Female Sexual Dysfunction – Causes, Symptoms and Treatment

If you’re reading this article, you may be trying to seek some relief, some guidance, some answers for why you’re struggling with an issue that you may not even know the name of yet. This overarching term — female sexual dysfunction — encompasses a variety of issues that impact both the physical and psychological components of women all over the world. And we’re here to help you figure out where to get started. 

Female sexual dysfunction is an umbrella term for women who experience pain during sex, painful spasms or contractions, low libido, and issues concerning orgasm and arousal. 

Approximately 40% of women worldwide have some type of sexual dysfunction, according to the National Institute of Health. 

What is sexual dysfunction? 

Having a sexual dysfunction can fall under these categories:

• Low libido/lack of desire to have sex. 
• Involuntary muscle spasms, known as vaginismus. 
• Vulvodynia, which is long-term persistent pain around the vulva. 
• Difficulty achieving an orgasm is known as female orgasmic disorder. 
• Medication-induced dysfunction
• Persistent genital arousal disorder

However, keep in mind that sexual dysfunction can be classified as something that doesn’t fall into these bullet points. It’s a broad swoop of conditions, and it isn’t limited to these few concerns.

What causes sexual dysfunction?

It’s difficult to pinpoint the exact cause of many of these conditions, which is why visiting a doctor is incredibly important because many different components may contribute to sexual dysfunction. 

Sexual function and dysfunction are related to the mind and body connection. In fact, sex can actually improve the brain’s cognition and reaction to stress, something we also store in the body.

For example, while you may feel desire, or have a high libido, you may have lubrication issues or cannot achieve an orgasm even though you want to. Something seems amiss, the mind is telling the body what it wants. Or, another example, is that you don’t desire sex, and your libido is low, however, you have persistent genital arousal disorder which leads to painful, almost constant orgasms or arousal. There may be a disconnect here and that link needs to be found again. 

Usually, a professional will examine both the mind (psychological) and the body (physical) to assess for a precise diagnosis. But this is also difficult to decipher. Psychological components can manifest physically and vice versa, meaning it can be a cyclical issue with a classic, “What came first? The egg or the chicken,” type diagnosis. 

Psychologically, depression and anxiety can contribute to sexual dysfunction. Sometimes, if depression is treated, a person’s sexual dysfunction can be improved. However, on the flip side, a person who begins taking antidepressants may notice a side effect such as low libido with their selective serotonin reuptake inhibitor (SSRI). 

Body image, past trauma, past abuse, current abuse, rejection, grief, and other mental illnesses can contribute to sexual dysfunction as well. 

In addition to this, shame over sex or sexually transmitted infections can also contribute to your interest or desire to have sex. This can manifest into vaginismus, where your muscles involuntarily contract, due to psychological factors that associate sex with something negative. 

Furthermore, contextual factors may contribute to sexual dysfunction. These are considered a person’s current situation. For example, fertility issues, surgery, attraction to your partner, the eroticism of the bedroom, or work stress can all create sexual dysfunction. 

Physically, hormones, medication, and illicit drug use may all be factors of sexual dysfunction. 

Menopausal women struggle with hormonal changes, which can cause vaginal dryness, changes in the urinary tract, and lack of libido. The walls of the vagina become thin during menopause, causing dryness and inelasticity due to decreased estrogen levels. This is something called vulvovaginal atrophy, and it makes intercourse incredibly painful. Oftentimes, women find relief in estrogen cream or lubrication. 

Sometimes, chronic pain conditions like fibromyalgia, irritable bowel syndrome, or interstitial cystitis can cause sexual dysfunction, which is the case for vulvodynia, where women are three times more likely to have one of these conditions. 

How is sexual dysfunction diagnosed? 

If your condition hasn’t resolved in six months, visiting the doctor is the main way to get diagnosed for your sexual dysfunction. Your doctor will interview you, and sometimes your partner, and go over your concerns. Oftentimes there will be a pelvic examination as well as a discussion about symptoms, other disorders, injuries to the pelvic area, sexual trauma, illicit drug use, relationship with partner, mood, self-esteem, childhood trauma, past sexual experiences, and mental health. 

By visiting your doctor and having a pelvic exam, they can rule out any serious type of abnormalities, especially to internal organs like the vulva, vagina, and cervix. 

Next, your doctor may order blood tests, to ensure that nothing is seriously wrong like cancer, diabetes, or cardiovascular disease. 

How do you treat sexual dysfunction?

Treatment of sexual dysfunction is often difficult and laborious, as doctors aren’t entirely trained on the pelvic floor and oftentimes don’t understand what the root of the condition is. On average, it takes a woman 10 years to be diagnosed with endometriosis, a condition that causes painful sex and painful periods, among a laundry list of other ailments. And this is just one condition. With a variety of issues at hand, it could take a woman with sexual dysfunction quite some time to figure out what is going on with her body. 

However, that doesn’t mean it isn’t impossible. The first step is getting help. 

Usually, a combination of medication, pelvic floor physical therapy, sex therapy, or talk therapy can be utilized as treatment. 

For women with menopause, estrogen therapy is a popular form of treatment that can be inserted into the vagina as a cream, tablet, or in a ring. Prasterone is another suppository that is inserted into the vagina to alleviate vaginal dryness. 

As for psychological treatments, many women seek cognitive behavioral therapists who can address images of depression, anxiety, body image, and negative self-talk. Words of affirmation and mindfulness are frequently used in therapy to address and observe disruptive thoughts that could be interfering with their sex life. As therapy continues, the therapist can dive deeper into childhood, past relationships, abuse, or trauma that could be interfering and contributing to any issues related to sex. 

Another successful form of therapy is couples therapy, where communication and relationship issues are addressed in a setting with a mediator — AKA the therapist. While couples therapy is known to be for people who are having issues, it can also be a comfortable place to discuss new things you want to try in the bedroom, or past trauma that you may not have been able to discuss. A safe space is created to move forward as a solid partnership. 

Other treatments include:

• Trigger-point pressure, which is when you apply pressure to sensitive areas of the muscles. 
• Natural libido enhancers, like food (think: ginseng, fenugreek, and chocolate) 
• Dilators, which are used to stretch to stretch the vaginal tissue.
• Bladder training for women who need to strengthen the muscles around the urethra and anus. 
• Physical therapy, where a professional reduces the pressure points of the pelvic muscles. 
• Yoga can open up the pelvic muscles, help stretch them, and open the hips. 
• Vibrators can be used to ease up the body on the clitoris without full penetration. 

Additionally, there are also lifestyle changes that could benefit your health and reduce your condition. 

• Avoid excessive alcohol
• Quit smoking
• Start exercising
• Carve out time for relaxing

The takeaway here is that female sexual dysfunction can be complicated, but it isn’t incurable. Prioritizing your health, finding the best doctor for your needs, and working diligently can improve your life and give you back your sensuality.