What Are Four Categories of Female Sexual Problems?

Symptoms of female sexual problems include: 

• Desire disorders
  • Less desire for sex than previously
  • No desire for sex
• Arousal disorders
  • Inability to stay sexually aroused
  • No sexual response
• Orgasmic disorders
  • Pain during orgasm
  • Inability to have an orgasm (anorgasmia)
• Sexual pain disorders
  • Pain during or after sex

Causes of female sexual problems depend on the problem and may include: 

• Desire disorders
  • Hormonal changes
  • Certain medical conditions
  • Some medications
    • Psychoactive medications
    • Cardiovascular and antihypertensive medications
    • Hormonal preparations
    • Histamine H2-receptor blockers and promotility agents
    • Indomethacin (Indocin)
    • Ketoconazole (Nizoral)
    • Phenytoin sodium (Dilantin)
  • Depression
  • Pregnancy
  • Stress
  • Fatigue
  • Lifestyle factors such as work stress or child care
  • Boredom with regular sexual routines
• Arousal disorders
  • Insufficient vaginal lubrication 
  • Inadequate sexual stimulation
  • Anxiety
  • Problems with blood flow problems to the vagina and clitoris 
  • Certain medications
    • Anticholinergics
    • Antihistamines
    • Antihypertensives
    • Psychoactive medications
• Orgasmic disorders
  • Sexual inhibition
  • Inexperience
  • Lack of knowledge
  • Psychological factors such as guilt, anxiety, or past sexual trauma or abuse
  • Insufficient stimulation
  • Chronic diseases 
  • Certain drugs or medications
    • Methyldopa (Aldomet)
    • Amphetamines and related anorexic drugs
    • Antipsychotics
    • Benzodiazepines
    • Selective serotonin reuptake inhibitor (SSRI) antidepressants
    • Narcotics
    • Trazodone (Desyrel)
    • Tricyclic antidepressants
• Sexual pain disorders
  • Poor lubrication
  • Vaginal dryness
  • Endometriosis
  • A pelvic mass
  • Ovarian cysts
  • Vaginitis
  • Scar tissue from a past surgery
  • Sexually transmitted diseases
  • Vaginismus (a painful, involuntary spasm of the muscles that surround the vaginal entrance is a condition) may occur in women who fear penetration will be painful, have sexual phobias, or previous traumatic or painful sexual experiences

Female sexual problems are diagnosed with a patient history and physical examination which includes a pelvic exam. Patients may also be asked about attitudes toward sex, past sexual trauma or abuse, relationship problems, or alcohol and drug use/abuse to help determine if these factors may be contributing to the dysfunction.

Tests to determine the cause of the sexual dysfunction may include: 

• A Pap smear to check for cancer
• Tests for sexually transmitted diseases (STDs)
• Other tests to rule out medical conditions that may cause sexual dysfunction

Treatment for female sexual problems varies and depends on the cause. Treatments may include: 

• Patient education to help women overcome anxiety about sexual function and performance
• Enhancing sexual stimulation 
  • Masturbation
  • Changing the sexual routine
  • Use of erotic videos or books 
• Anxiety can be alleviated with distraction
  • Erotic or non-erotic fantasies 
  • Music, videos, or television 
• Sensual massage
  • May create less pressure and anxiety surrounding sexual activity
• If the problem is due to pain:
  • Changing sexual positions 
  • Vaginal lubricants 
  • Relaxation before intercourse (warm bath, meditation)