How To Navigate Female Sexual Dysfunction

Reviewed by Whitney White, MS CMHC, NCC., LPC

Published 06/24/2022

Sexual dysfunction can be emotional to acknowledge and frightening to act on.

It can be emotional to acknowledge experiencing sexual dysfunction.

Feeling as though something is wrong in the body, especially something so vulnerable can cause a rather stressful domino effect -- and therefore, the normalization of sexual dysfunction conversations is imperative to the well-being of people worldwide.

First, let's define "sexual dysfunction."

What Is Sexual Dysfunction? 

The sexual dysfunction definition can change on a case-by-case basis. For reasons both physical and/or psychological, sexual dysfunction can be simply the inability to perform sexual acts or lacking the desire to.

Sexual dysfunction can be more complex, though, depending on the situation. For example, the inability to perform or the lack of desire to perform can happen at any given stage of the sexual response cycle.

Stages of The Sexual Response Cycle:

  1. Desire
    1. Emotionally: This can be thought of as excitement.
    2. Physically: Heart rate might increase, the face may blush, and blood flow to the genitalia increases.
  2. Arousal
    1. Emotionally: This is the second phase of being "turned on” often referred to as the "plateau."
    2. Physically: Genitalia sensitivity increases, as well as muscle tension.
  3. Orgasm
    1. Emotionally: The "climax" where feelings of elation will perhaps occur.
    2. Physically: Contractions of the muscles and physical release of liquids (ejaculation) occurs, often involuntarily.
  4. Resolution
    1. Emotionally: Feelings of fatigue are often the primary feeling post-orgasm.
    2. Physically: Women are capable of experiencing the second and third phases shortly after the resolution, but men typically need more time to physically recover.

A person with sexual dysfunction can experience issues in any or all of these stages. Understanding which phase might be causing the issue at hand is often the first step in addressing sexual dysfunction.

So, what are the causes?

Causes of Sexual Dysfunction

There is a wide range of causes that can result in sexual dysfunction due to underlying issues of the mind and/or the body.

These can include, but are not limited to:

  • Anxiety
  • Depression
  • Post-traumatic stress
  • Menopause
  • Alcoholism
  • Drug Abuse
  • Diabetes
  • Heart Disease
  • Gastrointestinal Issues
  • Bacterial Infections
  • Yeast Infections
  • Urinary Tract Infections
  • Kidney Disease
  • Liver Failure
  • General hormone imbalance

External forces can also be a cause of sexual dysfunction. For example, not everyone has to have substance abuse issues to struggle with substance-related sexual dysfunction. Causes could also be external or cultural; for example, someone who was taught by their family and/ or their surrounding community that sex is morally wrong may suffer from sexual dysfunction as a result of internalized shame and guilt.

Men and women alike can experience sexual dysfunction, but information about sexual dysfunction in females can often be under-researched and under-discussed.

Sexual Disorders 

The way sexual disorders are diagnosed is often categorized as the following:

  • Desire Disorder
  • Arousal Disorder
  • Orgasm Disorder
  • Post-Orgasm Disease
  • Erectile Disorder
  • Premature Ejaculation Disorder
  • Pain Disorder

Let's talk about the first one: "Desire Disorder." In men, it's defined as male hypoactive sexual desire disorder, and in women, it's defined as female sexual interest/arousal disorder.

Female Sexual Interest/Arousal Disorder 

Female sexual dysfunction (FSD) can be distinguished in many ways but often manifests itself in these two ways...

Hypoactive Sexual Desire Disorder: This is essentially the lack of libido for any type of sexual behavior.

Sexual Arousal Disorder: This is the lack of physical response to sexual stimulation.

Female arousal problems can be difficult to navigate and may cause feelings of embarrassment, guilt, general insecurity, and/or confusion.

But experiences of female sexual dysfunction are incredibly common in women of all ages and backgrounds.

An evaluation done by the University of Texas at Austin collected known data about FSD and assessed that 22% of women in the United States reported experiences of FSD, and in a pool of 29 countries, 23-46% of women reported feelings of low libido, and/or FSD.

Female sexual dysfunction can also be more prevalent in certain communities.

In fact, in 2013, the National Center for Biotechnology Information (NCBI) outlined the statistics for Kurdish women in western Iran with sexual dysfunction in a few different ways.

Prevalence of FSD among Kurdish women according to age:

  • 22% of women over the age of 20 reported experiences of FSD
  • 7% of women between the ages of 40-50 reported experiences of FSD

Reason for FSD among Kurdish women:

  • 3% of women attributed FSD to issues of desire
  • 5% of women attributed FSD to lubrication issues
  • 2% of women attributed FSD to problems with orgasms
  • 42% of women attributed FSD to satisfaction problems
  • 5% of women attributed FSD to pain

Studies like this one highlight just how common female sexual dysfunction is. Understanding how common it is is a vital step in normalizing conversation about it. 

