Whether speaking with patients or lunching with my friends, the topic of a lack of sexual desire seems to fill my day. As a doctor, I hear this complaint frequently. Women and their partners want to know why they lack a sex drive. Is there something wrong with them? Is there a magic pill to fix it? The DSM-V outlines four categories of sexual dysfunction. Many of which often intertwine.
Hypoactive sexual desire disorder
Patients most commonly report this type of sexual dysfunction category. Furthermore, it’s defined as a lack of sexual desire that causes women distress. Those who would rather do laundry than have sex might fall into this category. However, she understands that her lack of sexual desire could be problematic. In addition, she may feel guilty as it might harm her relationship. She might also feel like there is something wrong with her.
Several things can affect libidos. These include relationship issues, stress and certain medications, such as birth control pills and antidepressants. In addition, postpartum women report a lack of desire caused by exhaustion, stress, hormonal and physiological changes. Studies show this typically improves after three to six months. Women in this category can lack interest initially. However, once she feels pleasure, she can respond and enjoy sexual intercourse.
Sexual arousal disorder
Sexual arousal disorder occurs when a woman has trouble lubricating for sex or feeling stimulated. She may want to have sex but not feel physically aroused. Causes can include psychological problems, external stressors or medical issues, such as decreased blood flow to the sex organs. Additionally, many women notice an arousal disorder when experiencing menopause and hormonal changes. However, vaginal estrogen and over the counter lubricants can often help.
Orgasmic dysfunction refers to the inability to reach orgasm. It can also refer to the delay in reaching an orgasm despite adequate stimulation. Some women describe their orgasms as less intense or muted. The four types of orgasmic dysfunctions include:
- Primary anorgasmia is when a woman has never had an orgasm. This is seen in cases of sexual or emotional abuse. It is also experienced by women from some cultures who were taught that sex is dirty or not ladylike.
- Secondary anorgasmia represents reporting an orgasm while still having difficulty reaching them.
- Situational anorgasmia, the most common orgasmic dysfunction, refers to the ability to reach orgasm in solely specific situations such as masturbation or oral sex.
- General anorgasmia represents the total inability to achieve orgasm even though sexually aroused and stimulated regardless of situational circumstances.
Sexual pain disorders
The medical term for painful intercourse is dyspareunia. A vaginal infection like yeast or bacterial vaginosis can cause painful intercourse. In addition, thinning of the vaginal tissue and dryness from menopause can cause pain. Sometimes, it can also tear the tissue. Your gynecologist can evaluate you for vaginitis or vaginal atrophy with an exam.
Furthermore, when a woman anticipates pain, she may tighten her vaginal muscles. “Vaginismus” can result in more pain. Plus, partners may feel like the woman is too tight or hitting a brick wall. Sometimes, the sexual dysfunction disorder dyspareunia can be treated with medication. However, if the result of an emotional or relationship issues, difficulty with medication can ensue.
If you feel your sex life has deteriorated, it might be time to visit your gynecologist for an evaluation. They can help you determine possible causes for your symptoms. Fortunately, many of these problems can be treated easily. Often just hearing your symptoms can help your provider direct you on a path to a healthy sex life again.