Long considered a taboo subject, women’s sexuality is now openly discussed and portrayed on television, in magazines, and on the Internet. Most importantly, women themselves are becoming increasingly aware of their sexuality and their sexual health. Women of all ages are learning more about their sexuality.
What is “sexuality”? For a woman, as for a man, sexuality encompasses a very broad range of physical activities and psychological experiences. These activities fulfill an important physical and emotional need for closeness and intimacy!
• Sexuality doesn’t include just your sexual practices. It includes your feelings about yourself, how you relate to others, and about sex and previous sexual experiences, all of which are part of your sexual makeup.
• Your feelings about your partner and your relationship definitely affect your sexual satisfaction.
• Women’s interest in sex and responses to sexual stimulation vary widely. Although most women’s sexual responsiveness peaks in the late 30s and early 40s, a woman can have satisfying sexual experiences throughout her life.
• The quality of her experiences is affected by individual differences, by life situation, by age and hormonal levels, and by overall health and well-being.
• A sexual problem is anything that interferes with a woman’s satisfaction with a sexual activity. When this happens, it is often referred to by health professionals as Female Sexual Dysfunction (FSD).

Sexual Response Cycle
To understand why sexual problems occur, it is important to understand the sexual response cycle. This cycle is the same in both men and women, although at different rates and, obviously, with different physical changes. The cycle has 4 steps.
• Desire (Excitement Phase / Libido): Desire is a sexual “charge” that increases interest in and responsiveness to sexual activity.
• Arousal (Plateau Phase): Sexual stimulation – The 5 Senses: touch, vision, hearing, taste, smell, or imagination — brings about further physical changes.
• Orgasm (Climax): The peak of arousal that causes a pleasurable sensation.
• Resolution: The sexual organs return to their unaroused states, leaving one feeling content, relaxed, and possibly sleepy.
Every woman progresses through the cycle at her own rate, which is normal for her. A sexual problem may occur if ANY of these stages does NOT occur.

