Making the Diagnosis
Establishing the cause of sexual dysfunction is half the battle. The
stage of sexual activity at which a woman is having problems may offer some
clues. Other evidence may be found through physical and psychological testing.
Your family doctor can refer you to specialists who can help pinpoint what's
causing the problem.
In sexual desire disorder, a woman gains little or no pleasure from
sexual activity. The lack of pleasure almost always results in loss of
desire (which can sometimes happen first). The cause is likely depression or
drugs (prescription or otherwise) if the lack of interest is new and extends
to all partners and situations. On the other hand, this problem may point to
interpersonal factors if it's confined to one partner or one situation. If an
aversion to sexual pleasure has lasted through life, it may come from deep-seated
dilemmas about sexual gratification caused by family dysfunction or childhood
trauma.
Sexual arousal disorder refers to a woman's inability to become lubricated,
even after being sexually stimulated. The disorder may be lifelong but is more
commonly restricted to a particular partner.
Orgasmic disorder means that a woman may enjoy sexual activity but can't
reach orgasm. Physical causes are rare, except in cases of nerve damage in the
spine. Psychological factors may range from never having learned how to have
an orgasm, to unrealistic expectations from a partner, to feelings of guilt
at experiencing pleasure. Orgasmic disorder is diagnosed only when a woman has
no difficulty with arousal, only climax.