Female sexual dysfunctions, or female sexual disorders, are defined by the Diagnostic and Statistical Manual of Mental Disorders, the DSM, which is used internationally. The DSM is updated regularly according to the advancement of knowledge. The current version is DSM5.

Female sexual dysfunctions are defined there as:

• Female orgasmic dysfunctions
• Dysfunctions related to sexual interest and sexual arousal
• Genito-pelvic pain / and penetration dysfunctions

Main forms of sexual dysfunction in women

Difficulty reaching orgasm or lack of orgasm 

It’s female orgasmic dysfunction. It corresponds to a significant change at the level of orgasm: a decrease in the intensity of the orgasm, a lengthening of the time necessary to obtain an orgasm, a decrease in the frequency of the orgasm, or an absence of orgasm.

We speak of female orgasmic dysfunction if it lasts for more than 6 months and is not related to a health, mental or relationship problem and if it causes a feeling of distress. Note that women experiencing orgasm by stimulation of the clitoris, but no orgasm during penetration are not considered to have female sexual dysfunction by the DSM5.

Decreased desire or total absence of desire in women

This female sexual dysfunction is defined as a complete cessation or a significant decrease in sexual interest or sexual arousal. At least 3 criteria among the following must be met for there to be dysfunction:

• Lack of interest in sexual activity (lack of sexual desire),
• A marked decrease in sexual interest (decrease in sexual desire),
• An absence of sexual fantasies,
• An absence of sexual or erotic thoughts,
• Refusals on the part of the woman to have sex with her partner,
• An absence of a feeling of pleasure during sex.

For it to truly be a sexual dysfunction related to sexual interest and arousal, these symptoms must last for more than 6 months and cause distress on the part of the woman. . They should also not be related to illness or the use of toxic substances (drugs). This problem may be recent (6 months or more) or lasting or even continuous and have existed forever. It can be light, moderate, or heavy.

Pain during penetration and gyneco-pelvic pain

We speak of this disorder when the woman feels for 6 months or more recurrent difficulties at the time of penetration which manifest themselves in the following way:

• Intense fear or anxiety before, during, or after penetrative vaginal sex.
• Pain in the small pelvis or vulvovaginal area during penetrating vaginal sex or when attempting to have penetrating vaginal sex.
• Marked tension or contraction of the pelvic or lower abdominal muscles when attempting vaginal penetration.

To fit into this framework, we exclude women with non-sexual mental disorders, for example a state of post-traumatic stress (a woman who could no longer have sex following an attentive person does not fall within this framework), relational distress (domestic violence), or other major stresses or illnesses that can affect sexuality.

This sexual dysfunction can be mild, moderate or severe and last always or for a variable period (but always more than 6 months to enter the official definition).

Often times, the situations can sometimes become intertwined. For example, a loss of desire can cause pain during sex, which can be the cause of inability to reach orgasm, or even low libido.

Conditions or situations that cause sexual dysfunction

Among the main ones:

Lack of knowledge about sexuality. 

And the lack of learning as a couple. A lot of people think that sexuality is innate and that everything should work out just fine right away. It is not, sexuality is learned gradually. We can also note a rigid education having presented sexuality as prohibited or dangerous. It is still very common today.

The misinformation distilled by pornography.

Today omnipresent, it can disrupt the establishment of a serene sexuality, lead to fears, anxieties, even practices that are not conducive to the progressive development of a couple.

Difficulties in the couple.

benefits Conflicts not settled with the partner often have repercussions on the desire to have sex and to let go intimately with his (or her) partner.

Latent homosexuality or not recognized

This can have consequences on the course of sexual relations.

Stress, depression, anxiety.

Nervous tension generated by preoccupations (this includes wanting to absolutely please and satisfy your partner), stress, L ‘anxiety or trough generally reduces sexual desire and letting go.

Touching, sexual assault or rape

Women who have experienced sexual abuse in the past often report feeling pain during sex.

Health problems that affect the genitals or related.

Women who have a vaginitis, the urinary tract infection, a sexually transmitted infection or vestibulitis (an inflammation of the mucous membranes around the entrance to the vagina) experience vaginal pain during sex because of the discomfort and drying of the mucous membranes that these conditions cause.

Women withendometriosis often have pain at the time of intercourse. Having an allergy to certain fabrics used in the manufacture of underwear, spermicide or latex in condoms can also cause pain.

These difficulties, even treated can lead to sexual difficulties long afterwards. Indeed, the body has a memory and it can be afraid of sexual contact if it has experienced painful medical contact.

Chronic illnesses or taking medication.

Serious or chronic illnesses that greatly alter energy, psychological state and lifestyle (arthritis, cancer, chronic pain, etc.) often have repercussions on sexual ardor.

In addition, some medications decrease the flow of blood to the clitoris and genitals, making it more difficult to reach orgasm. This is the case with some drugs for high blood pressure. In addition, other drugs can decrease the lubrication of the vaginal mucosa in some women: birth control pills, antihistamines and antidepressants. Some antidepressants are known to slow down or block the onset of orgasm (in both men and women).

Pregnancy and its various states also modify sexual desire

Sexual desire may decrease in women who experience nausea, vomiting and breast pain, or if they are worried about pregnancy.

From the second trimester, sexual arousal tends to be higher because the blood circulation is activated in the sexual region, simply to train and nourish the child. This activation leads to increased irrigation and reactivity of the sexual organs. An increase in libido may result.

With the imminent arrival of the baby and the changes in the body which are accentuated, the mechanical gene (large belly, difficulty in finding a comfortable sexual position), can reduce sexual desire. Sexual desire naturally decreases after childbirth due to the breakdown of hormones. This leads to total blockage of desire in most women for at least 3 to 6 months as well as often severe vaginal dryness.

Moreover, because thechildbirth stretches muscles participating in orgasm, it is advisable to perform the perineal bodybuilding sessions prescribed by the doctor after childbirth. This helps to find better functional orgasms more quickly.

Decreased sexual desire at menopause.

Hormones estrogen and testosterone – women also produce testosterone, but in lesser amounts than men – seem to play an important role in the sexual desire. The transition to menopause, decreases estrogen production. In some women, this causes a drop in libido and above all, gradually over a few years, it can lead to vaginal dryness. This can create an unpleasant irritation during intercourse and it is strongly advised to talk to your doctor about it as there are currently solutions to remedy it.