3 Ways to Categorize Female Sexual Dysfunction and Their Treatments

Better Understand Female Sexual Dysfunction

Shy couple in bed together
PhotoAlto/Frederic Cirou / Getty Images

For many people, sex is a pleasurable part of their relationships. It's a fun form of connection, not difficult or painful. However, that's not true for everyone. Many men and women experience various forms of sexual dysfunction. Although it's difficult to find good estimates, research suggests that between 40 and 50 percent of women have sexual symptoms or problems at some point during their lives.

Sexual dysfunction occurs in men as well. Some studies suggest it affects up to three quarters of men by the time they're in their 80s.

Types of Female Sexual Dysfunction

Types of sexual dysfunction can be broken down into several categories. All sexual dysfunctions in both men and women are considered to be either organic or non-organic. Organic dysfunctions are those caused by medical factors. These include hormonal problems, skin diseases, scar tissue, and other biological concerns.

Sexually transmitted diseases can also contribute to sexual dysfunction. Non-organic dysfunctions are caused by psychological or situational factors. For example, a woman who has difficulty getting turned on because she is not attracted to her partner. A woman who is afraid of sex due to a history of assault would also be considered to have a non-organic dysfunction.

Another way that female sexual dysfunctions are categorized by the medical profession are as follows.

Most of these conditions can be either organic or non-organic.

  1. Sexual Desire Problems. These occur when a person has trouble feeling sexual desire. This may reflect a change over time. For example, many people experience less desire as they get older. However, there are also some people who have never experienced sexual desire. If they consider this a problem, it's a sexual dysfunction. However, some people identify as asexual, and do not consider a lack of sexual desire a problem.
  1. Sexual Aversion. This is when someone is afraid of sex. It may take the form of extreme anxiety around sexual interactions. In general, people with sexual aversion disorders attempt to avoid all sexual encounters.
  2. Lack of Sexual Enjoyment. For people who lack enjoyment, they have normal sexual response. They become physically aroused and have orgasms.  However, they do not find those experiences pleasurable.
  3. Sexual Response Problems. These are situations where there are issues with the sexual response. A person may have difficulty becoming physically aroused. There may not be sufficient blood flow or lubrication. Vaginal dryness is a common type of sexual dysfunction in women. It occurs more frequently after menopause.  However, it can occur in women of any age.
  4. Orgasm Problems. Some people have difficulty orgasming. Others can not orgasm at all. It's worth noting that relatively few women can orgasm from penetration alone. Most require some form of clitoral stimulation.
  5. Vaginismus. This is an involuntary tightening of the muscles that surround the vagina. It can make penetration painful or even impossible.
  1. Pain during Intercourse. Otherwise known as dyspareunia, pain during intercourse can be physical, psychological, or both.
  2. Excessive sexual drive. This is when a person wants an amount of sex that is not healthy for their life.

Still a third way of categorizing female sexual dysfunction is used by mental health providers. These providers start by categorizing problems as life long or acquired and generalized or situational. Then they assess the level of distress caused by the sexual dysfunction. Finally, they categorize problems in one of three ways. The first is problems of sexual interest and arousal. The second is orgasm difficulties. The final is pain or penetration disorders.

Women who experience sexual dysfunction will likely get different diagnoses depending on whom they ask for help. However, in many situation involvement of both a therapist and a medical doctor is useful in determining the cause and treatment for sexual problems.

Non-Medical Treatments for Female Sexual Dysfunction

Many people with sexual dysfunctions are treated by sex therapists and other behavioral health providers. These treatments don't mean that sexual function is a mental health problem. It's just that behavioral techniques can be very effective forms of treatment.

Sex therapy is talk therapy, it does not involve any physical interaction between therapist and client. Sex therapy starts with an evaluation. Then various types of homework are prescribed. This homework can either be done alone or, if a person is in a relationship, with a partner. One common technique used for sex therapy is sensate focus. Sensate focus is a series of exercises that help individuals progress from safe, non-sexual touch with a partner to achieving their sexual goals.

Sex therapists are usually social workers, psychologists, and mental health providers who have gotten advanced training in treating sexual health problems. One organization that certifies sex therapists is AASECT (aasect.org) - the American Association for Sexuality Educators, Counselors, and Therapists. They have a directory on their site of certified sexuality therapists around the world. It can be a good source for locating treatment.

Medical Treatments for Female Sexual Dysfunction

Most types of female sexual dysfunction are treated through a combination of behavioral techniques. However, when there are organic causes of dysfunction, medical treatments may be appropriate. For example, when hormone changes after menopause cause vaginal dryness, topical estrogen can be an enormous help.

Drugs can also be used to manage underlying medical conditions, like diabetes, that affect sexual functioning in both men and women. Or medications, like antidepressants, can be changed if they are having negative effects on desire or arousal. Researchers are also looking at medications that can directly treat sexual dysfunction. For example, in 2016, a vaginal insert was approved to treat sexual pain in post menopausal women.

Physical therapy can be very helpful for women with certain types of sexual dysfunction. Physical therapy can be used to address mobility limitations. It can also be used to directly treat pelvic floor problems associated with pain and vaginismus.

Surgery is not usually the first choice intervention for sexual dysfunction, but it can be very helpful for some women.  Women with adhesions from endometriosis or pelvic inflammatory disease may experience significant pain during sex. Some choose surgery to address these problems. This could include anything from removal of scar tissue to removal of the uterus. Hysterectomy can also help with sexual pain from fibroids and other uterine growths.

A Word From Verywell

If you're having sexual problems, talk to someone. Many women think that pain during sex is normal. However, sex shouldn't be something you have to suffer through. If you're interested in getting help, it's out there. That's true whether your goal is to be able to have your first orgasm or just to have more enjoyable sex with your partner. Treatment can help many women experience their sexual goals.

It can be hard to find a doctor or therapist who is experienced with sexual problems. Unfortunately, many doctors and therapists are not comfortable talking about sex. Still, compassionate, qualified providers can be found.

Sources:

FDA (2016, November 17). FDA approves Intrarosa for postmenopausal women experiencing pain during sex. Retrieved November 19, 2016, from http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm529641.htm

Frühauf S, Gerger H, Schmidt HM, Munder T, Barth J. Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Arch Sex Behav. 2013 Aug;42(6):915-33. doi: 10.1007/s10508-012-0062-0.

Jindal UN, Jindal S. Use by gynecologists of a modified sensate focus technique to treat vaginismus causing infertility. Fertil Steril. 2010 Nov;94(6):2393-5. doi: 10.1016/j.fertnstert.2010.03.071.

McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT. Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016 Feb;13(2):135-43. doi: 10.1016/j.jsxm.2015.12.019.

McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Segraves RT. Incidence and Prevalence of Sexual Dysfunction in Women and Men: A Consensus Statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016 Feb;13(2):144-52. doi: 10.1016/j.jsxm.2015.12.034.

Continue Reading