.

If you’re having pain during sex, try different positions. When you are on top, you have more control over penetration and movement. Emptying your bladder before you have sex, using extra lubrication or taking a warm bath before sex all may help. If you still have pain during sex, talk to your doctor. There are a variety of causes of pain during sex, so talk with your doctor. He or she can help you find the cause of your pain and decide what treatment is best for you.

Talk with your partner about what each of you like and dislike, or what you might want to try. Ask for your partner’s help. Remember that your partner may not want to do some things you want to try, and you may not want to try what your partner wants. You should respect each other’s comforts and discomforts. This helps you and your partner have a good sexual relationship. If you feel you can’t talk to your partner, your doctor or a counselor may be able to help you.

On-going research suggests that Viagra, the anti-impotence drug for men, may help to treat sexual disorders in women by increasing blood flow to the sexual organs and thereby increasing physical stimulation in the area.

……

However, the scientific community is still waiting for firm evidence to be published that the drug that the drug can work on women. A small study published earlier this year found no positive impact on postmenopausal women.

For the moment, doctors concentrate, where possible, on eliminating medications that might have a negative effect on sexual performance.

They also review contraceptive methods to ascertain whether this is a factor.

Women who suffer from vaginal dryness may also be recommended to use lubricants during intercourse.

Modern Medical treatment :
Effectively treating sexual dysfunction often requires addressing an underlying medical condition or hormonal change that’s affecting your sexuality.

Treating female sexual dysfunction tied to an underlying medical condition might include:

* Adjusting or changing medications that have sexual side effects
* Treating thyroid problems or other hormonal conditions
* Optimizing treatment for depression or anxiety
* Strengthening pelvic floor muscles
* Trying strategies recommended by your doctor to help with pelvic pain or other pain problems

Treating female sexual dysfunction linked to a hormonal cause might include:

* Estrogen therapy. Localized estrogen therapy — in the form of a vaginal ring, cream or tablet — can improve sexual function in a number of ways, including improving vaginal tone and elasticity, increasing vaginal blood flow, enhancing lubrication, and having a positive effect on brain function and mood factors that impact sexual response.
* Progestin therapy. In some research studies, women taking progestins experienced a decrease in sexual desire and vaginal blood flow. However, in other studies, women experienced improvements in desire and arousal when they took progestin in addition to estrogen. More studies are under way to see if different progestin regimens, alone or in combination with estrogen and other hormonal agents, may benefit sexual function. Progestins generally are prescribed to balance estrogen’s effect on the uterus and not to treat female sexual dysfunction.

* Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone is important for sexual function in women as well as men, although testosterone occurs in much lower amounts in a woman. Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction, other studies show little or no benefit.

Testosterone may be given as a cream or gel patch applied to your skin. Sometimes, testosterone is given as a pill or injection. Side effects, such as acne, excess body hair (hirsutism), enlargement of the clitoris, and mood or personality changes, are possible. Because long-term effects of testosterone therapy in women aren’t known, you should be closely monitored by your doctor.

Hormonal therapies won’t resolve sexual problems that have causes unrelated to hormones. Because the issues surrounding female sexual dysfunction are usually complex and multifaceted, even the best medications are unlikely to work if other emotional or social factors remain unresolved.

Emerging treatments
Tibolone is a drug currently used in Europe and Australia for treatment of postmenopausal osteoporosis. In a small study, women taking the drug experienced an increase in vaginal lubrication, arousal and sexual desire. But Tibolone hasn’t yet received Food and Drug Administration (FDA) approval for use in the U.S.

Some doctors recommend that women use Kegel exercises, which help to develop the muscles around the outer portion of the vagina that are involved in pleasurable sensations.

Psychological counselling can also play an important part in treating women with sexual problems, as can coaching in sexual foreplay and stimulation techniques.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://news.bbc.co.uk/2/hi/health/medical_notes/486081.stm
http://familydoctor.org/online/famdocen/home/women/reproductive/sex-dys/612.html
http://www.mayoclinic.com/health/female-sexual-dysfunction/DS00701/DSECTION=6