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Recognizing the Symptoms of Female Sexual DysfunctionDiagnosing Female Sexual DysfunctionIdentifying the Causes of Female Sexual DysfunctionTreating Female Sexual Dysfunction MedicallyCoping with Female Sexual Dysfunction

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Female sexual dysfunction (FSD) is complex; it often includes both a physiological component and a set of social, emotional, and psychological factors. There are four primary categories of FSD: low sexual desire, difficulty with arousal, lack of orgasm, and pain during sexual intercourse. Within each category, though, there are a number of potential causes and treatments. FSD can be frustrating, embarrassing, and upsetting, but there are ways to cope with your condition and work towards a healthy sex life. Start with Step 1 to learn more.

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EditPart 1 of 5: Recognizing the Symptoms of Female Sexual Dysfunction

  1. 1
    Take a lack of sexual desire seriously. It’s normal not to want sex when you are feeling tired, sick, stressed, or unhappy in your relationship. But if you notice that you have very low or nonexistent sexual desire most or all of the time, that’s a problem. You should seek treatment.
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  2. 2
    Pay attention to an inability to become aroused. Women with FSD frequently report that they do not feel aroused during sex or do not produce sufficient vaginal lubrication. If you do not become aroused during sexual activity, you should follow up with your physician.
  3. 3
    Understand that a lack of orgasm (anorgasmia) is a sign of female sexual dysfunction. If you do not have orgasms during sexual activity, you may simply need more (or different) stimulation. If, however, you have tried making adjustments and still cannot climax, you may have FSD. See your doctor to rule out certain medical causes and seek treatment.
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    Do not dismiss pain during intercourse. Persistent pain during sexual activity is a symptom of female sexual dysfunction and can occur for a variety of reasons. It’s important to see a doctor to rule out purely physical issues like endometriosis, ovarian cysts, and sexually transmitted infections. If there is no other discernible cause, you may be diagnosed with vaginismus (a specific form of FSD in which the muscles surrounding the vaginal entrance spasm involuntarily) or dyspareunia (a specific form of FSD in which sexual activity causes pain).

EditPart 2 of 5: Diagnosing Female Sexual Dysfunction

  1. 1
    Make an appointment with your primary care physician or gynecologist. To diagnose female sexual dysfunction, you’ll need to see a medical professional. Do not rely on a therapist alone (although therapy may indeed become an important part of your treatment). FSD is a medical condition, and a medical doctor needs to ensure that your sexual and reproductive organs are otherwise healthy.
  2. 2
    Give a complete medical and sexual history. Your doctor should ask for a detailed medical history, and he or she should also ask you about your sexual experiences. Many women find answering these questions embarrassing, but do your best to give complete and accurate responses. Be prepared to discuss:
    • your sexual identity and orientation
    • your sexual partner or partners and your relationship status
    • your ability or inability to feel sexual desire, become aroused, and achieve orgasm
    • any pain or discomfort you may be experiencing during sexual activity
    • the specific details of your symptoms and whether they occur with every partner and in every sexual position
    • any history of upsetting or traumatic sexual experiences
  3. 3
    Have a pelvic examination. Your doctor will probably recommend a standard pelvic exam, and this is a good first step. During a pelvic exam, he or she will examine your vulva, vagina, and cervix and perform a Pap test to check for any pre-cancerous or cancerous changes in your cervical cells.
    • Pelvic exams are generally painless, though they sometimes involve mild discomfort. If, however, you find the pelvic examination painful – particularly the insertion of the speculum (a medical device used to examine the cervix) – this may itself be a sign of vaginismus, a particular form of female sexual dysfunction. Be sure to report any discomfort to your doctor immediately.
  4. 4
    Undergo additional tests as recommended. In addition to the Pap test, your doctor may recommend various diagnostic tests to rule out physical conditions that may be causing or contributing to your symptoms.
  5. 5
    Get a specific diagnosis. Depending on the results of your tests and your description of your symptoms, your doctor may diagnose you with female sexual dysfunction, which may be global (occurring in all sexual situations) or situational (occurring in particular situations or with particular partners). He or she may also make a more specific designation, which can be helpful in pursuing the appropriate treatments. For example, you may have:
    • a disorder of desire (a condition involving a lack of sexual desire)
    • an arousal disorder (a condition involving a lack of sexual arousal)
    • an orgasmic disorder (a condition involving the inability to have an orgasm)
    • a sex pain disorder (a condition involving pain during sex, such as vaginismus or dyspareunia).

