Female sexual dysfunction

Women with sexual concerns often benefit from a combined treatment approach.

Sexual dysfunction in females is described as persistent, recurrent problems with sexual response, desire, orgasm or pain that lead to distress strain your relationship with your partner.

Many women experience problems with sexual function at some point. Female sexual dysfunction can occur at any stage of life.

It can be lifelong or be acquired later in life. It can occur only in certain sexual situations or in all sexual situations. Sexual response involves physiology, emotions, experiences, beliefs, lifestyle and relationships.

Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.

If you have ongoing sexual difficulties that distress you, make an appointment with your doctor.

It is very important that you do that even if you feel slightly embarrassed because 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. If sexual problems affect your relationship or worry you, make an appointment with your doctor.

Some factors may increase your risk of sexual dysfunction:

– Depression or anxiety v Heart and blood vessel disease v Neurological conditions, such as spinal cord injury or multiple sclerosis v Liver or kidney failure v Certain medications, such as antidepressants or high blood pressure medications v Emotional or psychological stress, especially with regard to your relationship with your partner v A history of sexual abuse.

SYMPTOMS

Your symptoms will depend on the type of female sexual dysfunction you have:

-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

CAUSES

Sexual problems often develop when you have an imbalance of your hormones, 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 oestrogen levels after menopause may lead to changes in your genital tissues and sexual responsiveness. A decrease in oestrogen leads to decreased blood flow to the pelvic region, which can result in needing more time to build arousal and reach orgasm, as well as less genital sensation. 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 a n d 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 also diminish your sexual responsiveness.

-Cultural and religious issues and problems with body image also can contribute.

DIAGNOSIS

To diagnose female sexual dysfunction, your doctor will:

-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 forthcoming you can be about your sexual history and current problems, the better your chances of finding an effective approach to treating 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. Your doctor may also refer you to a psychologist specializing in sexual and relationship problem

TREATMENT

Because female sexual dysfunction has many possible symptoms and causes, treatment varies. It’s important for you to communicate your concerns and understand your body and its normal sexual response. Also, your goals for your sex life are important in determining treatment and evaluating progress. Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.

Nonmedical treatment for female sexual dysfunction

-Talk and listen. Open communication with your partner makes a world of difference in your sexual satisfaction.

Even if you’re not used to talking about your likes and dislikes, learning to do so and providing feedback in a nonthreatening way sets the stage for greater intimacy.

-Practise healthy lifestyle habits. Go easy on alcohol. Drinking too much can blunt your sexual responsiveness.

-Be physically active. Regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy your sexual experience.

-Seek counselling. Talk with a psychologist who specializes in sexual and relationship problems. Therapy often includes education about how to optimize your body’s sexual response, ways to enhance intimacy with a partner, and recommendations for reading materials or couples exercises.

-Use a lubricant. A vaginal lubricant may be helpful during intercourse if you have vaginal dryness or pain during sex.

-Try a toy. Arousal may be enhanced with stimulation of the clitoris. Use a vibrator to provide clitoral stimulation or clitoral vacuum suction devices.

Medical treatment for female sexual dysfunction

Effective treatment for sexual dysfunction often requires addressing an underlying medical condition or hormonal change. A prescription medication for premenopausal women with low sexual desire also offers a treatment option. To treat sexual dysfunction tied to a medical condition, your doctor might recommend that you:

-Adjust or change medication that has sexual side effects v Treat a thyroid problem or other hormonal condition v Optimize treatment for depression or anxiety.

-Try strategies for relieving pelvic pain or other pain problems Treating female sexual dysfunction linked to a hormonal cause might include: v Oestrogen therapy. Localized 0estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.

-Androgen therapy. Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower amounts of testosterone.

Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction; other studies show little or no benefit. The risks of hormone therapy may vary, depending on whether oestrogen is given alone or with a progestin, your age, the dose and type of hormone, and health issues such as your risks of heart and blood vessel disease and cancer.

Others: One drug, sildenafil (Viagra), may prove beneficial for some women who have sexual dysfunction due to taking selective serotonin reuptake inhibitors), a class of drugs used to treat depression.

Lifestyle remedies

Try practicing these healthy lifestyle habits:

-Avoid excessive alcohol. Drinking too much blunts sexual responsiveness.

-Don’t smoke. Cigarette smoking restricts blood flow throughout your body.

-Be physically active. Regular aerobic exercise increases your stamina, improves your body image and elevates your mood.

-Make time for leisure and relaxation. Learn ways to decrease stress and relax amid the stresses of your daily life.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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