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Causes
By Mayo Clinic staffSeveral 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 experience orgasm.
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Hormonal. Lower estrogen levels after 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 experiencing 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.
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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.
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- Brotto LA, et al. Women's sexual desire and arousal disorders. Journal of Sexual Medicine. 2010;7:586.
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- Basson R. Women's sexuality and sexual dysfunction. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:742.
- Shifren JL. Sexual dysfunction in women: Epidemiology, risk factors, and evaluation. http://www.uptodate.com/home/index.html. Accessed March 30, 2010.
- Shifren JL. Sexual dysfunction in women: Management. http://www.uptodate.com/home/index.html. Accessed March 30, 2010.
- Basson R, et al. Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female arousal disorder. Journal of Women's Health & Gender-Based Medicine. 2002;11:367.
- Nurnberg HG, et al. Sildenafil treatment of women with antidepressant-associated sexual dysfunction. Journal of the American Medical Association. 2008;300:395.
- Nijland EA, et al. Tibolone and transdermal E2/NETA for the treatment of female sexual dysfunction in naturally menopausal women. Journal of Sexual Medicine. 2008;5:646.
- Kammerer-Doak D, et al. Female sexual function and dysfunction. Obstetrics and Gynecology Clinics of North America. 2008;35:169.
- Brotto LA, et al. A mindfulness-based group psychoeducational intervention targeting sexual arousal disorder in women. Journal of Sexual Medicine. 2008;5:1646.
- Brotto LA, et al. Eastern approaches for enhancing women's sexuality: Mindfulness, acupuncture, and yoga. Journal of Sexual Medicine. 2008;5:2741.
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