Female Sexual Dysfunction

    Fact-checked

    by:

    Last Updated: August 16, 2022

    In women, “sexual dysfunction” encompasses many conditions related to one’s ability to have or enjoy sex. Sexual dysfunction may involve issues with desire, arousal, orgasm, or intercourse. Because the causes of sexual dysfunction vary, treatments for the condition also vary.

    Female Sexual Dysfunction falls under the Healthy Aging & Longevity and Women’s Health categories.

    What is female sexual dysfunction?

    “Sexual dysfunction” is a blanket term for conditions that affect a person’s ability to have or enjoy sexual activity. In women, such conditions include:[1]

    • Hypoactive sexual disorder
    • Sexual aversion disorder
    • Female sexual arousal disorder
    • Female orgasmic disorder
    • Dyspareunia
    • Vaginismus

    What are the main signs and symptoms of female sexual dysfunction?

    The signs and symptoms of sexual dysfunction vary on the condition, but often involve:[2]

    • A lack of sexual desire
    • Difficulty becoming aroused
    • Difficulty having an orgasm, or being unable to have an orgasm
    • Experiencing painful intercourse

    How is female sexual dysfunction diagnosed?

    Sexual dysfunction is typically diagnosed with a combination of a patient interview, a physical examination (particularly a pelvic exam), and blood tests. Not all sexual dysfunction will have a physiological dimension, so one’s personal emotional/psychological/cultural experience of sex is important to factor in.[3][4]

    What are some of the main medical treatments for female sexual dysfunction?

    Medical treatment can vary based on the nature of the sexual dysfunction that a person is experiencing, but may include topical or systemic hormone therapy, phosphodiesterase inhibitors, or psychiatric medications such as antidepressants.[1]

    Have any supplements been studied for female sexual dysfunction?

    Maca is one of the better-studied supplements for libido (in both men and women), and can produce a notable increase in libido. Additionally, tribulus-terrestris may produce a small improvement in libido. A handful of studies have found promising but preliminary effects of fenugreek, eurycoma longifolia, panax ginseng, and rhodiola rosea.

    How could diet affect female sexual dysfunction?

    Diet primarily influences sexual dysfunction through diet-related health conditions. Undereating (e.g., due to “overdieting” or food insecurity) can suppress libido. Additionally, conditions such as obesity, metabolic-syndrome, and type-2-diabetes can negatively affect sexual function, so dietary practices that are conducive to healthy body weight (i.e., aiming to be neither over- nor underweight) and cardiovascular function are advisable.[5][6]

    Are there any other treatments for female sexual dysfunction?

    Psychotherapy can be beneficial when sexual dysfunction is related to psychological/emotional factors (such as anxiety, traumatic experience, or poor body image). Similarly, education about genital anatomy and the ways in which healthy sexual function varies can benefit individuals who are concerned about how their bodies/sexual behavior compares to “normal”.[1][3]

    Physical activity can benefit sexual dysfunction in a number of ways, including increasing stamina, elevating mood, and potentially improving body image.[7]

    Physiotherapy and vaginal dilators can also be useful tools for treating sexual dysfunction, particularly if hypertonicity of the vaginal muscles is involved.[8][9]

    What causes female sexual dysfunction?

    “Normal” sexual function requires the vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.[10] Physiological causes of sexual dysfunction can include issues with the genitourinary, cardiovascular, musculoskeletal, neurological, and endocrine systems. Emotional, psychological, and cultural causes can include the use of libido-affecting medications, anxiety and depression, traumatic experience, a sexually repressive cultural environment, poor body image, fatigue, and substance abuse.

    Examine Database: Female Sexual Dysfunction

    What works and what doesn't?

    Unlock the full potential of Examine

    Get started

    Research FeedRead all studies

    Frequently asked questions

    What is female sexual dysfunction?

    “Sexual dysfunction” is a blanket term for conditions that affect a person’s ability to have or enjoy sexual activity. In women, such conditions include:[1]

    • Hypoactive sexual disorder
    • Sexual aversion disorder
    • Female sexual arousal disorder
    • Female orgasmic disorder
    • Dyspareunia
    • Vaginismus
    What are the main signs and symptoms of female sexual dysfunction?

    The signs and symptoms of sexual dysfunction vary on the condition, but often involve:[2]

    • A lack of sexual desire
    • Difficulty becoming aroused
    • Difficulty having an orgasm, or being unable to have an orgasm
    • Experiencing painful intercourse
    How is female sexual dysfunction diagnosed?

