Female sexual dysfunction occurs when a woman is not able to fully, healthily, and pleasurably experience some or all of the various physical stages the body normally experiences during sexual activity. These stages can be broadly thought of as the desire phase, the arousal phase, and the orgasm phase. Sexual dysfunction also includes painful intercourse.
In women, sexual dysfunction takes many forms and has numerous causes. It is important to address all the aspects of a woman's sexuality – whether physical, psychological, physiological (mechanical), or interpersonal – in order to resolve the problems.
Female sexual dysfunction is actually quite common. It has been estimated that about 40% of women are affected by sexual dysfunction to some degree, and approximately 10% of women are unable to achieve orgasm.
Female sexual dysfunction may be related to physical factors, psychological factors, or a mixture of both. It can also be a matter of problems with technique: some women never fully experience sexual arousal and orgasm because they or their partners lack sexual knowledge. They may not understand how female sex organs respond or are stimulated, or don't use appropriate arousal techniques.
At the same time, sexual dysfunction has a strong interpersonal component. A person's view of their own sexuality is largely influenced by culture, society, and personal experience. It may be intimately connected to their own or society's ideas about the appropriate or inappropriate expression of sexual behaviour. These feelings may cause anxiety because of a personal or cultural association of sexual experience and pleasure with immorality and bad behaviour. Anxiety is then expressed physically by the body in a way that prevents normal sexual function. Anxiety can do this, for example, by stopping or slowing the state of sexual excitement that allows for the lubrication or moistening of the female genitalia – an important step towards fulfilling forms of sexual activity.
Personal character, disposition, and life experience play a role in sexual dysfunction. Fear of intimacy can be a factor in arousal problems. Experiences of abuse, either in childhood or in past or current relationships, can establish a cycle of associating sex with psychological or physical pain. Attempting sexual activity in these circumstances causes more psychological or physical pain. For example, if anxiety prevents lubrication, sexual intercourse can be painful.
Conflict, tension, and incompatibility with a sexual partner can cause sexual dysfunction. Depression may be a cause, and stress a contributing factor. Medications, including oral contraceptives, antihypertensives, antidepressants, and tranquilizers are very common causes of sexual dysfunction. Also, the use of oral contraceptives can decrease a woman's interest in sex. If you're taking any of these medications, talk to your doctor about its possible contribution to sexual problems.
Physical causes include disorders of the genitalia and the urinary system, such as endometriosis, cystitis, vaginal dryness, or vaginitis. Other conditions such as hypothyroidism, diabetes, multiple sclerosis, or muscular dystrophy can have an impact on sexual desire and ability. Surgical removal of the uterus or of a breast may contribute psychologically to sexual dysfunction if a woman feels her self-image has been damaged.
Certain prescription and over-the-counter medications as well as the use of illegal drugs or abuse of alcohol may contribute to sexual dysfunction. Cigarette smoking may have a negative effect on sexual arousal in women.
Although women can remain sexually active and experience orgasms throughout their lives, sexual activity often decreases after age 60. While part of this may be due to a lack of partners, changes such as dryness of the vagina caused by lack of estrogen after menopause may make intercourse painful and reduce desire. After menopause, about 15% of women feel a strong decrease in sexual desire.
Women who do not enjoy satisfying sexual experiences with their partners often report the following:
Most often, any of these responses have psychological complications. Whether the symptoms are due to physical factors, such as menopause, or have their origins in more deep-seated psychological triggers, many women are likely to feel inadequate or dysfunctional. They blame themselves for not being sexually responsive, have trouble explaining to their partners about how they feel, and experience low self-esteem as a result.