Female sexual disorder
Definition
Female
sexual arousal disorder (FSAD) occurs when a woman is continually unable to
attain or maintain arousal and lubrication during intercourse, is unable to
reach orgasm, or has no desire for sexual intercourse.
Description
The
disorder typically affects up to 25 percent of all American women, or an
estimated 47 million women. Three-fourths of women with FSAD are postmenopausal.
Women describe it as being "unable to get turned on," or being continually
disinterested in sex. It is also called "frigidity." Other terms for the
disorder include dyspareunia and vaginismus, both of which involve pain during
intercourse.
Causes
and symptoms
There are
numerous causes of this disorder. They include:
-
physical problems, such as endometriosis,
cystitis, or vaginitis
-
systemic problems, such as diabetes, high
blood pressure, or hypothyroidism. Even pregnancy or the postpartum period
(time after delivery of a child) may affect desire. Menopause is also known to
reduce sexual desire.
-
medications, including oral contraceptives,
anti-depressants, antihypertensives, and tranquilizers
-
surgery, such as mastectomy or hysterectomy
which may affect how a woman feels about her sexual self.
-
stress
-
depression
-
use of alcohol, drugs, or cigarette smoking
Symptoms
vary. A woman may have no desire for sex, or may not be able to maintain
arousal, or may be unable to reach orgasm. She may also have pain during sex or
orgasm, which interferes with her desire for intercourse.
Diagnosis
To make a
diagnosis, a woman's physician - either family doctor, gynecologist, or even
urologist -- takes a complete medical history to determine when the problem
started, how it presents, how severe it is, and what the patient thinks may be
causing it. The doctor will also conduct a complete physical examination,
looking for any abnormalities in the genital region
Treatment
The
physician should start by providing education about the disorder and
recommending various non-medical treatment strategies. These include:
-
use of erotic materials, such as vibrators,
books, magazines and videos
-
sensual massage, avoiding the genitals
-
position changes to reduce pain
-
use of lubricants to moisten the vagina and
genital area
-
kegel exercises to strengthen the vagina and
clitoris
-
therapy to overcome any relationship or
sexual abuse issues
Medical
treatments include:
-
estrogen replacement therapy, which may help
with vaginal dryness, pain and arousal
-
testosterone therapy in women who have low
levels of this male hormone (Side effects, however, may include deepening
voice, hair growth, and acne)
-
the EROS clitoral therapy device (EROS-CTD),
recently approved by the Food and Drug Administration; a small vacuum pump,
placed over the clitoris and gently activated to provide a gentle suction
designed to increase blood flow to the region, which, in turn, helps with
arousal
-
using the herb yohimbine combined with
nitric oxide has been found to increase vaginal blood flow in postmenopausal
women and thus help with some forms of FSAD
Alternative treatment
Natural
estrogens, such as those found in soy products and flax, may be effective.
Herbal remedies include belladonna, gingko, and motherwort. However, there is no
scientific evidence to prove these herbs actually help. Some women squirt
vitamin E in their vagina to increase lubrication.
Women may
also want to see a sexual therapist for additional help.
Prognosis
Generally, once women seek the appropriate help they are quite likely to find a
way to resolve their problems. Often, a holistic approach, using physical as
well as emotional therapies, is required for success.
Prevention
Maintaining a close and open relationship with a partner is one way to avoid the
emotional pain and isolation that can lead to sexual dysfunction. Additionally,
women should learn if any medications they take affect sexual function, and
should refrain from alcohol and drugs and quit smoking. Women who have anxieties
and fears about sexual intercourse, whether because of earlier abuse, rape, or a
prudish upbringing, should deal with those issues through therapy.
Key
Terms
Dyspareunia
pain in the pelvic area during or
after sexual intercourse.
Vaginismus
An involuntary spasm of the muscles
surrounding the vagina, making penetration painful or impossible.
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