What is female sexual dysfunction?

Female sexual dysfunction is a general term for anything "wrong" with a woman's sex life. It includes lack of libido (sex drive), problems having sexual intercourse and lack of orgasms.

It is very difficult to know what constitutes "normal" sexual function for women, which makes defining sexual dysfunction very difficult.

Here are some of the different manifestations of female sexual dysfunction, with some pointers on the possible causes and remedies.

Loss of Sex Drive

Possible causes include:

  • Relationship problems. If this is the case, you may find that you are attracted to others but not to your partner. If you can resolve the problems in your relationship, you may find the sexual side of things improves too.
  • Stress/anxiety. Reducing your stress levels may stop anxiety from interfering with your natural urges.
  • Depression. If you suffer from depression, you may well lose interest in all aspects of sex, as well as other things you used to enjoy. Consider talking to your doctor about whether you need counseling or antidepressants.
  • Having a baby. It's natural not to have sex for a few weeks after you have a baby. If your loss of sex drive persists, it may signal post-natal depression or a problem with your relationship.
  • Getting older. Age-related loss of sex drive tends to be gradual, although it may become more marked when you reach the menopause.
  • Contraception. Certain forms of contraception can reduce your sex drive—look in the booklet that comes with your tablets, or talk to your doctor.
  • Medications. Some medicines, especially certain antidepressants, can reduce your sex drive.
  • Alcohol. It's well documented that alcohol can inhibit sexual response.

Pain with Intercourse

Possible causes include:

  • Lack of lubrication. This may be due to lack of arousal or lack of estrogen after the menopause, or while you are breastfeeding. It can be more marked at certain times of your cycle. It tends to make intercourse painful right from the start of penetration. Try and find out what the cause is, if possible. Otherwise try a lubricant—a water-based one if you're using a barrier method of contraception.
  • Vaginismus. This is a spasm of the muscles around the opening of the vagina that makes penetration pretty much impossible. It almost always has a psychological cause, and is more common if you have had major sexual trauma such as sexual abuse or rape. Get yourself referred to a sexual dysfunction clinic with your partner.
  • Vaginal infection. Common infections such as thrush can make intercourse painful all the way up your vagina. Other infections, such as pelvic inflammatory disease may cause deep pain, more marked in certain positions. If you are fairly sure you have thrush, buy treatment from your chemist. If not, consult your doctor.
  • Endometriosis. This can cause deep pain on intercourse as well as painful periods.
  • Painful episiotomy scar after childbirth. These scars are always painful at first, but the pain should settle within a couple of months. If it doesn't, talk to your doctor.

Lack of Orgasm

Not having an orgasm usually has a psychological cause, causing lack of arousal. This may be because of relationship problems; anxiety; past sexual trauma; deeply ingrained negative feelings about sex (such as being taught from an early age that sex is dirty); or inadequate stimulation from your partner.

Lack of orgasm may mean that you have never had an orgasm, or that you have never had one from penetrative sex but can masturbate to orgasm.

If lack of orgasm doesn't concern you, there is no reason to seek help. If it does, you may want to get help before it damages your relationship. There are plenty of self-help books around, but referral to a psychosexual clinic with your partner may be the best option.

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