Female Sexual Dysfunction

The typical sexual cycle has four stages: excitement and arousal, plateau, orgasm, and resolution, which is when the body returns to normal. Some women can achieve orgasm multiple times before resolution. Many women with sexual dysfunction have problems getting aroused or reaching an orgasm.

You may experience one or more of the following:

• Little to no interest in sex.
• Little to no sensation.
• Difficulty becoming or staying aroused.
• Difficulty reaching orgasm.
• Pain during sexual stimulation or intercourse.

Many factors can contribute to female sexual dysfunction, including:

• Age, particularly menopause. The vagina becomes thinner, less lubricated and less elastic, which can cause pain during sex, especially after the ovaries stop making estrogen.
• Pain during intercourse for other reasons.
• Fluctuating hormones, which happens when you’re pregnant, breastfeeding or menopausal.
• Illness, especially conditions that affect the blood vessels.
• Certain medications.
• Partner problems.
• Behavioral health matters, such as anxiety or depression.
• Neurological conditions.
• Gynecological issues, such as vaginitis.
• A history of mental or physical trauma.
• Alcoholism and drug abuse.

The road toward treatment starts with an exam to look for physical causes. Because your mental health history is as important as your physical history, a therapist can help with issues related to behavioral health or past trauma.

If there is a physical cause, such as a hormone imbalance, your health care provider may prescribe medication. A physical abnormality, such as scarring from a previous surgery, can also be addressed.

If you’re feeling pain, your doctor will look for reasons why you’re experiencing discomfort and suggest a treatment.

When there is no apparent physical cause, you may benefit from seeing a behavioral health therapist who specializes in sexual matters. Learning about your body and how it responds can help. You may need more stimulation to either get aroused or achieve orgasm.

Remember, many women have occasional trouble in their sex lives. If it becomes a persistent problem — and it concerns you — see your health care provider.