    Sexual dysfunction is typically diagnosed with a combination of a patient interview, a physical examination (particularly a pelvic exam), and blood tests. Not all sexual dysfunction will have a physiological dimension, so one’s personal emotional/psychological/cultural experience of sex is important to factor in.[3][4]

    What are some of the main medical treatments for female sexual dysfunction?

    Medical treatment can vary based on the nature of the sexual dysfunction that a person is experiencing, but may include topical or systemic hormone therapy, phosphodiesterase inhibitors, or psychiatric medications such as antidepressants.[1]

    Have any supplements been studied for female sexual dysfunction?

    Maca is one of the better-studied supplements for libido (in both men and women), and can produce a notable increase in libido. Additionally, tribulus-terrestris may produce a small improvement in libido. A handful of studies have found promising but preliminary effects of fenugreek, eurycoma longifolia, panax ginseng, and rhodiola rosea.

    Do herbal aphrodisiacs work?
    Quick answer:

    It depends on the product touted to be an aphrodisiac, but some of them do apparently increase sexual desire; it is a relatively under-researched topic though, and we don't know why they increase sexuality.

    In general, yes; some compounds may act as aphrodisiacs (in addition to being pro-erectile agents, usually seen as a different category). Not all compounds touted to increase libido do, but quite a few herbs have shown to be effective in increasing libido and sexuality.

    A wide variety of herbals and related compounds are marketing for increasing sex drive and appetite. These aphrodisiacs are usually herbs that have been used traditionally for increasing 'vitality' or male 'sexuality' and are being investigated scientifically for their roles in either fighting age-related sexual decline or possibly to fight andropause (a term used to mimick menopause, describing the decline of vitality and testosterone seen in aging men).

    How can we tell if a compound is an aphrodisiac?

    No sufficient in vitro (in glass) test will tell if a compound is a good aphrodisiac, studies done on the subject matter must be in vivo (in life); usually a rat model.

    In general, rats are given a compound and then their sexuality is observed. Pre-sexual signs (anorectal sniffing of female rats) indicate libido whereas the frequency of sexual encounters (mounting, ejaculation latency, time to re-mount or time between ejaculations) indicate virility. These studies, if they note an increase in rat sexuality, serve as the starting evidence for what works as an aphrodisiac.

    It should be noted that rats can either be chemically or physically castrated or they can be otherwise healthy; this is an important distinction, as castracted rats serve as a model for human hypogonadism (chemically usually mimicks central hypothalamic hypogonadism, and crushing the poor rat testicles mimicks peripheral, or testicular, hypogonadism). Otherwise healthy rats would be a good model for otherwise healthy humans.

    After rat studies, compounds are sometimes tested in humans for their aphrodisiac effects. The results are usually obtained via self-report survey about how sexual the subjects felt during the trial period.

    Compounds that act as Aphrodisiacs

    Compounds that have been touted or otherwise shown to increase Aphrodisia and Sexual appetite are currently listed and updated on our categorical page on Aphrodisiac compounds.

    How could diet affect female sexual dysfunction?

    Diet primarily influences sexual dysfunction through diet-related health conditions. Undereating (e.g., due to “overdieting” or food insecurity) can suppress libido. Additionally, conditions such as obesity, metabolic-syndrome, and type-2-diabetes can negatively affect sexual function, so dietary practices that are conducive to healthy body weight (i.e., aiming to be neither over- nor underweight) and cardiovascular function are advisable.[5][6]

    Can alcohol influence female libido?

    Yes. Although a little alcohol might decrease one’s inhibitions and thus increase libido, too much alcohol acutely (drunkenness) or chronically (alcoholism) can lead to sexual disorders, loss of libido and less intense orgasms.

    Are there any other treatments for female sexual dysfunction?

    Psychotherapy can be beneficial when sexual dysfunction is related to psychological/emotional factors (such as anxiety, traumatic experience, or poor body image). Similarly, education about genital anatomy and the ways in which healthy sexual function varies can benefit individuals who are concerned about how their bodies/sexual behavior compares to “normal”.[1][3]

    Physical activity can benefit sexual dysfunction in a number of ways, including increasing stamina, elevating mood, and potentially improving body image.[7]

    Physiotherapy and vaginal dilators can also be useful tools for treating sexual dysfunction, particularly if hypertonicity of the vaginal muscles is involved.[8][9]

    Can exercise reduce symptoms of female sexual dysfunction?

