Sexual dysfunction in women

Prevalence 8-50% in women and refers to primarily low libido.

Female sexual dysfunctions are substantially undetected and under addressed, and often undocumented even when recognized.

Distress related to sexual function is the hallmark of female sexual dysfunction. 

Low sexual desire usually accompanied by low levels of arousal and excitement , infrequent organisms and sexual dissatisfaction

While in association of cardiovascular risk factors with female sexual dysfunction has been suggested, it is mostly concluded that female sexual dysfunction is more strongly related to psychosocial factors.

Typical sexual phases of desire, arousal, orgasm and resolution overlap and the sequence can vary.

Sexual distress that occurs in sexual dysfunction is described as bothering, concern, unhappiness, frustration, anger, or hopelessness.

Sexual problems in women are more prevalent with age, but sexual distress decreases with age, making the prevalence of female sexual disorders approximately stable throughout the lifespan of women.

Sexual distress can manifest as distressing behavior as a reduced or absent initiation of sexual activity, avoidance of sexual situations, or participation in sexual activity without desire.

Prevalence increases after the third decade and after oophorectomy.

It may be lifelong or acquired after a period of normal functioning and situational or generalized, and related distress is characterized as mild, moderate, or severe.

Patients may experience multiple aspects of their sexual response problems and these may be concurrent.

Common after breast cancer diagnosis.

Sexual dysfunctions manifest as chronic sexual symptoms related to sexual pain and the three phases of sexual response cycle: desire, arousal, and orgasm.

Female sexual dysfunction are distinguished by their persistence for a minimum of three months, occurrence with at least 75% of sexual experiences, and their association with sexually related personal distress.

Female sexual dysfunction may be lifelong or acquired after period of normal functioning and may be situational, psychological, interpersonal, and social and cultural risk factors.

More than half of patients with breast or gynecological cancer survivors report longstanding sexual side effects, often comprising physical and emotional well being.

Dyspareunia and vaginismus have been merged into a single category, genito-pelvic pain penetration disorder, and pain can occur with initial penetration, deep thrusting or with noncoital sexual activities.

Some women have persistent vulvar pain with provocation, known as provoked vestibulodynia.

Depression and marital status are independent predictors of female sexual dysfunction.

There is a bidirectional association between anxiety and depression and poor sexual function.

Most studies support the use of testosterone for impaired sexual desire disorders.

No androgen level is predictive of low female sexual function and the majority of women with low dehydroepiandrosterone levels do not have sexual dysfunction.

Associated with hypertension.

Metabolic syndrome is associated with decreased sexual activity, desire, and satisfaction in women.

Coronary artery disease is more prevalent in women with low sexual activity.

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