Female Sexual Dysfunction: What It Is and How to Overcome It

Sexual dysfunction is when something goes wrong during any part of the sexual experience, stopping you or your partner from enjoying it fully. This could be ongoing issues with sexual response, desire, orgasm, or pain. If these problems keep happening and cause stress or affect your relationship, they are considered sexual dysfunction from a medical perspective.

Phases of a female sexual cycle

• Desire(commonly referred to as libido)
• Excitement(arousal)
• Orgasm
• Resolution

Causes of Female Sexual Dysfunction:

There are several reasons why women may experience sexual dysfunction, including:

Vasculogenic Causes: Conditions like high blood pressure, high cholesterol, smoking, and reduced blood flow to the clitoris and vagina can affect sexual function. These issues can alter estrogen levels and lead to the weakening of vaginal and clitoral muscles.

Neurogenic Causes: Nerve damage from spinal cord injuries, diabetes, or trauma (like pelvic fractures or surgery) can impact sexual response.

Hormonal/Endocrine Causes: Changes in estrogen levels, menopause, problems with hormone-regulating glands, or medical conditions like premature ovarian failure can all affect sexual health. Long-term use of birth control or lack of estrogen and testosterone also plays a role.

Musculogenic Causes: The pelvic floor muscles (like the levator ani and perineal membrane) help with sexual arousal and orgasm. If these muscles are too tight, they can cause pain during sex (conditions like dyspareunia or vaginismus). If they are too weak, it can reduce sexual sensation or make it hard to reach orgasm.

Psychogenic Causes: Emotional and relationship factors like self-esteem, body image, anxiety, depression, or relationship quality can influence sexual function.

Medications: Certain medications, like antidepressants (SSRIs), diabetes and blood pressure meds, alcohol, and medications for epilepsy or mental health conditions, can lower sexual desire and affect orgasm.

Treatment:

Acknowledgement & Support: Recognising and validating a woman's experience is the first important step.

Gentle Examination: Gentle examination may be required in certain cases to confirm diagnosis of certain conditions like Vaginismus.

Pelvic Floor Physiotherapy: The first line of treatment focuses on relaxing the pelvic floor muscles (different from what’s done for pelvic organ prolapse) to prevent spasms.

Psychological Therapies: Support women with the emotional side of sexual health, from relationship issues to processing past painful experiences.

Pelvic Floor Botox: If physiotherapy doesn’t help, Botox injections into the pelvic floor muscles may be useful in treatment of certain conditions like Vaginismus where conservative options have failed.

Testosterone for Postmenopausal Women with HSDD: Testosterone is important for libido and sexual response. For postmenopausal women with HSDD (Hypoactive Sexual Desire Disorder), careful assessment is needed. Testosterone treatment can help but must be monitored with questionnaires and blood tests, under medical supervision.

At Lotus Medics, we know sexual health is a key part of a woman’s overall health. We provide thorough assessments and use a multidisciplinary approach, involving specialists like endocrinologists, physiotherapists, psychologists, and GPs, to improve both the woman's and the couple's sexual wellbeing.