EditPart 3 of 5: Identifying the Causes of Female Sexual Dysfunction

  1. 1
    Check for physical causes. FSD is a very complex medical condition. It can stem directly from a physical cause, or it may involve physical, emotional, psychological, and social factors in any combination. To begin with, though, your doctor should look for physical causes of your symptoms. These may include:
    • urinary problems
    • bowel problems
    • neurological disorders
    • arthritis
    • pain disorders
    • endometriosis
    • pelvic inflammatory disease (PID)
    • uterine, cervical, or vaginal problems
    • sexually transmitted infections
    • complications following pelvic surgery
  2. 2
    Consider hormonal causes. Women’s hormones shift at various times in life, including at puberty, during pregnancy and after giving birth, when breastfeeding, and during menopause. These hormonal shifts can affect your sexual desire and satisfaction. During menopause, in particular, your decreased estrogen levels may create changes in your genitals themselves and in your experience of sex.
  3. 3
    Discuss your medications with your doctor. Certain medications may decrease your sex drive or make it more difficult for you to have an orgasm. These include certain antidepressants as well as blood pressure medications, antihistamine medications, and chemotherapy medications.
  4. 4
    Don’t neglect psychological causes. FSD often has a psychological component, even when there are also physical issues present. Anxiety, depression, and stress can create difficulties with desire, arousal, and orgasm, as can traumatic events from your past. Problems with body image and self confidence may also cause or exacerbate female sexual dysfunction.
  5. 5
    Evaluate your relationship. If your symptoms are new or specific to a particular partner, then your relationship may be contributing to your symptoms. This may be especially true if your relationship is a stressful, emotionally-draining, or abusive one.
  6. 6
    Take social factors into consideration. For some women, circumstances related to culture, religion, and upbringing may play a role in FSD. If you were raised to view female sexuality as dirty, wrong, or threatening, for example, you may need to deal with the issues that resulted from your upbringing.

EditPart 4 of 5: Treating Female Sexual Dysfunction Medically

  1. 1
    Address any underlying physical problems. Treating FSD is complicated, and treatments vary tremendously depending on your specific symptoms and circumstances. That said, the first step should be addressing physical causes. If your doctor discovers any medical problems that may be causing or contributing to your symptoms, you may find relief simply by treating those problems.
  2. 2
    Treat hormonal causes. If your FSD is caused or exacerbated by hormonal problems, you may benefit from estrogen and/or androgen therapy. Estrogen (a female hormone) can be used in the form of a vaginal cream, tablet, or ring; it can improve blood flow and address any issues you may have with elasticity and lubrication. Androgen (“male” hormones like testosterone, which are also found, in lower levels, in women) is a more controversial treatment for female sexual dysfunction, but your physician may recommend that you try it.
  3. 3
    Adjust your medications. If you are taking medications that may have sexual side effects, your doctor may be able to adjust your dosage or switch you to something different.
  4. 4
    Consider medication for psychological conditions. If you have depression, anxiety, panic disorders, post-traumatic stress disorder (PTSD), or other psychological issues, you may need to try medication. If you are already taking medication for any of these conditions, your prescription and dosage may need to be adjusted.
  5. 5
    Try physical therapy. If one of your symptoms is pain during intercourse, you may benefit from some forms of physical therapy. Women with vaginismus, for example, sometimes treat it successfully by using prescribed dilators to become gradually accustomed to penetration. Ask your doctor for a referral.

EditPart 5 of 5: Coping with Female Sexual Dysfunction

  1. 1
    Communicate openly with your sexual partner or partners. Honest communication is absolutely crucial for women with FSD. Tell your partner what your symptoms are; request patience and understanding. Some women find discussing sex embarrassing or intimidating, but it can be very helpful to convey your likes and dislikes to your partner and help this person support you.
  2. 2
    Find a therapist. If at all possible, find a therapist, counselor, psychologist, or psychiatrist who specializes in relationships and sexuality. Even if the causes of your FSD are physical, a therapist can help you cope. If some of the causes of your symptoms are psychological or social, therapy is even more important: your therapist can work with you to devise a treatment strategy.
    • Depending on your symptoms and circumstances, part of this therapy may be educational. Your therapist can help you learn about female desire, arousal, and orgasm, and he or she may be able to help you and your partner find techniques and strategies to make sexual activity more comfortable and satisfying.
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    Do Kegel exercises. Kegel exercises target the muscles of your pelvic floor. To do a Kegel exercise, contract the muscles you would use to stop the flow of urine; hold for a few seconds, then relax. Try to do twenty at a time, as many times per day as possible. These exercises may help make sex more comfortable and satisfying.
  4. 4
    Try artificial lubrication. Vaginal lubricants are available over the counter and can help you have a more satisfying sex life, especially if dryness and a lack of arousal are problems for you. In general, water-soluble lubricants are best; you want something without chemicals, added sugars, or glycerin, which could cause irritation.
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    Modify your sex life. Some women find that their problems with desire, arousal, and orgasm are related, at least in part, to feelings of boredom. Consider using erotic books or videos to help you feel sexier; if you feel comfortable, try adding sex toys or acting out fantasies with your partner. If painful intercourse is a problem for you, try engaging in sexual activities that do not include intercourse.
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    Find activities that help you relax. Try yoga, meditation, walking, gardening, or reading – the key is to find something that makes you feel calm, centered, and healthy.
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    Look for additional sources of support. Community and online support groups may help you feel less alone.
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EditTips

  • Unfortunately, female sexual dysfunction (along with female sexuality in general) is not understood completely by the medical community. Certain doctors and therapists may be more knowledgeable than others, so look for professionals who are experienced, supportive, sensitive, and responsive to your concerns. You may have to try more than one person.
  • One of the biggest struggles for women with female sexual dysfunction is embarrassment. They often feel too embarrassed to report their symptoms to their physicians or therapists, and they avoid romantic and sexual relationships rather than having to explain their issues to potential partners. Do your best to overcome these feelings, if you have them. You deserve a healthy, happy, satisfying sexual life. It’s worth it to tell your doctor about your symptoms and pursue treatment.
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Categories: Women’s Health

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