(© BillionPhotos.com - stock.adobe.com)
There is no standard definition of normal sexual function. Rather, what determines sexual dysfunction (not functioning normally) in a woman is her unique experience of dis-ease in sexual well-being. We can, however, make one generalization about sexual dysfunction among women – it is common. It is impossible, though, to say how many women are affected. Many studies on sexual dysfunction have excluded women without partners or excluded women entirely.
The term dysfunction means at least one aspect of sexuality is of considerable concern to the affected woman. It has negative effects on her mental health, social functioning, and general well-being. The distress can decrease quality of life to a degree as great as that of chronic back pain or diabetes.
There are several types of sexual dysfunction
Complaints of sexual dysfunction can be grouped. There is, however, an overlap of groups, and various dysfunctions can be present together.
Hypoactive sexual desire (Low sex drive)
This is a marked decrease in the desire to engage in sexual activity. Spontaneous desire is reduced or absent. Their response to erotic cues is reduced or absent. After the initiation of sex, there is also an inability to sustain desire.
Sexual arousal dysfunction
Even though there is a desire for sexual activity and sufficient stimulation, the following responses are absent or markedly diminished: lubrication, genital engorgement or sensitivity, nipple hardening, skin flushing, increased heart rate, blood pressure, or respiratory rate, flushing, and feelings of sexual excitement or pleasure.
Orgasmic dysfunction
There is an absence or decreased frequency of orgasm, or its intensity is diminished, although sexual desire and adequate stimulation are present.
Other dysfunctions
These are disorders that do not fit the above categories.
To diagnose the disorder, symptoms should have been present for at least several months and are associated with significant distress for the individual.
How to assess if you’re dealing with sexual dysfunction
Biologic and hormonal factors
This includes sex hormone deficiency, depression, illness, fatigue, urinary incontinence, gynecological conditions, and the effect of prescription and nonprescription medications, alcohol, or other drug use.
Intrapersonal/developmental factors
Trauma (physical, mental, emotional, medical), negative emotions (anxiety, fear, shame, guilt), poor body image, gender identity issues, and a patient’s level of education can all contribute to sexual dysfunction.
Expectation of negative outcome
Sexual dysfunction may stem from previous episodes of disappointing or painful sex.
Interpersonal factors
Lacking a partner, relationship discord, or lack of emotional intimacy can affect sexual well-being.
Contextual factors
Lack of privacy, cultural norms, religious beliefs, and safety concerns could contribute to sexual health issues.
Lack of appropriate stimuli
Sexual dysfunction may also stem from a lack of knowledge regarding sexual stimulation, a partner in poor health, or a partner’s sexual dysfunction.
How to treat sexual dysfunction
Treatment starts with changing modifiable factors. Medications known to be associated with sexual dysfunction, commonly antidepressant therapy, should be adjusted or changed.
Psychosocial interventions are often effective. Some of these interventions may involve sexual counseling, body awareness counseling, cognitive therapy, or couples counseling.
Sexual therapy may involve pelvic floor relaxation, vaginal dilator therapy, and devices that may enhance clitoral sensation and orgasm in women with an arousal disorder.
Pharmaceutical treatment is complex and beyond the scope of this article. There are both hormonal and nonhormonal drugs in various forms, oral and topical. So far, the results have been encouraging. Your healthcare provider can discuss drug treatments with you if they’re deemed necessary.
The bottom line
You are not alone. Sexual dysfunction is common. Your healthcare provider may not mention the issue, but you should. Be your best advocate for your quality of life.
Determining the cause of sexual dysfunction is complex. Arriving at a diagnosis may test your patience. If your healthcare provider’s skills are limited in this area, ask for a referral or seek out a practitioner of sexual medicine.
Finding treatment can take trial and error and time to be effective. Stick to the process – satisfactory sexual function is a vital part of our identity and very individual. If you have a sexual partner, include them throughout the process of diagnosis and treatment. If they choose not to be involved, follow through with the process yourself.
