Female Sexual Dysfunction

Human sexual function is an essential component of life, both in species propagation as well as the quality of life. Sexual dysfunction can lead to reduced quality of life and potentially procreative advancement.

Male sexual dysfunction, especially erectile dysfunction, has been extensively studied and effective therapies are available for men with this disorder.

However, female sexual dysfunction (FSD) is more complicated and significantly less is understood in comparison to male sexual dysfunction.

Female sexual dysfunction (FSD) is a prevalent problem, afflicting approximately 40% of women and there are few treatment options.

FSD is more typical as women age and is a progressive and widespread condition.

Common symptoms associated with FSD include diminished vaginal lubrication, pain, and discomfort upon intercourse decreased sense of arousal, and difficulty in achieving orgasm.

Only a small percentage of women seek medical attention.

In comparison to the overwhelming research and treatment for erectile dysfunction in males, specifically with the development of phosphodiesterase type 5 inhibitors, significantly less has been explored regarding FSD, and treatment is primarily limited to psychological therapy.

Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease, and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men.

Sexual function results from a complex neurovascular process that is controlled by psychological and hormonal inputs.

Like any coordinated physiological response, multiple systems are involved in this function.

In respect to proper vaginal and clitoral function, a sufficient blood supply is required for a satisfying sexual experience.

Demonstrates relative pressure and volume values from the vagina and labia as well as the clitoris, respectively, during a period of arousal, orgasm, and post-orgasm.

Vaginal and labial data were derived from partial oxygen pressures detected at each tissue site while magnetic resonance imaging of the clitoris measured changes in volume during neutral and stimulating visual imagery represents a typical sexual response in women,

However, the complexity and unique individual response allow for numerous sites of dysregulation, which can lead to sexual dysfunction.

FSD is defined by the World Health Organization as the various ways in which a woman is unable to participate in a sexual relationship as she would wish.

FSD is more complex and difficult to categorize due to a woman’s perception of sex when compared to males.

FSD is a multifaceted disorder, comprising anatomical, psychological, physiological, as well as social-interpersonal components.

With several existing FSD definitions, the most descriptive encompasses FSD as the persistent / recurring decrease in sexual desire or arousal.

The difficulty / inability to achieve an orgasm, and/or the feeling of pain during sexual intercourse.

Appreciating the uniqueness of each FSD facet is critical in our understanding and potential treatment of FSD in general terms.

Hypoactive sexual desire disorder (HSDD) is the persistent or recurrent absence of sexual fantasies/thoughts and/or desire for sexual activity leading to personal distress.

Female sexual arousal disorders (FASD) can be defined as a recurrent inability to attain or maintain until completion, sexual activity.

An example of this is an adequate lubrication/swelling response of sexual excitement. The arousal response consists of vasocongestion in the pelvis, vaginal lubrication, and expansion and swelling of external genitals.

Orgasmic disorders can be categorized with FASD and are described as the persistent or recurrent difficulty, delay in, or absence of, attaining orgasm following sufficient sexual stimulation and arousal that leads to personal distress.

Sexual pain disorders are another form of FSD and are diagnosed as followed:

Dyspareunia, the recurrent or persistent genital pain associated with sexual intercourse, vaginismus, the recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration, and noncoital sexual pain disorder, the recurrent or persistent genital pain induced by noncoital sexual stimulation.

Throughout society, sexual disorders for women are influenced by both health-related and psychosocial factors. Taken together, this dynamic is associated with impaired quality of life and interpersonal relationships.

Significant improvements in overall clinical care have allowed the management of quality of life complications and not just the treatment of life-threatening diseases

Importantly, several studies have linked cardiovascular diseases with sexual dysfunction, in both females and males. Therefore, the treatment of FSD as purely a lifestyle disorder may severely underestimate the seriousness of the situation

Indeed, the prevalence of sexual dysfunction in women with chronic compensated heart failure suggests a reduction in quality of life.

FSD is challenging due to the multifaceted and varied inputs that define this disorder.

Clinically, treatment success is variable in women with sexual dysfunction due to the rationale that not every woman responds to sexual stimulus treatment the same.