Female Sexual Dysfunction
What is “normal” and what is “abnormal” for a female sexual response? During the past few decades, medical research has attempted to define the female “sexual response cycle” and provide answers to these questions. Women increasingly expect not just definitions, but also therapies that will provide solutions. The fact that, in one survey, up to 43% of women felt they suffered from sexual dysfunction, points to this being an important and prevalent issue.
No matter how it is defined, the female sexual response cycle can involve interplay of psychological, social, cultural, hormonal and physical factors. Female sexual dysfunction is often broken down into four broad categories or types, but clearly any one category can be influenced by another. These categories are: Desire disorder, arousal disorder, orgasmic disorder and sexual pain disorder. Many current research studies and treatment therapies focus on disorders of either the Desire or Arousal phase of the female sexual response. Menopausal research has looked at therapies that treat physical changes of the female genital tract, and their impact on sexual function.
Low Desire or Low Libido: Also known as Hypoactive Sexual Desire Disorder, this has been defined as “the deficiency or absence of sexual fantasies/thoughts, and/or desire for or receptivity to sexual activity”, such that it causes “personal distress”. In other words, “it bothers me that I don’t have very much interest in having sex” or, “I hardly ever even think about it anymore”. This can be particularly distressing if it is a distinct change from a previously satisfying level of interest in sex. Numerous clinical trials are examining the role of testosterone in this disorder.
Arousal Disorder: Arousal occurs during the “excitement phase” of the sexual response cycle, it involves increased blood flow to the genital area, pleasant body sensations, vaginal lubrication and swelling, and other physical body responses to sexual stimulation. Some women may find that they are just as interested in sex as ever, but that the body response is sluggish or just not there. “Nothing happens”. This category of sexual dysfunction is currently the subject of intense research, with medication for the disorder being used in clinical trials.
Orgasmic Disorder: Defined as difficulty with, or inability in attaining orgasm, even after adequate sexual stimulation and arousal. As with most definitions, it is considered a “disorder” only if also causing personal distress. Because it can be a direct consequence of Arousal Disorder, therapies treating problems of arousal become particularly important.
Sexual Pain Disorders: When women have recurrent or persistent genital or vaginal pain associated with intercourse, it is important for them to see a practitioner who can diagnose the cause of the pain. Although there can be many causes, perhaps one of the most common ones is the “atrophy” (thinning, dryness and other changes) of the vaginal tissues due to hormonal losses at menopause. Some vaginal infections (yeast, bacterial vaginosis) can cause painful intercourse.
Dr. Kroll has been a leading investigator in the area of female sexual function. She has been a principal investigator for studies for Viagra, testosterone, and flibanserin for women. She has appeared on national tv, international symposia and even on our own KUOW discussing these important concerns. She works closely with sex therapists, couples counselors and physical therapists to provide her patients with options for treatment. Sexual dysfunction in women is complex and multi-factorial. It requires a dedicated team and dedicated patients to make improvements. While we have no “quick fixes,” we work together with you as a team toward optimal sexual functioning.
For more information or to schedule an appointment, call 206-522-3330