Female sexual dysfunction

Definition

Sexual dysfunction in women may involve a reduction in sex drive, a strong dislike of sexual activity, difficulty becoming aroused, inability to achieve orgasm, or pain with sexual activity or intercourse.

Alternative Names

Frigidity; Sexual dysfunction - female

Considerations

Traditionally, sexual dysfunction in women was thought to be largely due to psychological problems. Recent research is beginning to uncover many physical causes for sexual problems in women. While many sexual problems have an underlying psychological component, possible physical causes must be ruled out in the initial examination.

Common Causes

• Anxiety or depression
• Changes related to menopause
• Communication problems with partner
• Damage to nerves due to surgery or trauma
• Fear of pain, infection, or being pregnant
• Feelings of guilt and shame about sex
• History of sexual abuse
• Infection or gynecological disease
• Lack of appropriate stimulation
• Lack of lubrication
• Medication
• Stress or fatigue

Home Care

Home care depends on the cause. Family planning and birth control may be helpful for problems caused by a fear of pregnancy.

Call your health care provider if

Call your health care provider if the problem is persistent or accompanied by other unexplained symptoms.

What to expect at your health care provider's office

Your health care provider will perform a physical examination, which may include a pelvic exam. Your provider may ask detailed questions about relationships, current sexual practices, attitudes towards sex, other medical conditions you might have, medications you may be taking, and other possible symptoms.

Treatment for sexual dysfunction will depend on the cause. It may include changes in your current sexual activities, stopping or changing medications where possible, adding a new medication, or surgery. Referral to a specialist with expertise in treating sexual dysfunction may be necessary. Psychological counseling may be recommended.

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References

Bhasin S, Basson R. Sexual dysfunction in men and women. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 19.

Shafer LC. Sexual disorders and sexual dysfunction. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 36.

Clayton AH, Hamilton DV. Female sexual dysfunction. Psychiatr Clin North Am. 2010 Jun;33(2):323-38.