Does sexual dysfunction only happen to men? No, women also have it.

Author: Lou Wenjia Peking Union Medical College Hospital

Reviewer: Zhu Lan, Chief Physician, Professor, Doctoral Supervisor, Peking Union Medical College Hospital

Many people think that sexual dysfunction only occurs in men, but this is not true. It can also occur in women.

The incidence of female sexual dysfunction has been increasing year by year, which has really affected the quality of life of many female friends. So what kind of disease is it?

Female sexual dysfunction refers to the phenomenon that women encounter difficulties in any stage of sexual behavior. Patients feel distress, depression or tension in the relationship between their partners, and the above symptoms persist for at least 6 months (except for sexual dysfunction caused by drugs).

The incidence of female sexual dysfunction varies in different countries. The incidence in Asia is 26.1% to 73.2%, and the incidence in different regions of my country is also different.

1. Classification of female sexual dysfunction

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According to the classification proposed by the American Urological Diseases and Sexual Health Committee in 1998, female sexual dysfunction is divided into four categories : sexual desire disorder, sexual arousal disorder, orgasm disorder and sexual intercourse pain. Among them, sexual desire disorder and orgasm disorder are the most common.

1. Sexual desire disorder : including hyposexuality and sexual aversion. Hyposexuality is manifested as persistent or repeated lack of sexual fantasies or sexual desire. Sexual aversion refers to the patient's extreme aversion or avoidance of all (or almost all) genital contact with the sexual partner.

2. Sexual arousal disorder : manifested as a lack of corresponding subjective excitement and physiological response throughout the entire sexual activity, such as the inability to obtain or maintain lubrication or swelling of the genitals for sufficient sexual excitement.

Currently, the American Psychiatric Association's diagnosis of mental disorders combines sexual desire disorder and sexual arousal disorder into sexual interest/arousal disorder, which we often call "sexual indifference."

3. Orgasm disorder : refers to the delay or absence of orgasm after normal sexual excitement.

4. Pain during sexual intercourse disorder : refers to genital pain associated with sexual intercourse, including dyspareunia, vaginismus, and vulvar pain.

Clinically, the diagnostic criteria for female sexual dysfunction are mainly based on the symptoms subjectively described by female patients. Therefore, there is a lack of objective diagnostic methods or "gold standards". However, female sexual function can be assessed through a variety of questionnaires, which can also help in the diagnosis of female sexual dysfunction.

2. Factors that cause sexual dysfunction in women

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There are many factors that lead to sexual dysfunction in women, including psychological and social factors, physiological factors and diseases.

1. Psychological and social factors : Female sexual dysfunction is the result of the synergistic effect of multiple factors, among which psychological and social factors always play an important role, and sexual concepts, emotions and psychological disorders are also the main causes of the disease.

First, influenced by traditional culture, education and other social factors, female patients have conservative sexual concepts and do not value their sexual experiences. Even if problems arise, they are ashamed to mention them. These troubles also prevent them from receiving timely treatment and help.

Secondly, disharmony in the relationship between partners is also an important cause of sexual dysfunction. If the two parties often quarrel over trivial matters, or the relationship between the two parties is cold and there is little emotional communication, they will develop a dislike for each other's body, which will lead to a decrease in sexual desire.

Finally, the pressure from work and life cannot be ignored. With the improvement of the social status of modern women, women play an increasingly important role in society. When the pressure from life and society increases, women feel physically and mentally exhausted, which can also lead to a lack of sexual desire.

2. Physiological factors : Studies have shown that age is an important factor leading to female sexual dysfunction. Female sexual function may change to varying degrees with age, which is closely related to factors such as pelvic floor muscle relaxation, glandular secretion and decreased hormone levels.

Numerous studies have shown that the incidence of female sexual dysfunction increases with age. Other studies have shown that the decrease in estrogen levels after menopause, especially the appearance of menopausal urogenital syndrome in women, makes the incidence of the disease higher.

In addition, women may also experience female sexual dysfunction after giving birth. This is because childbirth can cause changes or even damage to the reproductive organ tissues and nerves, and changes in the secretion of sex hormones in women after childbirth can lead to postpartum sexual dysfunction.

3. Disease-related factors : The occurrence of female sexual dysfunction is also related to a variety of chronic diseases, such as diabetes, breast cancer surgery, polycystic ovary syndrome and reproductive tract infection.

Studies have suggested that high blood sugar levels can cause damage to the reproductive system, such as causing disorders in the synthesis and secretion of sex hormones, sexual dysfunction, and reduced reproductive capacity. However, diabetes is not the only factor causing female sexual dysfunction. Increasing age, menopause, and long-term abnormal glycated hemoglobin levels can easily lead to worsening sexual dysfunction in diabetic patients.

III. Treatment methods and preventive measures

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Due to the complexity of the pathophysiological mechanism of female sexual dysfunction, multiple dimensions of dysfunction may occur. Therefore, there is a lack of simple and effective drugs in clinical practice, and the treatment model is not fixed.

Treatments for female sexual dysfunction include drug therapy and non-drug therapy. Drug therapy includes peripherally acting drugs, centrally acting drugs, sex hormones, antidepressants and some Chinese herbal medicines. Some current research results show that the effects of new drugs under development seem to be limited. Considering the multifactorial characteristics of sexual dysfunction, drug therapy must be based on psychotherapy and a harmonious relationship between sexual partners.

Non-drug treatment includes sexual physiology, such as treatment for pelvic organ prolapse or urinary incontinence, improvement of partner relationships, and psychological treatment. Among them, psychological treatment and behavioral treatment are very important components. Through psychological or psychoanalysis and conversation therapy, the pathogenic factors can be discovered and corresponding targeted psychological guidance can be taken.

In addition, developing good living habits and sexual physiological hygiene can also effectively reduce the incidence of sexual dysfunction. Among them, healthy diet, adequate sleep and physical exercise can promote overall health and sexual health, while paying attention to the hygiene of sexual organs and sexual life and taking appropriate contraceptive measures can avoid sexual psychological disorders caused by related diseases.

References

[1] Chen Xiaojie, Wei Qun, Wang Zilian, et al. Research progress on the influencing factors of female sexual dysfunction[J]. Kang Yi, 2022(15): 293-295.