Causes
Female sexual dysfunction can have a physiological basis in the body (something
is physically wrong), a psychological basis in the mind, or be the result of
both underlying mental and physical problems. It can also be a matter of
problems with technique: some women never fully experience sexual arousal and
orgasm because they or their partners lack sexual knowledge. They may not understand
how female sex organs respond or are stimulated, or don't use appropriate arousal
techniques. In these cases, a lack of understanding of the function of the clitoris,
the female sex organ producing orgasm, may be at the root of the problem.
At the same time, sexual dysfunction has a strong interpersonal component.
A person's notion of their own sexuality is largely determined by culture, society,
and personal experience. It may be intimately connected to their own or society's
ideas about the appropriate or inappropriate expression of sexual behavior.
These feelings may cause anxiety because of a personal or cultural association
of sexual experience and pleasure with immorality and bad behavior. Anxiety
is then expressed physically by the body in a way that prevents normal sexual
function. Anxiety can do this, for example, by stopping or slowing the state
of sexual excitement allowing the lubrication or moistening of the female genitalia -
an important step towards fulfilling forms of sexual activity.
Personal character, disposition, and life experience play a large part in
sexual dysfunction. Fear of intimacy can be a factor in arousal problems.
Experiences of abuse, either in childhood or in past or current relationships,
can establish a cycle of associating sex with psychological or physical pain.
Attempting sexual activity in these circumstances causes more psychological
or physical pain. For example, if anxiety prevents lubrication, sexual intercourse
can be painful.
Conflict, tension, and incompatibility with a sexual partner can cause sexual
dysfunction. Depression may be a cause, and stress a contributing factor.
Medications, including oral contraceptives, antihypertensives, antidepressants,
and tranquilizers are very common causes of sexual dysfunction. Also, the use
of oral contraceptives can decrease a woman's interest in sex. If you're taking
any of these medications, talk to your doctor about its possible contribution
to sexual problems.
Physical causes include disorders of the genitalia and the urinary system
such as endometriosis, cystitis, vaginal dryness, or vaginitis. Other conditions
such as hypothyroidism, diabetes mellitus, multiple sclerosis, or muscular dystrophy
can have an impact on sexual desire and ability. Surgical removal of the uterus
or of a breast may contribute psychologically to sexual dysfunction if a woman
feels her self-image has been damaged.
Certain prescription and over-the-counter medications as well as the use of illegal drugs
or abuse of alcohol may contribute to sexual dysfunction. Cigarette smoking may
have a negative effect on sexual arousal in women.
Although women can remain sexually active and experience orgasms throughout
their lives, sexual activity often decreases after age 60. While part of this
may be due to a lack of partners, changes such as dryness of the vagina caused
by lack of estrogen after menopause may make intercourse painful and reduce
desire. After menopause, about 15% of women feel a strong decrease in sexual
desire.