SEXUAL DYSFUNCTION, FEMALE

General Information

DEFINITION--Female sexual dysfunction may involve an inability to experience sexual pleasure (arousal dysfunction); or an inability to achieve orgasm (orgasmic dysfunction).

BODY PARTS INVOLVED--Brain and central nervous system; autonomic nervous system.

SEX OR AGE MOST AFFECTED--Sexually active women.

SIGNS & SYMPTOMS

• Lack of sexual desire; inability to enjoy sex.
• Lack of vaginal lubrication.
• Failure to achieve orgasm, even when sexually aroused.

CAUSES

• Inadequate or ineffective foreplay.
• Psychological problems, including depression, poor self-esteem, sexual abuse or incest. Feelings of shame or guilt about sex. Fear of pregnancy. Stress and fatigue.
• Two-career marriages (work, children and household tasks leave little energy for sex).
• Acute illness or chronic illness.
• Inexperience or inadequate information about sexuality on the part of either partner.
• Repressed anger toward the sexual partner that may result from feelings of being used as a sexual object, physical or emotional abuse, jealousy or fears of disloyalty, or lack of true intimacy.
• Drug abuse including alcohol.
• Gynecologic factors (infection or other disorders).
• Aging (sexual desire may decline).
• Children (hormonal changes in pregnancy cause many women to lose interest in sex).
• Surgery on the reproductive organs.

RISK INCREASES WITH

• Use of some medications, such as MAO inhibitors, antidepressants, beta-adrenergic blockers, narcotics, barbiturates and for some women, use of birth-control pills.
• Couple discrepancies in expectations and attitudes towards sex.
• Proximity of other people in the home (children, mother-in-law).

HOW TO PREVENT

• Talk with your partner about your needs.
• Seek counseling to resolve feelings.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests may include laboratory blood tests and other studies to rule out physical causes of arousal or orgasmic dysfunction.
• If no physical problems are found, a detailed sexual history is the most important tool for determining an appropriate treatment program.

APPROPRIATE HEALTH CARE

Possible treatment methods:

• For childhood sexual abuse problems- psychotherapy or counseling.
• For arousal dysfunction-relaxation techniques, sensate focus exercises, counseling (usually with a sex therapist).
• For orgasmic problems-self stimulation, new behavior patterns and sexual homework with partner (usually in conjunction with sex therapy.
• For medication caused problems-change in dosage, discontinuing or different medication.
• Other problems-family therapy, sensate conditioning, referral to sex therapist.

POSSIBLE COMPLICATIONS

• Permanent inability to enjoy sex.
• Damage to interpersonal relationships.

PROBABLE OUTCOME--Best predictors of positive outcome are the desire to change and an overall healthy relationship. Arousal dysfunction is more difficult to treat and outcome may vary.

How To Treat

GENERAL MEASURES--

• Self-help suggestions for you and your partner: Admit the problem and try to establish open communication with your partner. Pretending to have orgasms leaves the problem unsolved. Reduce stress in your life (see How to Cope with Stress in Appendix). Spend time together as a couple that is nonsexual; go on regular dates. Spend time touching or cuddling that doesn't lead to sex. Don't let age stop you from enjoying sex. You are never too old for sexual activities.

MEDICATION--Medication is not necessary unless the sexual problem is due to some underlying medical condition.

ACTIVITY--No restrictions. Exercise regularly to reduce stress and improve your self-image. A healthy body and mind promote enjoyable sex.

DIET-- Eat a well-balanced diet. Vitamin and mineral supplements may be helpful. Weight loss program may be recommended if either partner is overweight. Avoid alcohol.

Call Your Doctor If

You have sexual problems and you want help in resolving them.