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You can develop female sexual dysfunction at any age, but sexual problems are most common when your hormones are in flux – for example, when you've just had a baby or when you're making the transition into menopause. Sexual concerns may also occur with major illness, such as cancer.
Your problems might be classified as female sexual dysfunction if you experience one or more of the following and you’re distressed about it:
- Your desire to have sex is low or absent
- You can’t maintain arousal during sexual activity, or you don’t become aroused despite a desire to have sex
- You cannot experience an orgasm
- You have pain during sexual contact
Several factors may contribute to sexual dissatisfaction or dysfunction. These factors tend to be interrelated.
- Physical. Physical conditions that may cause or contribute to sexual problems include arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems and neurological disorders such as multiple sclerosis. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease your sex drive and your body’s ability to achieve orgasm.
- Hormonal. Lower estrogen levels during the menopausal transition may lead to changes in your genital tissues and your sexual responsiveness. The folds of skin that cover your genital region (labia) become thinner, exposing more of the clitoris. This increased exposure sometimes reduces the sensitivity of the clitoris, or may cause an unpleasant tingling or prickling sensation. In addition, the vaginal lining becomes thinner and less elastic, particularly if you’re not sexually active. At the same time, the vagina requires more stimulation to relax and lubricate before intercourse. These factors can lead to painful intercourse (dyspareunia), and achieving orgasm may take longer. Your body’s hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.
- Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress. The worries of pregnancy and demands of being a new mother may have similar effects. Longstanding conflicts with your partner – about sex or any other aspect of your relationship – can diminish your sexual responsiveness as well. Cultural and religious issues and problems with your own body image also may contribute. Emotional distress can be both a cause and a result of sexual dysfunction. Regardless of where the cycle began, you usually need to address relationship issues for treatment to be effective.