Sexual problems
The types of sexual problems in women correspond to the stages of the sexual response cycle. The sexual problems reported by women commonly consist of 3 – 4 types:
o Lack of sexual desire / Libido
o Difficulties becoming sexually aroused or achieving orgasm (Anorgasmia)
It has been estimated that 7% to 10% of women suffer from some sort of orgasmic disorder.
o Pain during intercourse / Dyspareunia) is not uncommon
Causes of Female Sexual Dysfunction (FSD)
The causes of sexual problems are as varied and complex as the human race.:
• Relationship problems
• History of Abuse
• Attitudes Toward Sex
• Sexual Problems of the Partner
• Emotional problems
• Insufficient stimulation
• Gynecologic problems:
o Vaginal dryness
o Vaginismus
o Sexually Transmitted Diseases (STD’s)
o Vaginitis
o Endometriosis, Pelvic Mass, Ovarian Cyst and/or Surgical Scars
o Pelvic Inflammatory Disease (PID)
o Nerve Damage after Surgery
• Physical / Medical Conditions:
o Tiredness (Fatigue)
o Chronic Diseases, i.e., Diabetes, Heart Disease, Liver Disease & Kidney Disease
o Cancer
o Neurologic Disorders
o Vascular (blood flow) Disorders
o Hormonal Imbalances
o Menopause
o Pregnancy
o Alcohol or Drug Abuse
• Medications:
Anti-Depressants (Selective Serotonin Re-uptake Inhibitor (SSRI)), i.e., Prozac and Zoloft.
Chemotherapy Drugs
Anti-Hypertensive Agents
Antipsychotic Medications
• Other Medical Treatments, i.e., Radiation Therapy.
When to Seek Medical Care
NOT all sexual problems require medical attention (temporary).
However, any sexual problem that persists for more than a few weeks is worth a visit to your doctor. He or she can rule out medical or medication causes, as well as, refer you to other specialists if necessary: a psychotherapist, a marriage counselor, or a sex therapist.
Certain problems require Immediate Attention:
• If intercourse suddenly becomes painful when it wasn’t before.
• If you have reason to believe you have a sexually transmitted disease (STD’s).
• Any unusual reaction to sexual activity, such as headache, brief chest pain, or pain elsewhere in the body.
Diagnosis of Female Sexual Dysfunction (FSD)
• Extensive Medical Interview
• A complete Physical Examination; and +/-Gynecologist and/or other Specialists.
• Laboratory Studies, particularly “Free” Hormone levels; and other tests to rule-out undiagnosed medical conditions, particularly Thyroid Disorders, HTN & DM.
• Rarely, Radiological tests.
Female Sexual Problems Treatment
• Treatment for sexual problems varies depending on the type of problem. Sometimes NO treatment is required.
Self-Care of Female Sexual Dysfunction (FSD)
Treatment is not needed for all sexual problems. Some problems can be solved by you and your partner alone with a little openness and creativity. (There are some book resources).
• Patience and Understanding
• Talking the problem out with your partner
• Try to make the solution fun, i.e., inject a little romance and excitement into your sexual routine:
o Date Night
o Erotic Videos or Books
o Fantasize about what arouses you sexually; if appropriate, tell your partner about these fantasies.
o Masturbation
o Sensual Massage and other forms of Touch
o Try new Sexual Positions or Scenarios
o Relaxation Techniques, i.e., warm bath before having sex
o Vaginal Lubricant, including some of the OTC Vasodilators
Female Sexual Problems Medical Treatment
If the sexual problem is caused by a medical or physical problem, your health care professional or consulting specialist will suggest an appropriate treatment plan.
This will vary, of course, depending on the nature of the problem.
The PLAN: (Any or All)
Medication
Lifestyle Changes
Surgery (Tumors and Cysts)
Counseling (lack of knowledge about the sexual response cycle)
Effective Therapies
• Vaginal lubricants, Boudreaux’s Pharmacy’s “Scream Cream”
• BHRT, including Topical Vaginal Hormones, i.e., Estrogen and Testosterone
• Clitoral Therapy Devices
• +/- OTC Supplements and Herbal Remedies – CAUTION
• Drugs:
Sildenafil (Viagra) – The effects of Viagra in women have been studied, but results are not conclusive.
Bupropion (Wellbutrin) – It has been used to treat certain cases of orgasmic disorders, and preliminary studies have confirmed its effectiveness in some patients.
ADDYI is the first and only FDA-approved treatment for acquired, generalized hypoactive (low) sexual desire disorder—HSDD— in women who have not gone through menopause. Possibly, marginally effective!!!
Female Sexual Problems Other Therapy
Psychotherapy
Can help to identify problems in a woman’s life that may be expressed as sexual problems.
• Past sexual or other abuse, rape, or traumatic sexual encounters.
• Unresolved emotional issues or dissatisfaction with other areas of life.
The Focus: Resetting the woman’s attitudes toward sex.
The Goal: Getting rid of old attitudes (got in the way of enjoyable sex); and Establishing new attitudes (increase sexual responsiveness).
If the problem relates to your relationship, couples counseling is recommended.
The couples’ therapist is trained and experienced at helping couples recognize, understand, and solve their problems.
Couples Therapy and Couples Group Therapy
Group Therapy / Support Groups
Sex Therapy “sensate focus”

Prevention of Female Sexual Dysfunction (FSD)
Open and Honest Communication
Adopt a Healthy Lifestyle (promote overall well-being)
• Eat a healthy diet.
• Don’t use tobacco.
• Get active physically for at least 30 – 45 minutes every day.
• Get plenty of rest (7 – 8.5 hours – Uninterrupted).
• Keep stress under control.
• If you drink alcohol, do so in moderation.
• Have regular recommended health screenings, i.e., Hormone Testing, Pap Smear, Thermography, Mammography, Colonoscopy and Prostate Exam (PSA, free and total).