Acknowledgment, identification and treatment of Female Sexual Disorders (FSD)

Female sexuality has always been a sensitive topic of discussion among general populations. While few refused to accept female sexuality as an important subject that needs further studies, others continually researched and published articles on female sexuality. However, the topic remained so obscure that women wanting to research on their sexual health cannot easily get information on it.

Things have changed considerably in recent years. People are more open to discussing the problems related to women sexuality and not limit themselves to problems related to female pregnancy. Before the discussion on the problems of female sexuality, it is important to understand what is meant by ‘sexuality’.

Sexuality is not the act itself. It includes a lot of physical and psychological activities and experiences which develop one’s need for closeness and intimacy.

• Your sexual history and your feelings about yourself and your sexual partner, the kind of sexual experiences you have had-all determine your sexual make up.
• A woman’s sexual needs and arousal vary a lot. Most women have heightened sexual responsiveness around late 30’s and early 40’s. This does not mean that women cannot have satisfactory sexual experiences throughout their lives.
• The quality of sexual experiences whether it is of a woman or a man depends heavily on individual feelings and the age of the individual or even life-situations and overall health of an individual.
• Any problem that interferes with a woman’s ability to be satisfied by a sexual experience is generally termed as female sexual dysfunction (FSD) by health professionals.

The sexual responsiveness of a woman is required at various junctures of the act in itself. These junctures include:

• Desire (excitement phase) to engage in sexual activity.
• Arousal (plateau phase) of the body noticed by the secretion of liquids within the vagina that moistens the vagina, labia and vulva.
• Orgasm (climax) is the rhythmic contraction of the body that provides a pleasurable sensation.
• Resolution is the phase where the body returns to its unaroused state, having a feeling of satisfaction and peace.
• If a female body fail to have any of the above mentioned stages during a sexual experience it is understood that she is suffering from a sexual problem.

Identification of causes

There can be various physical and psychological reasons for a woman to suffer from FSD. These are:

Physical: A lot of medical problems like cancer, multiple sclerosis, bladder problems, kidney failures and heart diseases lead to sexual dysfunctions.

Medical: There are certain medications like antidepressants, antihistamines, blood pressure medicines and chemotherapy drugs which hinder sexual arousal and ones inability to have orgasms.

Hormonal: Hormonal changes and decrease in the level of estrogen hormone can lead to lower sexual responsiveness. Women going through menopause have fluctuating hormones leading to changes in genital tissues and decreased flow of blood to the pelvic region. These lead to low genital sensations, thus, leading to deferred arousal and orgasm. Low sexual activity leads to thinning of vaginal walls. These lead to painful intercourse or dyspareunia. Hormone levels also fluctuate after giving birth or during breastfeeding leading to dryness in the vagina and decreased desire for sexual activity.

Societal and psychological problems: People suffering from anxiety and depression have shown symptoms of sexual dysfunctions. Even a history of sexual abuse can lead to decreased arousal and leads to anxiety. The continuous stress of becoming pregnant and child rearing also affects sexual activity. The kind of relationship one has with her partner and the mental connection between couples has a lot of implication on the woman’s ability to perform sexually and have a successful sexual intercourse.

Risk factors

There are various risk factors that if left untreated can lead to added problems related to female sexuality. The risk factors are:

• Anxiety or depression
• Spinal cord injury or multiple sclerosis
• Vulvovaginal atrophy and lichen scleroses are few gynecological disorders that lead to sexual dysfunctions
• A history of sexual abuse

Treatment

There are various diagnoses that are performed by a doctor to understand the reasons for sexual dysfunction in women in order to provide the right treatment. A doctor would need your complete history of sexual activity and medical history to understand the cause of your problem. Pelvic examination detects physical changes like thinning of vaginal walls which might lead to scarring or pain affecting sexual arousal. Blood tests are suggested to understand underlying health conditions that might lead to sexual dysfunction.

According to the reports, doctors will suggest various treatments to patients. One thing that should be kept in mind is that sexual dysfunction is a problem only if it bothers you.

There are non-medical as well as medical treatments for female sexual dysfunctions.

Non-medical treatments include:

• Having a healthy communication with your partner about your likes and dislikes. Providing feedback in a nonthreatening way will lead to greater intimacy between partners.
• Practicing healthy lifestyle like limiting alcohol consumption and leading an active life will increase your general stamina and reduce depression making it easier for someone to get into the mood for sexual activity.
• Finding a professional counselor who specializes in sexual problems or couple therapy will help in understanding your body’s needs.
• Using lubricants during sex can combat vaginal dryness and help in stimulation.
• Using sexual devices for stimulating the clitoris can lead to a pleasurable experience.

Medical treatments

Estrogen therapy: This therapy helps in sexual function by increasing vaginal elasticity and tone by use of local estrogen therapy in the form of vaginal ring, tablet or cream.

The consequences of estrogen therapy vary according to the physical and medical conditions of an individual including cancer and heart and blood vessel diseases. Estrogen, when given alone or with progestin, will also have risk factors of estrogen therapy. Having a clear idea of the risks of hormone therapy is important and one should have a conversation with the doctor before going forward with the hormone therapy.

Androgen therapy: This includes testosterone. While testosterone is required for the proper sexual function of men, women also need small amount of testosterone for healthy sexual function.

There are different opinions about the effectiveness of androgen therapy. While few women with sexual dysfunction have benefited from androgen therapy while others have shown little or no benefit.

Ospemifene (Osphena): This helps women with vulvovaginal atrophy by reducing pain during sexual intercourse.

Flibanserin (Addyi): An antidepressant that has been approved by the Food and Drug Administration to treat low sexual desire in premenopausal women. Addyi is daily pills that boost sexual desire but can have serious side effects like nausea, sleepiness, fainting, low blood pressure, fatigue and dizziness especially when mixed with alcohol.

FSD is a serious problem among women and the percentage of women suffering from it is also increasing with every passing year. Thus, addressing this issue becomes important and urgent in recent times.