Persistent, recurrent problems with sexual response, desire, orgasm or pain - that distress you or strain your relationship with your partner - are known medically as sexual dysfunction.
Many women experience problems with sexual function at some point, and some have difficulties throughout their lives. Female sexual dysfunction can occur at any stage of life. It can occur only in certain sexual situations or in all sexual situations.
Sexual response involves a complex interplay of physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction, and treatment often involves more than one approach.
Symptoms vary depending on what type of sexual dysfunction you're experiencing:
If sexual problems affect your relationship or worry you, make an appointment with your doctor for evaluation.
Sexual problems often develop when your hormones are in flux, such as after having a baby or during menopause. Major illness, such as cancer, diabetes or heart and blood vessel (cardiovascular) disease, can also contribute to sexual dysfunction.
Factors - often interrelated - that contribute to sexual dissatisfaction or dysfunction include:
Some factors may increase your risk of sexual dysfunction:
To diagnose female sexual dysfunction, your doctor may:
Your doctor may also refer you to a counselor or therapist specializing in sexual and relationship problems.
Keep in mind that sexual dysfunction is a problem only if it bothers you. If it doesn't bother you, there's no need for treatment.
Because female sexual dysfunction has many possible symptoms and causes, treatment varies. It's important for you to communicate your concerns, as well as to understand your body and its normal sexual response. Also, your goals for your sex life are important for choosing a treatment and evaluating whether or not it's working for you.
Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.
To treat sexual dysfunction, your doctor might recommend that you start with these strategies:
Effective treatment for sexual dysfunction often requires addressing an underlying medical condition or hormonal change. Your doctor may suggest changing a medication you're taking or prescribing a new one. Possible treatments for female sexual dysfunction might include:
Estrogen Therapy: Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
The risks of hormone therapy may vary depending on your age, your risk of other health issues such as heart and blood vessel disease and cancer, the dose and type of hormone and whether estrogen is given alone or with a progestin.
Talk with your doctor about benefits and risks. In some cases, hormonal therapy might require close monitoring by your doctor.
Ospemifene (Osphena): This medication is a selective estrogen receptor modulator. It helps reduce pain during sex for women with vulvovaginal atrophy.
Androgen Therapy: Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower levels of testosterone.
Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction, other studies show little or no benefit.
Flibanserin (Addyi): Originally developed as an antidepressant, flibanserin is approved by the Food and Drug Administration (FDA) as a treatment for low sexual desire in premenopausal women.
A daily pill, Addyi may boost sex drive in women who experience low sexual desire and find it distressing. Potentially serious side effects include low blood pressure, sleepiness, nausea, fatigue, dizziness and fainting, particularly if the drug is mixed with alcohol. Experts recommend that you stop taking the drug if you don't notice an improvement in your sex drive after eight weeks.
Bremelanotide (Vyleesi): Bremelanotide is another FDA-approved treatment for low sexual desire in premenopausal women. This medication is an injection you give yourself just under the skin in the belly or thigh before anticipated sexual activity.
Some women experience nausea, which is more common after the first injection but tends to improve with the second injection. Other side effects include vomiting, flushing, headache and a skin reaction at the site of the injection.
To boost your sexual health, find ways to be comfortable with your sexuality, improve your self-esteem and accept your body. Try practicing these healthy lifestyle habits:
Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.
Having erection trouble from time to time isn't necessarily a cause for concern. If erectile dysfunction is an ongoing issue, however, it can cause stress, affect your self-confidence and contribute to relationship problems. Problems getting or keeping an erection can also be a sign of an underlying health condition that needs treatment and a risk factor for heart disease.
If you're concerned about erectile dysfunction, talk to your doctor - even if you're embarrassed. Sometimes, treating an underlying condition is enough to reverse erectile dysfunction. In other cases, medications or other direct treatments might be needed.
Erectile dysfunction symptoms might include persistent:
A family doctor is a good place to start when you have erectile problems. See your doctor if:
Male sexual arousal is a complex process that involves the brain, hormones, emotions, nerves, muscles and blood vessels. Erectile dysfunction can result from a problem with any of these. Likewise, stress and mental health concerns can cause or worsen erectile dysfunction.
Sometimes a combination of physical and psychological issues causes erectile dysfunction. For instance, a minor physical condition that slows your sexual response might cause anxiety about maintaining an erection. The resulting anxiety can lead to or worsen erectile dysfunction.
In many cases, erectile dysfunction is caused by something physical. Common causes include:
The brain plays a key role in triggering the series of physical events that cause an erection, starting with feelings of sexual excitement. A number of things can interfere with sexual feelings and cause or worsen erectile dysfunction. These include:
As you get older, erections might take longer to develop and might not be as firm. You might need more direct touch to your penis to get and keep an erection.
Various risk factors can contribute to erectile dysfunction, including:
Complications resulting from erectile dysfunction can include:
The best way to prevent erectile dysfunction is to make healthy lifestyle choices and to manage any existing health conditions. For example:
For many people, a physical exam and answering questions (medical history) are all that's needed for a doctor to diagnose erectile dysfunction and recommend a treatment. If you have chronic health conditions or your doctor suspects that an underlying condition might be involved, you might need further tests or a consultation with a specialist.
Tests for underlying conditions might include:
The first thing your doctor will do is to make sure you're getting the right treatment for any health conditions that could be causing or worsening your erectile dysfunction.
Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options. Your doctor can explain the risks and benefits of each treatment and will consider your preferences. Your partner's preferences also might play a role in your treatment choices.
Oral medications are a successful erectile dysfunction treatment for many men. They include:
All four medications enhance the effects of nitric oxide - a natural chemical your body produces that relaxes muscles in the penis. This increases blood flow and allows you to get an erection in response to sexual stimulation.
Taking one of these tablets will not automatically produce an erection. Sexual stimulation is needed first to cause the release of nitric oxide from your penile nerves. These medications amplify that signal, allowing normal penile function in some people. Oral erectile dysfunction medications are not aphrodisiacs, will not cause excitement and are not needed in people who get normal erections.
The medications vary in dosage, how long they work and side effects. Possible side effects include flushing, nasal congestion, headache, visual changes, backache and stomach upset.
Your doctor will consider your particular situation to determine which medication might work best. These medications might not treat your erectile dysfunction immediately. You might need to work with your doctor to find the right medication and dosage for you.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, get your doctor's permission. Medications for erectile dysfunction do not work in everyone and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you:
Other medications for erectile dysfunction include:
Battery-powered penis pump for erectile dysfunction.
If medications aren't effective or appropriate in your case, your doctor might recommend a different treatment. Other treatments include:
Recent studies have found that exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction.
Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk.
Discuss an exercise plan with your doctor.
If your erectile dysfunction is caused by stress, anxiety or depression - or the condition is creating stress and relationship tension - your doctor might suggest that you, or you and your partner, visit a psychologist or counselor.
For many people, erectile dysfunction is caused or worsened by lifestyle choices. Here are some steps that might help: