Female Sexual Dysfunction - FSD

Disorder

Description

Hypoactive sexual desire disorder†

Chronic lack of interest in sexual activity

Sexual aversion disorder†

Persistent or recurrent phobic avoidance of sexual contact with a partner

Sexual arousal disorder†

Persistent or recurrent inability to attain or maintain sexual excitement

Orgasmic disorder†

Chronic difficulty in attaining (or inability to attain) orgasm following sufficient arousal

Dyspareunia

Pain during intercourse

Vaginismus

Involuntary vaginal spasms that interfere with penetration

Noncoital sexual pain

Genital pain following stimulation during foreplay

† These must cause the woman distress in order to qualify as FSD.

Source: Basson R, et al. “Report of the International Consensus Development Conference on Female Sexual Dysfunction: Definitions and Classifications,” Journal of Urology (March 2000), 163:888–895.

Conditions, procedures, and drugs that can affect sexual response in women

Condition

Effect(s)

Estrogen insufficiency

Reduced vaginal lubrication

Testosterone insufficiency

Reduced libido

Diabetes

Reduced vaginal lubrication, vaginal infections

Thyroid, adrenal, pituitary disorders

Reduced vaginal lubrication

Sickle cell anemia

Decreased arousal and orgasm

Spinal cord damage, stroke, Parkinson’s disease, multiple sclerosis

Decreased vaginal lubrication, arousal, orgasm

Vaginitis, pelvic inflammatory disease, endometriosis

Vaginismus, dyspareunia

Prolapsed uterus or uterine fibroids

Decreased arousal

Kidney failure requiring dialysis

Decreased arousal and desire due to hormone imbalance

Arthritis

Chronic pain that limits motion

Sjögren’s syndrome

Decreased lubrication

Procedure

Effect(s)

Oophorectomy

Decreased estrogen and lubrication

Episiotomy

Tightness of vaginal opening

Mastectomy, colostomy

Loss of self-esteem and sources of stimulation; fear of discomfort

Drugs

Effect(s)

Antihypertensives (diuretics, beta blockers, calcium-channel blockers, anti-adrenergics)

Reduced libido, difficulty reaching orgasm

Anticholinergics (propantheline, methantheline)

Decreased lubrication

Barbiturates

Various problems at high doses

Benzodiazepines (diazepam, alprazolam)

Difficulty reaching orgasm

Antidepressants

Difficulty reaching orgasm

Cancer chemotherapy (cyclophosphamide, anti-estrogens)

Vaginal dryness, reduced libido, difficulty reaching orgasm

Opiates (morphine, codeine, methadone)

Reduced libido

Sources: Carlson K, et al. Harvard Guide to Women’s Health; Lightner D. Mayo Clinic Proceedings, 2002 77: 698–702