There are many reasons why a woman may experience a sexual health problem.  Certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high blood pressure), excessive alcohol use or vaginal infections can cause sexual problems. Depression, relationship problems or abuse (current or past abuse) can also cause sexual dysfunction. You may have less sexual desire during pregnancy, right after childbirth or when you are breastfeeding. After menopause many women feel less sexual desire, have vaginal dryness or have pain during sex due to a decrease in estrogen (a hormone in the body). The stresses of everyday life can also affect your ability to have sex. Being tired from a busy job or caring for young children may affect your sexual desire. You may also be bored by a long-standing sexual routine.

There are several types of sexual dysfunctions. They can be lifelong problems that have always been present, acquired problems that develop after a period of normal sexual function or situational problems that develop only under certain circumstances or with certain partners. Causes of sexual dysfunctions can be psychological, physical or related to interpersonal relationships or sociocultural influences.

Sometimes determining what is causing the issue is as important as treating it, in case the risk factor can be eliminated and the sexual health concern disappear.  Learning that something you are doing or a medication you are taking may cause a problem in the future may mean you want to modify the activity now or talk with your doctor about an alternative medication.  You may have several sexual health concerns from the same risk factor or from multiple risk factors.  It may be helpful to let your doctor know that you have some of these risk factors because that may help in diagnosing the specifics of your desire, arousal, orgasm and/or sexual pain issues and subsequently in treating them.  You may have none of the risk factors listed.  The causes and risk factors listed on this site are provided as information only and are not meant for self-diagnosis and treatment.

Diagnosis of women’s sexual health concerns begins with identification of the sexual health problem. This includes undergoing a sexual, medical and psychosocial history and physical examination, independent psychologic evaluation, completion of psychometrically validated outcome questionnaires, and laboratory testing. The next phase involves educational discussions with the patient and the partner, if possible, concerning relevant topics such as physiology of sexual function and pathophysiology of sexual dysfunction based on the pertinent information identified during the identification phase. Specific individual patient (and partner) educational needs and goals of sexual heath care management need to be addressed.

Treatment of women's sexual health concerns follows a step-care process that begins with modification of reversible causes and then proceeds to first-line, second-line, and third-line treatment strategies. Maneuvers to modify reversible causes include sex therapy, cognitive behavior therapy, physical therapy, lifestyle changes including exercise and diet, alteration of prescription medications, discontinuation of recreational drugs, management of partner sexual dysfunction, and other behavior modifications such as relaxation therapy. First-time therapies include hormone therapy (androgens, local and/or systemic estrogens, progestins), dopamine agonist therapy, oral phosphodiesterase type-5 inhibitors and vacuum clitoral device therapy. Second-time therapies include invasive maneuvers such as reconstructive surgery.The most logical, efficacious way to restore sexual function in women with sexual health problems is to manage the sexual problem with multiple disciplines, proceed in a step-care process and, whenever possible, to engage the partner.