Symptoms
Symptoms vary depending on what type of sexual dysfunction you’re experiencing:
Low sexual desire. This most common of female sexual dysfunctions involves a lack of sexual interest and willingness to be sexual.
Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.
When to see a doctor
If sexual problems affect your relationship or worry you, make an appointment with your doctor for evaluation.
Causes
Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.
Factors — often interrelated — that contribute to sexual dissatisfaction or dysfunction include:
Physical. Any number of medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems, can lead to sexual dysfunction. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sexual desire and your body’s ability to experience orgasm.
Hormonal. Lower estrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in estrogen leads to decreased blood flow to the pelvic region, which can result in less genital sensation, as well as needing more time to build arousal and reach orgasm. The vaginal lining also becomes thinner and less elastic, particularly if you’re not sexually active. These factors can lead to painful intercourse (dyspareunia). Sexual desire also decreases when hormonal levels decrease.
Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.
Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress and a history of sexual abuse. The worries of pregnancy and demands of being a new mother may have similar effects.
Long-standing conflicts with your partner — about sex or other aspects of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with body image also can contribute.
Risk factors
Some factors may increase your risk of sexual dysfunction:
Depression or anxiety
Heart and blood vessel disease
Neurological conditions, such as spinal cord injury or multiple sclerosis
Gynecological conditions, such as vulvovaginal atrophy, infections or lichen sclerosus
Certain medications, such as antidepressants or high blood pressure medications
Emotional or psychological stress, especially with regard to your relationship with your partner
A history of sexual abuse.
Diagnosis
To diagnose female sexual dysfunction, your doctor may:
Discuss your sexual and medical history. You might be uneasy talking with your doctor about such personal matters, but your sexuality is a key part of your well-being. The more upfront you can be about your sexual history and current problems, the better your chances of finding an effective way to treat them.
Perform a pelvic exam. During the exam, your doctor checks for physical changes that affect your sexual enjoyment, such as thinning of your genital tissues, decreased skin elasticity, scarring or pain. Order blood tests. Your doctor may recommend blood tests to check for underlying health conditions that might contribute to sexual dysfunction.
Your doctor may also refer you to a counselor or therapist specializing in sexual and relationship problems.
Treatment
Keep in mind that sexual dysfunction is a problem only if it bothers you. If it doesn’t bother you, there’s no need for treatment.
Because female sexual dysfunction has many possible symptoms and causes, treatment varies. It’s important for you to communicate your concerns, as well as to understand your body and its normal sexual response. Also, your goals for your sex life are important for choosing a treatment and evaluating whether or not it’s working for you.
Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.
Preparing for your appointment
If you have ongoing sexual difficulties that distress you, make an appointment with your doctor. You may feel embarrassed to talk about sex with your doctor, but this topic is perfectly appropriate. A satisfying sex life is important to a woman’s well-being at every age.
You might have a treatable, underlying condition, or you might benefit from lifestyle changes, therapy or a combination of treatments. Your primary doctor will either diagnose and treat the problem or refer you to a specialist.
Here’s some information to help you prepare for your appointment.
What you can do
Gather information about:
Your symptoms. Take note of any sexual difficulties you’re having, including when and how often they occur.
Your sexual history. Your doctor likely will ask about your relationships and experiences since you became sexually active. He or she also might ask about any history of sexual trauma or abuse.
Your medical history. Write down any medical conditions you have, including mental health conditions. Jot down the names and doses of medications you take or have recently taken, including prescription and over-the-counter drugs.
Questions to ask your doctor.
Create a list of questions to make the most of your time with your doctor.
Some basic questions to ask your doctor about your sexual concerns include:
What might be causing my sexual difficulties?
Do I need medical tests?
What treatment do you recommend?
If you’re prescribing medication, are there possible side effects?
How much improvement can I reasonably expect with treatment?
Are there lifestyle changes or self-care steps that might help?
Do you recommend therapy?
Should my partner be involved in treatment?
Do you have printed material you can give me? What websites do you recommend?
Don’t hesitate to ask other questions that occur to you.
Dr. Priti has also been continually involved with guiding married couples in her practice of fertility.Dr Priti Vyas is the founder of ‘One-to-One Guidance Centre’ and she is India’s first gynaecologist trained in treating Female Sexual Dysfunction. She has given lectures on Family Happiness, Teenagers Sexual development, Female Sexual Dysfunction at various medical conferences. She has been on the panel for adolescent girl child, health care (Asia level). She has spoken on various women related issues at Goldman & Sachs, TCS and various corporates.
Dr Priti Vyas conducts seminars and workshops on various topics like Ensuring Successful Marriage, Womens Intimacy Issues, Understanding Your Teenager, Managing Career without affecting Family Happiness and Women’s health awareness programs.
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