Female sexual dysfunction: dysfunction of sexual desire, arousal, and orgasm

Chapter 36 FEMALE SEXUAL DYSFUNCTION: DYSFUNCTION OF SEXUAL DESIRE, AROUSAL, AND ORGASM



Kathleen Dor


Problems with sexual desire, arousal, and orgasm in women are very common and cause significant personal distress. The American Foundation for Urologic Disease classifies these problems as four disorders: hypoactive sexual desire disorder, sexual aversion disorder, sexual arousal disorder, and female orgasmic disorder. A discussion of each of these disorders is beyond the scope of this text. Dyspareunia is discussed in Chapter 11.


A wide variety of factors contribute to sexual dysfunction, including age, smoking, chronic diseases, relationship difficulties, prior trauma, surgery, low socioeconomic status, and education. Individually, sexuality incorporates family, societal, and religious beliefs and is altered with aging, health status, and personal experience. Sexual activity also incorporates interpersonal relationships; each partner brings unique attitudes, needs, responses, and health matters into the sexual experience.


The diagnosis of female sexual dysfunction requires the physician to obtain a detailed patient history that defines the dysfunction, identifies causative or confounding medical or gynecologic problems, and contains pertinent psychosocial information. Establishment of the patient’s sexual orientation is necessary and is best achieved through nonjudgmental, direct questions. Questioning the patient about what she thinks is causing the problem may elicit insight.



Medications That May Cause Sexual Dysfunction in Women




α-Adrenergic blockers


Amphetamines


Antiepileptic medications


Anticholinergic medications


Antipsychotic medications


Antihistamines


Benzodiazepines


β blockers


Cholesterol-lowering medications


Cyclophosphamide


Digitalis


Diuretics


Gonadotropin-releasing hormone agonists


Oral contraceptives


Selective serotonin reuptake inhibitors


Spironolactone


Trazodone


Vasodilators



Causes of Sexual Dysfunction (in Arousal, Desire, and Orgasm) in Women




Adrenal disorders


Aging


Alcohol overuse or abuse


Anxiety


Autoimmune diseases


Bowel incontinence


Breast cancer


Cardiac disease


Colostomy


Depression


Diabetes


Dyspareunia


Genital abnormalities


Gynecologic neoplasms


Gynecologic surgery


Hyperprolactinemia

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Jun 4, 2016 | Posted by in GYNECOLOGY | Comments Off on Female sexual dysfunction: dysfunction of sexual desire, arousal, and orgasm

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