Interest in understanding female sexuality has grown rapidly over the past decade, but researchers still strive to accurately define, assess and treat sexual issues and dysfunction in women of all ages.
In order to treat female sexual dysfunction, clinicians must first define what constitutes sexual “problems” for women and devise ways to accurately measure and diagnose symptoms. Women and their physicians must be able to identify the point at which a problem becomes severe enough to qualify as a clinical disorder deserving of more detailed evaluation and possible treatment.
This is not easy because sexual behaviors and needs are not the same for all women, and female sexual function is a complicated mix of physical, psychological, hormonal, and emotional factors. Various health conditions, surgeries or medications can also greatly influence a woman’s sexual response and activity.
Clinicians have agreed upon a few working definitions, although modifications are likely to be made as our understanding of female sexuality continues to develop. Currently, female sexual dysfunction (FSD) includes four categories of disorders:
• hypoactive sexual desire disorder (HSDD) or low libido
• female sexual arousal disorder (FSAD)
• female orgasmic disorder (FOD)
• sexual pain disorder including dyspareunia (genital pain during intercourse) and vaginismus (involuntary contraction of the vaginal wall during intercourse)
Female sexual dysfunction involves any one of these disorders, and for some women includes two or more. To make a full diagnosis, physicians will also ask if patients’ symptoms are recent or lifelong, apply to only specific situations/partner(s) or apply generally, and if a specific cause or event contributed to their dysfunction.
Physicians and therapists currently make a distinction between sexual complaints, dysfunction and disorders. As complaints become prolonged they are classified as dysfunctions, and a dysfunction becomes a disorder once a woman feels that the problem is causing “distress” or having a strong impact on her life.