What if the cure for adding more luster to your life is a fulfilling, sex life? But what happens when a woman feels distress about her sex life? Or she experiences sexual pain? Is there anything that she can do about it?
The answer is an emphatic yes! The good news is that there are solutions available.
Female sexual dysfunction encompasses various issues that can affect a woman's sexual function and well-being. There is an array of sexual function conditions that can affect a woman's sexual function. It includes problems like sexual pain, difficulty achieving orgasm, arousal challenges, and decreased sexual desire. These issues can be lifelong or acquired overtime. Female sexual dysfunction is defined as a perceived persistent problem with sexual response that causes her distress.
Many women may feel uncomfortable discussing these concerns with their healthcare practitioners, and some physicians may not be well equipped to address them. Finding a provider who is both comfortable and skilled in evaluating and treating these conditions is crucial for a successful resolution.
So, what does the evaluation and treatment of female sexual dysfunction involve?
1. Comprehensive Medical History: The first step is taking a thorough medical history, exploring psychological, medical, lifestyle, and medication related factors that could contribute to sexual dysfunction. This should cover relationship dynamics, satisfaction levels, sociocultural attitudes, stress and more. A detailed sexual history including sexual activity, function, and identity is essential for a complete assessment.
2. Identifying Specific Concerns: Pinpointing the exact issues and assessing their impact on a women's life and relationships is crucial. Standardized questionnaires may be used to assist in this process and provide a baseline for tracking progress during treatment.
3. 360-Degree Approach: Treating a sexual problem requires addressing multiple aspects of a woman's life. Topics such as trauma history, upbringing, menopausal status, birth history, prior surgeries, medication use, sleep, stress and evolving relationships are all considered. The goal is to tailor treatment to the individual’s unique needs and circumstances.
4. Team-Based Approach: Collaboration with various health professionals including: sex therapists, marriage and family therapists, pelvic floor physical therapists, neurologists, physical medicine and rehabilitation physicians, acupuncturists, gastroenterologists, and nutritionists may be necessary to effectively manage the condition.
5. Lifestyle Changes and Education: Discussions may include lifestyle adjustments, nutritional guidance, stress management techniques and patient education related to sexuality. Involving a partner in the treatment process is also important.
6. Medications: Depending on the specific condition, medications such as hormones, psychotropic agents or herbal supplements may be prescribed. If sexual dysfunction is related to medication side effects, consultations with the prescribing physician can be arranged.
Regular follow-up visits are generally recommended until the condition improves.
In essence, an integrative, 360-degree approach to an evaluation is performed. A sexual problem is like a prism- each aspect of it needs to be addressed and treated. Throughout a woman’s life cycle, her feelings and needs about sexuality may change as may her relationships. Also, every woman’s sexual interest, response, and needs differ. The purpose of the history is to assess what specifically distresses her and how it is impacting her life and her relationships.
I believe that the most important factor to treatment of female sexual dysfunction is finding the correct diagnosis to address. In my practice, I take an integrative and collaborative approach and I also explain to our patients that a team approach of utilizing other health professionals to help address her condition is key to a successful outcome. I first assess the patient’s goals and we address her expectations.
What are risk factors of female sexual dysfunction?
Female sexual dysfunction can stem from various sources, including psychological factors like anxiety or depression, relationship issues, history of abuse or trauma, medication side effects (such as oral contraceptives), medical conditions (like diabetes), fatigue, stress, and gynecological problems such as pelvic floor dysfunction, endometriosis, or history of traumatic deliveries. This is not an exhaustive list and multiple factors can contribute to a woman’s sexual health challenges.
What are types of female sexual dysfunction?
Female sexual dysfunction encompasses different phases of the sexual response cycle and are often overlapping. It can be categorized into the following general groups:
Desire
Arousal
Orgasm
Sexual pain disorders
Each category comprises specific conditions that causes distress for the individual, but detailed descriptions are beyond the scope of this blog post.
What does the physical exam involve?
Depending on the specific sexual concern, a targeted comprehensive physical exam is performed. A comprehensive gynecological sexual medicine exam typically includes visual observations of anatomy, skin abnormalities, and in cases of pain, a cotton swab or Q-tip test to assess tenderness. Vulvoscopy may also be used to examine skin changes. Vulvoscopy involves a magnification lens and light to look for skin changes or other dermatologic conditions of the vulva. A pelvic floor exam using a finger may be used to assess areas of pain or tension also.
What types of additional tests might be ordered?
Additional tests may include pelvic ultrasounds, CT scans, or MRI scans as needed to complement the physical exam. Hormonal testing through blood testing is routine. Specialized DNA-based swabs may also be used for an evaluation of chronic vaginal infections to identify underlying causes.
Overall, I feel that the time has come for women to embrace their sexuality and optimize their sexual health. It is an important facet to our humanity. With more practitioners becoming adept at evaluating and managing these conditions, it is my hope that female sexual dysfunction will no longer be a taboo topic but discussed openly and addressed appropriately.