Female Sexual Dysfunction

/Female Sexual Dysfunction
Female Sexual Dysfunction 2017-11-20T10:03:18+00:00

Female Sexual Dysfunction

Female Sexual Problems

Sexual dysfunction or Sexual problems refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm.

To maximize the benefits of medications and behavioral techniques in the management of sexual dysfunction it is important to have a comprehensive approach to the problem, A thorough sexual history and assessment of general health and other sexual problems (if any) are very important. When a sexual problem is managed inappropriately or sub-optimally, it is very likely that the condition will subside immediately but re-emerge after a while. When this cycle continues, it strongly reinforces failure that eventually makes clients not to access any help and suffer it all their life. So, it is important to get a thorough assessment from professionals and therapists who are qualified to manage sexual problems. