Female Sexual Dysfunction

Female sexual dysfunction affects between 25-69% of women - with lack of sexual interest being the most common complaint. For women, sexual response can be dependent on medical issues, medications, surgeries, past traumas, hormones, pregnancy and lactation, insomnia and relationship issues.

It's clear that the root cause can be incredibly complex, which is why you want to look at the whole picture - your physical, mental and emotional health. According to the DSM 5, there are four definitions for sexual dysfunction:

1. Sexual desire disorders - this can be the absence of sexual desires or fantasies, as well as an aversion to sex or a partner.

2. Sexual arousal disorders - the inability to have or sustain arousal with sexual activity, not having adequate lubrication or lack of sexual excitement.

3. Orgasmic disorders - inability to have an orgasm following sexual excitement.

4. Sexual pain disorders - genital pain that is associated with intercourse, or recurrent involuntary contractions of the perineal muscles when vaginal penetration occurs.

Desire

This was reported to be the most common disorder, and can be affected by many causes - many of which have been addressed above. Women may specifically have hyposexual desire or sexual aversion. These states may be accompanied by interpersonal distress including frustration, grief, feelings of incompetence, loss, sadness, worry, etc.

Orgasm

Orgasmic disorder was the next most common complaint, in which many factors can affect orgasm. Orgasmic timing may be spontaneous, too early or too late. There may not be any pleasure associated with orgasm. Lastly orgasm may occur in conjunction to undesirable symptoms (ie. pain, cognitive changes, etc.).

Arousal

Arousal arises from the contribution of a genital response, central nervous system response and the processing of sexual stimuli. However, when there is a diminished or lack or arousal it may be due to a disruption in one of these relationships - a neurovascular injury or dysfunction, central nervous system activity, or information processing of sexual stimuli.

Pelvic Floor

The pelvic floor is a group of muscles that support the pelvic organs and span the bottom of the pelvis. There are many reasons why someone would develop pelvic pain - but specifically for women it may be due to hormonal changes (birth control use, pregnancy, menopause), or they may be noticing pelvic organ prolapse, incontinence, hypertonic muscles, vaginismus, pain with sex, or pain with specific parts of the vagina (ie. vulvodynia).

How to Treat

Treatment depends on which definitions you fall under. But overall diet and lifestyle can have an huge impact on sexual function. Ideally this would be focusing on a mediterranean diet, increasing exercise, getting to a 'normal' body mass index, improving mood and sleep, and exploring social activity and social support.

Supplementation and botanicals can be incredibly helpful too, and would depend on the type dysfunction you might be experiencing. Treatment works best in an integrative environment - where a Naturopathic Doctor can work alongside a pelvic floor physiotherapist and sex therapist.

Next Steps

Sex should not hurt and it shouldn't be a struggle to become aroused - after all, it's an incredibly healthy activity. 

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