Sexual dysfunction in women may involve a reduction in sex drive, a strong dislike of sexual activity, difficulty becoming aroused, inability to achieve orgasm, or pain with sexual activity or intercourse.

Traditionally, sexual dysfunction in women was thought to be largely due to psychological problems. Recent research is beginning to uncover many physical causes for sexual problems in women. While many sexual problems have an underlying psychological component, possible physical causes must be ruled out in the initial examination.

• Anxiety or depression
• Changes related to menopause
• Communication problems with partner
• Damage to nerves due to surgery or trauma
• Fear of pain, infection, or being pregnant
• Feelings of guilt and shame about sex
• History of sexual abuse
• Infection or gynecological disease
• Lack of appropriate stimulation
• Lack of lubrication
• Medication

Home care depends on the cause. Family planning and birth control may be helpful for problems caused by a fear of pregnancy.

Call your health care provider if the problem is persistent or accompanied by other unexplained symptoms.

Your health care provider will perform a physical examination, which may include a pelvic exam. Your provider may ask detailed questions about relationships, current sexual practices, attitudes towards sex, other medical conditions you might have, medications you may be taking, and other possible symptoms.

Treatment for sexual dysfunction will depend on the cause. It may include changes in your current sexual activities, stopping or changing medications where possible, adding a new medication, or surgery. Referral to a specialist with expertise in treating sexual dysfunction may be necessary. Psychological counseling may be recommended.

Eyler AE, Biggs WS. Medical human sexuality in family medicine practice. In: Rakel RE. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 55.

Lentz GM. Emotional aspects of gynecology: sexual dysfunction, eating disorders, substance abuse, depression, grief, loss. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007: chap 9.