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

Published on 10/03/2015 by admin

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Last modified 10/03/2015

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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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