    A moderate amount of exercise can increase levels of hormones in the body including testosterone, estrogen, cortisol, prolactin, and oxytocin — all of which play a role in one’s sex drive. Regular exercise has been shown to improve sexual satisfaction, partly by improving mood and sexual wellbeing.[16] These effects may also be linked to exercise creating a more positive body image in some individuals. Exercise may also alleviate sexual dysfunction in women who are using antidepressants and women who have had a hysterectomy.[16] As with all things, the dose matters! Whereas moderate levels of physical activity are associated with better sexual function and lower sexual distress, excessive exercise is associated with poor sexual function and low sexual satisfaction.[7]

    How does cannabis use influence female sexual dysfunction?

    cannabis use is frequently associated with feelings of euphoria that may enhance mood, increase sexual desire, and boost arousal — leading to a better sexual experience. Unfortunately, there is a lack of research on the effects of cannabis on sexual function. Cannabis use has been linked to increase sexual frequency in women.[17] Higher frequency of cannabis use has been found to be unrelated to sexual problems in women [18] and in fact, some studies find that women who frequently use cannabis report greater sexual satisfaction than less-frequent or non-users.[19]

    What causes female sexual dysfunction?

    “Normal” sexual function requires the vascular, neurological, hormonal, and psychological systems to function together. As such, issues with any of these symptoms may produce issues with sexual function.[10] Physiological causes of sexual dysfunction can include issues with the genitourinary, cardiovascular, musculoskeletal, neurological, and endocrine systems. Emotional, psychological, and cultural causes can include the use of libido-affecting medications, anxiety and depression, traumatic experience, a sexually repressive cultural environment, poor body image, fatigue, and substance abuse.

    How does stress influence female sexual dysfunction?

    Chronic stress, depression, and anxiety may all contribute to sexual dysfunction. When stress levels go up, hormones like cortisol and epinephrine are released, which can diminish sex drive and libido. Women who experience chronic high stress have lower levels of genital arousal, higher levels of cortisol, and more distraction during moments of sexual arousal.[11] Even a brief period of acute stress can diminish sexual arousal.[12] Long-term stress due to sexual abuse, worries about pregnancy or infertility, and the increased demands of becoming a mother are also sources of social and psychological stress that may contribute to sexual dysfunction.[13]

    Does low estrogen cause sexual dysfunction?

    During menopause, the decline in estrogen and testosterone can diminish one’s sex drive, arousal, and interest in sex. However, not all postmenopausal women report a loss of sex drive and, in fact, lower levels of stress and anxiety due to motherhood may actually lead to improved intamacy and libido during this stage of life. Low estrogen levels do contribute to vulvovaginal atrophy (characterized by dryness, itching, irritation, and reduced vaginal lubrication),reduced vaginal blood flow, and the capacity for arousal and orgasm.[14] Treatment with estrogen therapy seems to improve many of these symptoms.[15]

    References

    1. ^Frank JE, Mistretta P, Will JDiagnosis and treatment of female sexual dysfunction.Am Fam Physician.(2008-Mar-01)
    2. ^MedlinePlusSexual Problems in Women
    3. ^Emerson CRReview of low libido in women.Int J STD AIDS.(2010-May)
    4. ^Mayo Clinic Female sexual dysfunction
    5. ^Mollaioli D, Ciocca G, Limoncin E, Di Sante S, Gravina GL, Carosa E, Lenzi A, Jannini EAFLifestyles and sexuality in men and women: the gender perspective in sexual medicine.Reprod Biol Endocrinol.(2020-Feb-17)
    6. ^Towe M, La J, El-Khatib F, Roberts N, Yafi FA, Rubin RDiet and Female Sexual Health.Sex Med Rev.(2020-Apr)
    7. ^Maseroli E, Rastrelli G, Di Stasi V, Cipriani S, Scavello I, Todisco T, Gironi V, Castellini G, Ricca V, Sorbi F, Fambrini M, Petraglia F, Maggi M, Vignozzi LPhysical Activity and Female Sexual Dysfunction: A Lot Helps, But Not Too Much.J Sex Med.(2021-07)
    8. ^Rosenbaum TYPhysiotherapy treatment of sexual pain disorders.J Sex Marital Ther.(2005)
    9. ^Verbeek M, Hayward LPelvic Floor Dysfunction And Its Effect On Quality Of Sexual Life.Sex Med Rev.(2019-10)
    10. ^Dirk Rösing, Klaus-Jürgen Klebingat, Hermann J Berberich, Hartmut A G Bosinski, Kurt Loewit, Klaus M BeierMale sexual dysfunction: diagnosis and treatment from a sexological and interdisciplinary perspectiveDtsch Arztebl Int.(2009 Dec)
    11. ^Hamilton LD, Meston CMChronic stress and sexual function in women.J Sex Med.(2013-Oct)
    12. ^Ter Kuile MM, Vigeveno D, Laan EPreliminary evidence that acute and chronic daily psychological stress affect sexual arousal in sexually functional women.Behav Res Ther.(2007-Sep)
    13. ^Mayo Clinic StaffFemal Sexual Dysfunction
    14. ^Simon JAIdentifying and treating sexual dysfunction in postmenopausal women: the role of estrogen.J Womens Health (Larchmt).(2011-Oct)
    15. ^Kovalevsky GFemale sexual dysfunction and use of hormone therapy in postmenopausal women.Semin Reprod Med.(2005-May)
    16. ^Stanton AM, Handy AB, Meston CMThe Effects of Exercise on Sexual Function in Women.Sex Med Rev.(2018-Oct)
    17. ^Sun AJ, Eisenberg MLAssociation Between Marijuana Use and Sexual Frequency in the United States: A Population-Based Study.J Sex Med.(2017-11)
    18. ^Smith AM, Ferris JA, Simpson JM, Shelley J, Pitts MK, Richters JCannabis use and sexual health.J Sex Med.(2010-Feb)
    19. ^Kasman AM, Bhambhvani HP, Wilson-King G, Eisenberg MLAssessment of the Association of Cannabis on Female Sexual Function With the Female Sexual Function Index.Sex Med.(2020-Dec)

