Female Sexual Dysfunction

“Sexual dysfunction” is a blanket term for conditions that affect a person’s ability to have or enjoy sexual activity. In women, such conditions include:^[1]

• Hypoactive sexual disorder
• Sexual aversion disorder
• Female sexual arousal disorder
• Female orgasmic disorder
• Dyspareunia
• Vaginismus

The signs and symptoms of sexual dysfunction vary on the condition, but often involve:^[2]

• A lack of sexual desire
• Difficulty becoming aroused
• Difficulty having an orgasm, or being unable to have an orgasm
• Experiencing painful intercourse

Sexual dysfunction is typically diagnosed with a combination of a patient interview, a physical examination (particularly a pelvic exam), and blood tests. Not all sexual dysfunction will have a physiological dimension, so one’s personal emotional/psychological/cultural experience of sex is important to factor in.^[3][4]

Medical treatment can vary based on the nature of the sexual dysfunction that a person is experiencing, but may include topical or systemic hormone therapy, phosphodiesterase inhibitors, or psychiatric medications such as antidepressants.^[1]

Maca is one of the better-studied supplements for libido (in both men and women), and can produce a notable increase in libido. Additionally, tribulus-terrestris may produce a small improvement in libido. A handful of studies have found promising but preliminary effects of fenugreek, eurycoma longifolia, panax ginseng, and rhodiola rosea.

Diet primarily influences sexual dysfunction through diet-related health conditions. Undereating (e.g., due to “overdieting” or food insecurity) can suppress libido. Additionally, conditions such as obesity, metabolic-syndrome, and type-2-diabetes can negatively affect sexual function, so dietary practices that are conducive to healthy body weight (i.e., aiming to be neither over- nor underweight) and cardiovascular function are advisable.^[5][6]

Psychotherapy can be beneficial when sexual dysfunction is related to psychological/emotional factors (such as anxiety, traumatic experience, or poor body image). Similarly, education about genital anatomy and the ways in which healthy sexual function varies can benefit individuals who are concerned about how their bodies/sexual behavior compares to “normal”.^[1][3]

Physical activity can benefit sexual dysfunction in a number of ways, including increasing stamina, elevating mood, and potentially improving body image.^[7]

Physiotherapy and vaginal dilators can also be useful tools for treating sexual dysfunction, particularly if hypertonicity of the vaginal muscles is involved.^[8][9]

“Normal” sexual function requires the vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.^[10] Physiological causes of sexual dysfunction can include issues with the genitourinary, cardiovascular, musculoskeletal, neurological, and endocrine systems. Emotional, psychological, and cultural causes can include the use of libido-affecting medications, anxiety and depression, traumatic experience, a sexually repressive cultural environment, poor body image, fatigue, and substance abuse.