What is female sexual dysfunction (FSD)?

Many women have a low sex drive or trouble having an orgasm.  Some women are not bothered by this, but others are.  A woman has female sexual dysfunction, also called FSD, when she is upset or unhappy about her sexual health.
There are several types of sexual dysfunction:

• Low sexual desire
• Trouble becoming aroused
• Trouble having an orgasm
• Pain during sex

A woman might have more than one of these issues, which are often related to each other.  Sexual dysfunction can be lifelong or temporary.  It can happen all the time, only with a certain partner, or only at certain times, such as after pregnancy. 
A healthy sex life depends on a complex mix of many factors.  The same is true for a troubled sex life. Health issues, certain prescription medicines, changes in hormone levels, partner or family issues, and psychological concerns can all contribute to FSD.

Did you know?

Studies show that about 33 percent of American women have low sex drive.  Of those, about one in three women are upset about having low sex drive.  That’s about 10 percent of all women in the U.S.

What treatments are available for FSD?

Choice of treatment depends on the cause of your problems.  Often, a combination of treatments works best.  If you have a medical condition that is causing your FSD,

Lifestyle Changes

Some women find that losing weight, eating a healthy diet, exercising, stopping smoking, and getting enough sleep helps increase their sense of well-being and interest in sex. 
Try finding ways to be comfortable with your own sexuality.  This may involve thinking about your attitudes toward sex when you were growing up, finding ways to improve your self-esteem, and accepting your body as it is.

Estrogens

Estrogens can help with vaginal dryness and painful intercourse.  Two types of prescription estrogens are available: local (vaginal) and whole-body (systemic).

• Local estrogens comes in very low doses and is inserted into the vagina as a cream or tablet.  It also comes in a vaginal ring. Local treatment doesn’t have the health risks of whole-body estrogens because only small amounts of estrogens reach the bloodstream.
• Whole-body estrogens, also called hormone therapy, is taken as a pill, skin patch, gel, or spray.  Because it affects the whole body, it has some health risks, such as stroke and blood clots. These events are rare in healthy women using hormone therapy close to menopause. Women who have not had a hysterectomy also need to take progestin, another female hormone, to prevent uterine cancer.

Causes of FSD Physical Causes

Physical Causes

• Health problems:  diabetes, heart disease, cancer, arthritis, multiple sclerosis, or alcohol abuse
• Medicines to treat high blood pressure, depression, pain; oral contraceptives
• Gynaecological issues: 
• Medical conditions such as endometriosis, cystitis, pelvic muscle problems, or chronic pelvic pain
• Pelvic or genital surgeries that cause scarring, decreased blood flow, or nerve damage to the genital area

Hormonal Causes

• A drop in estrogens levels from menopause (natural or surgical) or premature ovarian failure (when the ovaries stop working before age 40), which can cause vaginal dryness and painful intercourse
• Possibly, a drop in levels of testosterone, which women produce in small amounts, after removal of the ovaries*

Psychological and Emotional Causes

• Mental distress:  stress, anxiety, depression, eating disorders, past sexual abuse, fear of unwanted pregnancy
• Relationship issues:  boredom, anger, power struggles, abuse (physical or emotional)
• Religious or cultural beliefs about sex