    Examine Database References

    1. Libido - de Souza KZ, Vale FB, Geber SEfficacy of Tribulus terrestris for the treatment of hypoactive sexual desire disorder in postmenopausal women: a randomized, double-blinded, placebo-controlled trialMenopause.(2016 Nov)
    2. Libido - Akhtari E, Raisi F, Keshavarz M, Hosseini H, Sohrabvand F, Bioos S, Kamalinejad M, Ghobadi ATribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled studyDaru.(2014 Apr 28)
    3. Libido - Gama CR, Lasmar R, Gama GF, Abreu CS, Nunes CP, Geller M, Oliveira L, Santos AClinical Assessment of Tribulus terrestris Extract in the Treatment of Female Sexual DysfunctionClin Med Insights Womens Health.(2014 Dec 22)
    4. Libido - Vale FBC, Zanolla Dias de Souza K, Rezende CR, Geber SEfficacy of Tribulus Terrestris for the treatment of premenopausal women with hypoactive sexual desire disorder: a randomized double-blinded, placebo-controlled trialGynecol Endocrinol.(2018 May)
    5. Libido - Meston CM, Rellini AH, Telch MJShort- and long-term effects of Ginkgo biloba extract on sexual dysfunction in womenArch Sex Behav.(2008 Aug)
    6. Libido - Wheatley DTriple-blind, placebo-controlled trial of Ginkgo biloba in sexual dysfunction due to antidepressant drugsHum Psychopharmacol.(2004 Dec)
    7. Libido - Morales A, Black A, Emerson L, Barkin J, Kuzmarov I, Day AAndrogens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiencyAging Male.(2009 Dec)
    8. Libido - Conaglen HM, Suttie JM, Conaglen JVEffect of deer velvet on sexual function in men and their partners: a double-blind, placebo-controlled studyArch Sex Behav.(2003 Jun)
    9. Libido - Harte CB, Meston CMThe inhibitory effects of nicotine on physiological sexual arousal in nonsmoking women: results from a randomized, double-blind, placebo-controlled, cross-over trialJ Sex Med.(2008 May)
    10. Sexual Function - Brooks NA, Wilcox G, Walker KZ, Ashton JF, Cox MB, Stojanovska LBeneficial effects of Lepidium meyenii (Maca) on psychological symptoms and measures of sexual dysfunction in postmenopausal women are not related to estrogen or androgen contentMenopause.(2008 Nov-Dec)
    11. Sexual Function - Dording CM, Schettler PJ, Dalton ED, Parkin SR, Walker RS, Fehling KB, Fava M, Mischoulon DA double-blind placebo-controlled trial of maca root as treatment for antidepressant-induced sexual dysfunction in womenEvid Based Complement Alternat Med.(2015)
    12. Sexual Function - Kashani L, Raisi F, Saroukhani S, Sohrabi H, Modabbernia A, Nasehi AA, Jamshidi A, Ashrafi M, Mansouri P, Ghaeli P, Akhondzadeh SSaffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled studyHum Psychopharmacol.(2013 Jan)
    13. Depression Symptoms - Sue Gessler, Michael King, Alessandra Lemma, Julie Barber, Louise Jones, Susan Dunning, Val Madden, Stephen Pilling, Rachael Hunter, Peter Fonagy, Karen Summerville, Nicola MacDonald, Adeola Olaitan, Anne LanceleyStepped approach to improving sexual function after gynaecological cancer: the SAFFRON feasibility RCTHealth Technol Assess.(2019 Feb)