Pain And FSD

Pain-related to sexual intercourse can be a very vulnerable reality to share with healthcare physicians. Though it can be scary, it is more common than you may think.

Sexual Pain Disorders are often further broken down into the following categories:

  • Dyspareunia: Recurring pain within the genitalia at any point during or after intercourse.
  • Vaginismus: Random, recurring muscle spasms in the pelvis, making intercourse painful and/or impossible.
  • Non-Coital Sexual Pain Disorder: This disorder is similar to dyspareunia, but the pain does not happen during sexual interactions.

Infections can also be a source of pain during intercourse, though it tends to be temporary, and with the treatment of the infection itself, subsequent pain is usually alleviated.

Female Sexual Arousal Disorder & The DSM 5

According to the Diagnosis and Statistical Manual of Mental Disorders (DSM 5), there are four main categories for criteria in which female sexual disorders need to be diagnosed.

  1. Low libido, lack of interest in sexual conduct, and lack of response to sexual stimuli
  2. The feelings have persisted for at least six months
  3. The feelings have been a burden for the individual
  4. The feelings cannot be explained by another source

The DSM 5 also asks for specifications about; the length of time these feelings have been present, under what circumstances they occur, and how severe the experiences range.

Research about women's health could, unfortunately, still be considered far behind research concerning men's health. This reality can cause a trickle-down effect when it comes to those individuals seeking out their own medical guidance. Though men frequently seek assistance for erectile dysfunction, women are less likely to seek assistance for FSD.

If you think you might be experiencing female sexual dysfunction, take this free, short, online assessment to get a confidential evaluation of your symptoms. For further help or official diagnosis, seek assistance.

What Is Frigidity in Women?

In psychological terms, frigidity is used to describe the inability of a woman to climax during sexual intercourse, often used in tandem with the term "failure" to perform.

"Frigid women" were those who experienced feelings of female sexual dysfunction, but the term itself placed an unspoken negative connotation on the experience and a sense of blame towards the woman for the problem.

These choices in language: "frigid" and "failure" -- can make a woman feel both suppressed and broken. Nowadays, most people will name the disorder as female sexual dysfunction during diagnosis, as we've been referencing.

What Causes A Woman to Have Low Libido?

As previously stated, both physical and psychological issues can be reasons as to why a woman experiences a lower sex drive.

There is nothing inherently wrong with an individual who lacks libido. Though societal standards may suggest otherwise, being sexually active is not for everyone.

The lack of libido only becomes a problem when the individual experiencing it feels as though their quality of life has also diminished because of it. Some people are asexual, meaning they do not experience sexual attraction, and they live comfortably and openly with their sexuality. To learn more about asexuality, click here.

At What Age Does A Woman Stop Being Sexually Active?

There is no point in life in which a woman necessarily stops being sexually active. That said, it's more likely for a woman to experience flux in libido as hormones change. Hence, the association between menopause and an assumption concerning sexual activity, or lack thereof.

During menopause, women can experience a litany of symptoms including, but not limited to:

  • Hot Flashes
  • Sleep Problems
  • Vaginal Dryness
  • Occasional Spotting
  • Mood Swings
  • Fluctuation In Weight
  • Dry Skin
  • Hair Thinning
  • Soreness
  • Depression
  • Anxiety
  • Loss of Libido

Essentially, a woman's ovaries age with them. For that reason, typically, when a woman hits 45-55 years old, their bodies stop producing average hormones like estrogen, progesterone, and testosterone. When this significant drop in hormone production occurs, sometimes it also affects desire and arousal.

Sexual Dysfunction and Relationships

Sexual dysfunction is not something an individual experience alone. Given the sheer fact that sexual intercourse requires consenting adults, the person experiencing sexual dysfunction will often also have to deal with the tandem problems it may create in a relationship setting.

Relationship strife due to sexual dysfunction can be stressful, frightening, and depressing for both parties involved. In many cases, the partner on the other side of the sexual dysfunction might have a difficult time understanding that the sexual dysfunction is not personal or not related to anything they've said and/or done.

Understanding the reasons for sexual dysfunction is the first important step. Then, being able to communicate the reasons for sexual dysfunction to one's partner is expected. But that's often easier said than done.

Being equipped with knowledge and the language to explain female sexual dysfunction is the best way to begin these conversations.

Undiagnosed and unaddressed FSD can take a toll on an individual's mental health in other capacities. For personal guidance or couple's counseling, please seek professional assistance from a licensed professional.