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Sexual Dysfunction

What is sexual dysfunction?

Sexual complaints are common among women, with as many as 40% of women expressing concerns regarding sexual function during routine visits. When these complaints cause personal distress or in some cases, distress in a relationship, they are considered a sexual dysfunction. Sexual dysfunctions occur in four categories:

  • Disorders of low desire
  • Disorders of arousal – decreased or increased
  • Impaired orgasm
  • Disorders causing pain

What causes sexual dysfunction?

Changes in sexual health can be due to a variety of causes:

  • Menopause
  • Hormone disorders
  • Cancer treatment
  • Surgery
  • Fertility treatment
  • Childbirth
  • Chronic pelvic pain
  • Infections
  • Fibroids
  • Endometriosis

In some cases, sexual dysfunction occurs without a known cause.

What are the symptoms of sexual dysfunction?

The most common sexual dysfunction can cause a loss of desire to initiate sexual relations with a partner, or difficulty becoming aroused after contact is initiated. There may be decreased lubrication, or pain. Pain may be located on the outside or vulva, within the vagina, or deep in the pelvis. The location of the pain can be helpful in determining the cause.

How is sexual dysfunction diagnosed?

Your doctor will take a thorough history and perform a physical exam, as many other medical problems and medications may affect your sexual function. Laboratory tests may include thyroid function, steroid hormones, and other tests. In some cases, imaging with ultrasound or MRI is needed to better understand what may be causing pain.

How is sexual dysfunction treated?

It is important to know that you can talk with your doctor openly about your sexual problems. Having your problems understood and validated can be very helpful and lead to a solution. Treatment depends upon the cause of your problem.

In some cases, your doctor may prescribe medication to increase sexual desire. Not all medications may be effective in every patient. Other considerations may include lifestyle changes, relaxation techniques, physical therapy, visiting a store with items designed to enhance pleasure, or a regular exercise program to improve body image. At times, the help of a therapist who specializes in sexual disorders is helpful.

Pain may be managed with non-habit-forming medications. In some cases, surgery is indicated to remove the problem that is causing pain, such as fibroids or endometriosis.