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A Brief Overview of Female Sexual Dysfunction (FSD)

When a woman comes into my care they often ask me multiple questions about sexual concerns and I find that I am trying to explain exactly what female sexual dysfunction is and how it is very multifaceted. The term “sexual dysfunction” refers to problems or conditions that prevent or inhibit pursuit or enjoyment of sexual activity. Often we get asked if there is a common age for women to experience a change in sexual desire. It is estimated that 43% of American women suffer from sexual dysfunction. One-third of all women, regardless of age, have diminished or no sexual interest. That’s about 10% of all women in the United States. Some women are not bothered by this, but others are. In addition, nearly one-fourth of all women do not experience orgasm, while one-fifth of women suffer sexual pain disorders.

There are multiple types of sexual dysfunction:

  • Low sexual desire. This is the most common of female sexual dysfunctions and it involves a lack of sexual interest and willingness to be sexual. It is often called hypoactive sexual desire disorder (HSDD).
  • Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty with arousal or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.

A woman might have one or more of these issues, and they are oftentimes related to one other. Female sexual dysfunction can be lifelong or temporary. It can happen all the time, only with a certain partner, or only at certain times, such as after pregnancy, cancer, trauma or during midlife/menopause. Female sexual dysfunction involves a bio-psycho-social component. A healthy sex life depends on multiple factors. The same is true for a troubled sex life. Health issues, certain prescription medicines, changes in hormone levels, partner or family issues, and psychological concerns can all contribute to FSD.


What are the causes of FSD?

General Physical

  • Health problems that can lead to FSD include heart disease, diabetes, cancer arthritis, multiple sclerosis, or alcohol abuse
  • Medicines that can lead to FSD include blood pressure medication, depression, pain medications, and oral contraceptives
  • Dietary changes and issues with your thyroid, gut or adrenal health could also lead to issues with FSD



  • Medical conditions such as endometriosis, cystitis, vaginismus, vestibulodynia, polycystic ovaries, pelvic muscle problems, or chronic pelvic pain
  • Pelvic or genital surgeries that can cause scarring, decreased blood flow, or nerve damage to the genital area
  • Recurrent yeast infections or bacterial changes in the vagina can also lead to painful intercourse



  • A change or decrease in hormone levels from peri/menopause (natural or surgical), breastfeeding, or premature ovarian insufficiency (when the ovaries stop working before age 40), can cause vaginal dryness and atrophy and painful intercourse
  • It is also possible that a drop in levels of testosterone, which women produce in small amounts, after removal of the ovaries


Psychological and Emotional

  • Mental distress: stress, anxiety, depression, eating disorders, past sexual abuse/trauma, fear of unwanted pregnancy
  • Relationship issues: boredom, anger, abuse (physical or emotional)
  • Religious or cultural beliefs about sex


What are the treatments that are available for FSD?

Often, a combination of treatments works best and treatment options will also depend on the cause of your problems. If you have a medical condition that is causing your FSD, visit us at The SHOW Center to see how we can help you.

Talking and Counseling. Consider talking with your partner about what’s going on. Sometimes a better line of communication is all that is needed. If necessary, you may want to get counseling, by yourself or with your partner. Sex counseling is often a good option to be included to address the entire bio-psycho-social component. Please reach out to us at The SHOW Center to see how we can add this form of care to help with your sexuality concerns.

Lifestyle Changes. Some women find that losing weight, eating a healthy diet, exercising, stopping smoking, and getting enough sleep helps increase their sense of well-being and interest in sex. Try finding ways to be comfortable with your own sexuality. This may involve thinking about your attitudes toward sex when you were growing up, finding ways to improve your self-esteem, and accepting your body as it is.

Managing Medicines. If certain medicines are causing problems, your doctor might be able to change your prescription. Other medicines also can help.

Many affected individuals are resistant to discussing such issues with their healthcare providers. Your SHOW Center provider is a board-certified, women’s and gender health nurse practitioner with specialty training in female sexual medicine. She has dedicated her 19-year career to caring for women. Please reach out to us at so that we are able to help you get to the root of your condition. I look forward to hearing from you!


Shine brightly,

Dr. Heather Quaile