Female Sexual Dysfunction

There are many factors that can decrease a women's desire for sex, such as her overall health, fatigue, self-image, stress, and the quality of her relationship. All of these factors must be considered when evaluating a woman for FSD.

Arousal disorders affect up to 31 percent of women with FSD. Although many women have the desire to have sex, they do not experience sexual arousal.

Female orgasmic disorder can be defined as delay in or absence of attaining an orgasm following sufficient sexual stimulation and arousal, which causes personal distress.

There are many causes of pain disorders and these disorders are much more common in post-menopausal women due to a decrease in estrogen. Some other common causes of pain disorders, such as vulvar vestibulitis, are more difficult to treat and many require surgical intervention.

In the Sexual Wellness Program, an FSD evaluation consists of a detailed history and physical examination. This also involves completing pre-clinic questionnaires for the patient and her partner. Most women will have laboratory testing to evaluate her hormone levels as well as to look for other causes of FSD, such as hypothyroidism. If indicated, some women will have specialized testing such as genital ultrasound, quantitative sensory testing, or endothelial function testing.

An algorithm is used for treating FSD which involves identification, education, modification, medical therapy, and surgery (if needed).

• Treatment involves primarily identification of the problem, such as a desire disorders or pain disorders. Identification of the problem is made through the history, physical examination, questionnaire responses, and laboratory and specialized testing.
• After identifying the problem, we focus on educating the patient and her partner on female sexual dysfunction, the female anatomy, and the causes and treatments for the different types of sexual dysfunction disorders.
• Many times modifications will have to be made in a women's lifestyle (i.e. diet, exercise, stress reduction) or in her medications. Women may need to undergo biofeedback or relaxation techniques.
• Medical therapy involves hormonal and non-hormonal treatments. Hormonal treatments many include estrogen and/or testosterone replacement therapy. Non-hormonal treatments include medications such as Wellbutrin or certain natural herbs.
• Surgical therapy is indicated in only a select group of women, particularly those who suffer from pain disorders. Surgical procedures include labioplasty, vestibulectomy, and incontinence procedures.

If indicated, some women will require a referral to another specialist, such as a sex therapist, psychiatrist, or an endocrinologist. We have designed a group of specialists all specially trained to treat the issues of female sexual dysfunction.