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Symptoms and Signs of Female Sexual Problems

Doctor's Notes on Female Sexual Problems

Female sexual problems refer to anything that interferes with a woman's satisfaction with a sexual activity. It is also referred to as female sexual dysfunction (FSD) by medical professionals. The sexual response cycle includes four phases: desire (excitement phase), arousal (plateau phase), orgasm (climax), and resolution. A problem with one or more of these phases can result in dissatisfaction. There are numerous possible causes for female sexual dysfunction including relationship problems, emotional problems, insufficient stimulation, gynecologic problems, physical or medical conditions, medications, some medical treatments, a history of abuse, attitudes toward sex, and sexual problems of the partner.

Symptoms of female sexual problems include lack of interest in or desire for sex, difficulties becoming sexually aroused, problems achieving orgasm, and pain during intercourse (dyspareunia).

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Female Sexual Problems Symptoms

Sexual problems

The types of sexual problems in women correspond to the stages of the sexual response cycle. Inability to achieve any of the stages can interfere with sexual satisfaction and thus create a problem. Any of these can be very distressing for a woman, because everyone deserves a satisfying sex life. They can be distressing for her partner, too, and can lead to problems in the relationship.

  • The sexual problems reported by women commonly consist of three types:
    • Lack of sexual desire: Lack of interest in sex, or desire for sex, is a common problem in both men and women, but especially in women. Lack of desire stops the sexual response cycle before it starts. Lack of desire is temporary in some people and an ongoing problem in others.
    • Difficulties becoming sexually aroused or achieving orgasm: Inability to become sexually aroused is sometimes related to lack of desire. In other cases, the woman feels sexual desire but cannot become aroused. Orgasm may be delayed or not occur at all (anorgasmia). This can be very distressing for a woman who feels desire and becomes aroused. It can create a vicious cycle in which the woman loses interest in sex because she does not have an orgasm. It has been estimated that 7% to 10% of women suffer from some sort of orgasmic disorder.
    • Pain during intercourse: Pain during intercourse (dyspareunia) is not uncommon. Like other sexual problems, it can cause a woman to lose interest in sex.

Female Sexual Problems Causes

The causes of sexual problems are as varied and complex as the human race. Some problems stem from a simple, reversible physical problem. Others can stem from more serious medical conditions, difficult life situations, or emotional problems. Still others have a combination of causes. Any of the following can contribute to sexual problems:

  • Relationship problems: Discord in other aspects of the relationship, such as distribution of labor, childrearing, or money, can cause sexual problems. Issues of control or even abuse in the relationship are especially harmful to sexual harmony. Such problems can prevent a woman from communicating her sexual wants and needs to her partner.
  • Emotional problems: Depression, anxiety (about sex or other things), stress, resentment, and guilt can all affect a woman's sexual function.
  • Insufficient stimulation: A woman's (or her partner's) lack of knowledge about sexual stimulation and response may prevent a woman from achieving a satisfactory experience. Poor communication between partners can also be a culprit here.
  • Gynecologic problems: A number of pelvic disorders can cause pain in intercourse and thus decrease satisfaction.
    • Vaginal dryness: The most common reason for this in younger women is insufficient stimulation. In older women, the decrease in estrogen that occurs in perimenopause or menopause is the cause of vaginal dryness. Poor lubrication can also be linked to hormone imbalances and other illnesses and to certain medications. It can inhibit arousal or make intercourse uncomfortable.
    • Vaginismus: This is a painful spasm of the muscles surrounding the vaginal opening that causes the vaginal opening to "tighten." It can prevent penetration or make penetration extremely painful. Vaginismus can be caused by injuries or scars from surgery, abuse, or childbirth, by infection, or by irritation from douches, spermicides, or condoms. It can also be caused by fear.
    • Sexually transmitted diseases: Gonorrhea, herpes, genital warts, chlamydia, and syphilis are infectious diseases spread by sexual contact. They can cause changes in the genitals that make sex uncomfortable or even painful.
    • Vaginitis: Inflammation and irritation of vaginal tissues due to infection or other causes can make intercourse uncomfortable or painful.
    • Endometriosis, pelvic mass, ovarian cyst, surgical scars: Any of these can cause an obstruction or anatomical changes that prevent intercourse or make it difficult or painful.
    • Pelvic inflammatory disease: This is an infection of the vagina that moves up into the cervix, uterus, and ovaries. It can be very painful on its own and make intercourse extremely painful.
    • Nerve damage after surgery: Unavoidable cutting of small nerves during pelvic surgery (such as hysterectomy) may decrease sensation and response.
  • Physical conditions: Many physical or medical conditions can decrease a woman's satisfaction with her sex life.
  • Medications: Certain medications can reduce desire or arousal. One well-known group of drugs that have this effect are the selective serotonin-reuptake inhibitor (SSRI) group of antidepressants, which includes drugs such as Prozac and Zoloft. Others include certain chemotherapy drugs, drugs for high blood pressure, and antipsychotic medications.
  • Other medical treatments: Treatments such as radiation therapy for certain types of cancer can reduce vaginal lubrication. They can also make skin and the membranes lining the genitals tender and sensitive.
  • History of abuse: A woman who has suffered sexual or other abuse may have trouble trusting her partner enough to relax and become aroused. She may have feelings of fear, guilt, or resentment that get in the way of a satisfactory experience, even if she cares deeply about her current partner.
  • Attitudes toward sex: Many people, either because of the way they were brought up or because of earlier bad experiences, don't view sex as a normal and enjoyable part of a couple's relationship. They may associate sex or sexual feelings with shame, guilt, fear, or anger. On the other hand are people who have unrealistic expectations about sex. Portrayals of sex in television and movies as always easy and fantastic mislead some people into believing that is how it is in real life. These people are disappointed or even distressed when sex is sometimes not earth-shattering or when a problem occurs.
  • Sexual problems of the partner: If a woman's partner has sexual problems, such as impotence or lack of desire, this can inhibit her own satisfaction.

Female Sexual Dysfunction Treatment for Women's Sexual Disorders Slideshow

Female Sexual Dysfunction Treatment for Women's Sexual Disorders Slideshow

Sexual dysfunction is a common concern shared by many women. Problems may occur during any phase of the sexual response cycle (excitement, plateau, orgasm, and resolution) that prevent a woman from experiencing sexual satisfaction. Many women are reluctant or embarrassed to discuss their sexual problems, but it's important to tell your doctor what you are experiencing since most cases of sexual dysfunction can be treated.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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