Q: What are the causes of female sexual dysfunction and loss of libido?
A: The same diseases that
cause erectile dysfunction in men can lead to sexual dysfunction in women.
These include diabetes, heart disease, high cholesterol, spinal cord
injury, hormonal disorders and smoking. And just as prostate-removal
surgery can lead to impotence, pelvic surgery may lead to nerve or
blood-vessel damage that causes sexual problems. These physical conditions
may or may not interact with emotional issues that contribute to sexual
dysfunction, such as relationship problems, low self-esteem, poor body
image or a history of sexual trauma or abuse. In addition, certain drugs
can impair sexual function.
Q: What effect do
antidepressants have on women’s sexual interest?
A: Antidepressants can impact
both sexual function and libido. Women taking these drugs may report
decreased arousal, increased vaginal dryness and increased difficulty
reaching orgasm. Women who notice such side effects should speak to their
physician about switching medications or decreasing the dose.
Q: Can a hysterectomy
impact a woman’s sexual function?
A: Yes. We have seen a
large number of women who noted that their sexual response dramatically
changed following hysterectomy. They report a loss of sexual desire,
decreased vaginal lubrication and a loss of genital sensation. Even if the
ovaries are preserved, women still often experience these symptoms.
We are currently working to identify
the specific nerves and blood vessels that are vital to female sexual
function, and to develop ways to perform “nerve-sparing”
hysterectomies, similar to the nerve-sparing prostatectomies in men.
Q: What happens to women
sexually as they go through menopause?
A: Many women experience a change in their sexual function during the
years immediately before and after menopause. This is primarily a result
of a decrease in estrogen and testosterone
levels. As women age, they also experience decreased blood flow to their
genitals. Common complaints include a loss of desire, diminished responsiveness
and low sexual arousal. Vaginal atrophy, which involves thinning, drying
and irritation of the vaginal lining, causes significant distress for
the menopausal woman.
In addition, the interplay of
psychological, cultural and interpersonal factors all contribute to the
aging woman’s sexual experience. Unfortunately, our culture does not
encourage or acknowledge sexuality in the older woman.
But sex later in life has its
benefits. A woman no longer has to worry about becoming pregnant. She can
enjoy her partner and the empty nest — often for the first time.
Q: What is the role of
hormone replacement therapy (HRT) in women’s sexual function?
A: Given to menopausal and
postmenopausal women, HRT helps to prevent osteoporosis and cardiovascular
disease as well as vaginal atrophy, sexual dysfunction and incontinence.
We are evaluating the effect of the combination of HRT with other
medications such as Viagra on female sexual function, and have found
dramatic improvement in sexual responsiveness.
Q: How important is sexual
function for women’s general health?
A: Due to subtle social
taboos that still exist today, many women are uncomfortable reporting
sexual dysfunction. They often feel that they are not entitled to sexual
satisfaction and are uncomfortable talking about it, even with their
partners.
But sexuality is a basic part of
women’s general wellness. Experiencing a positive and functional sex
life enhances feelings of self-esteem and positive body image. A
satisfying sexual relationship also helps to build an emotional connection
with one’s partner and higher levels of intimacy.
Q: What treatments are
available for women with sexual function complaints?
A: Historically, the only
treatment option for women suffering from sexual dysfunction was sex
therapy, lubricating gels and hormone replacement therapy (natural
progesterone cream). These treatments can be effective for some women, and
are often most helpful when used in combination.
[A M N News Online]
Last Revised at December 6, 2007 by Amalia K. Gagarina, M.S., R.D.
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