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In The Lab

Female sexual dysfunction

Diagnosis Sexual dysfunction

Vials

To diagnose female sexual dysfunction, your doctor may:
 

  • Discuss your sexual and medical history. You might be uneasy talking with your doctor about such personal matters, but your sexuality is a key part of your well-being. The more upfront you can be about your sexual history and current problems, the better your chances of finding an effective way to treat them.
     

  • Perform a pelvic exam. During the exam, your doctor checks for physical changes
    that affect your sexual enjoyment, such as thinning of your genital tissues, decreased skin elasticity, scarring or pain.

     

  • Order blood tests. Your doctor may recommend blood tests to check for underlying health conditions that might contribute to sexual dysfunction.
     

Your doctor may also refer you to a counselor or therapist specializing in sexual and relationship problems.

Treatment Infertility

Keep in mind that sexual dysfunction is a problem only if it bothers you. If it doesn't bother you, there's no need for treatment.
 

Because female sexual dysfunction has many possible symptoms and causes, treatment varies. It's important for you to communicate your concerns, as well as to understand your body and its normal sexual response. Also, your goals for your sex life are important for choosing a treatment and evaluating whether or not it's working for you.
 

Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.

Nonmedical treatment for female sexual dysfunction

To treat sexual dysfunction, your doctor might recommend that you start with these strategies:
 

  • Talk and listen. Open communication with your partner makes a world of difference in your sexual satisfaction. Even if you're not used to talking about your likes and dislikes, learning to do so and providing feedback in a nonthreatening way sets the stage for greater intimacy.
     

  • Practice healthy lifestyle habits. Limit alcohol — drinking too much can blunt your sexual responsiveness. Be physically active — regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy sexual experiences.
     

  • Seek counseling. Talk with a counselor or therapist who specializes in sexual and relationship problems. Therapy often includes education about how to optimize your body's sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.
     

  • Use a lubricant. A vaginal lubricant may be helpful during intercourse if you have vaginal dryness or pain during sex.

Medical treatment for female sexual dysfunction

Effective treatment for sexual dysfunction often requires addressing an underlying medical condition or hormonal change. Your doctor may suggest changing a medication you're taking or prescribing a new one.
 

Treating female sexual dysfunction linked to a hormonal cause might include:
 

  • Estrogen therapy. Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
     

    The risks of hormone therapy may vary depending on your age, your risk of other health issues such as heart and blood vessel disease and cancer, the dose and type of hormone and whether estrogen is given alone or with a progestin.
     

    Talk with your doctor about benefits and risks. In some cases, hormonal therapy might require close monitoring by your doctor.
     

  • Ospemifene (Osphena). This medication is a selective estrogen receptor modulator. It helps reduce pain during sex for women with vulvovaginal atrophy.
     

  • Androgen therapy. Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower levels of testosterone.

    Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction; other studies show little or no benefit.
     

  • Flibanserin (Addyi). Originally developed as an antidepressant, flibanserin is approved by the Food and Drug Administration as a treatment for low sexual desire in premenopausal women.
     

    A daily pill, Addyi may boost sex drive in women who experience low sexual desire and find it distressing. Potentially serious side effects include low blood pressure, sleepiness, nausea, fatigue, dizziness and fainting, particularly if the drug is mixed with alcohol. Experts recommend that you stop taking the drug if you don't notice an improvement in your sex drive after eight weeks.

Lifestyle and home remedies female Infertility 

To boost your sexual health, find ways to be comfortable with your sexuality, improve your self-esteem and accept your body. Try practicing these healthy lifestyle habits:
 

  • Avoid alcohol. Drinking too much blunts sexual responsiveness.
     

  • Don't smoke. Cigarette smoking restricts blood flow throughout your body. Less blood reaches your sexual organs, which means you could experience decreased sexual arousal and orgasmic response.
     

  • Be physically active. Regular aerobic exercise increases your stamina, improves your body image and elevates your mood. This can help you feel more romantic, more often.
     

  • Make time for leisure and relaxation. Learn ways to decrease stress, and allow yourself to relax amid the stresses of your daily life. Being relaxed can enhance your ability to focus on your sexual experiences and may help you attain more satisfying arousal and orgasm.

Alternative medicine

More research is needed, but therapies that may help improve sexual satisfaction include:
 

  • Mindfulness. This type of meditation is based on having an increased awareness and acceptance of living in the present moment. You focus on what you experience during meditation, such as the flow of your breath. You can observe your thoughts and emotions, but let them pass without judgment.
     

  • Acupuncture. Acupuncture involves the insertion of extremely thin needles into your skin at strategic points on your body. Acupuncture may have positive effects on low libido and lubrication difficulties, especially if these problems are related to the use of some antidepressant medications.
     

  • Yoga. During yoga, you perform a series of postures and controlled breathing exercises to promote a flexible body and a calm mind. Certain subsets of yoga aim to channel the body's sexual energy and improve sexual functioning.

Preparing for your appointment

If you have ongoing sexual difficulties that distress you, make an appointment with your doctor. You may feel embarrassed to talk about sex with your doctor, but this topic is perfectly appropriate. A satisfying sex life is important to a woman's well-being at every age.
 

You might have a treatable, underlying condition, or you might benefit from lifestyle changes, therapy or a combination of treatments. Your primary doctor will either diagnose and treat the problem or refer you to a specialist.
 

Here's some information to help you prepare for your appointment.

What you can do

Gather information about:
 

  • Your symptoms. Take note of any sexual difficulties you're having, including when and how often they occur.
     

  • Your sexual history. Your doctor likely will ask about your relationships and experiences since you became sexually active. He or she also might ask about any history of sexual trauma or abuse.
     

  • Your medical history. Write down any medical conditions you have, including mental health conditions. Jot down the names and doses of medications you take or have recently taken, including prescription and over-the-counter drugs.
     

  • Questions to ask your doctor. Create a list of questions to make the most of your time with your doctor.

Some basic questions to ask your doctor about your sexual concerns include:
 

  • What might be causing my sexual difficulties?
     

  • Do I need medical tests?
     

  • What treatment do you recommend?
     

  • If you're prescribing medication, are there possible side effects?
     

  • How much improvement can I reasonably expect with treatment?
     

  • Are there lifestyle changes or self-care steps that might help?
     

  • Do you recommend therapy?
     

  • Should my partner be involved in treatment?

What to expect from your doctor

Your doctor might ask a number of personal questions and might want to include your partner in the interview. To help determine the cause of your problem and the best course of treatment, be ready to answer questions such as:

  • What problems are you having?

  • How much do these problems bother you?

  • How satisfied are you with your relationship?

  • Do you become aroused during sexual interactions with your partner?

  • Do you have orgasms?

  • If you've had orgasms in the past but no longer can, what's different?

  • Do you have pain with intercourse?

  • What form of birth control, if any, do you use?

  • Do you use alcohol or recreational drugs? How much?

  • Have you ever had surgery that involved your reproductive system?

  • Have you been diagnosed with other medical conditions, including mental health conditions?

  • Have you ever had an unwanted sexual experience?

What you can do in the meantime

Keep the lines of communication open with your partner. Be honest about your dissatisfaction or the problem you have. Consider alternatives for intimacy and engage in sexual activities that are rewarding for both of you.

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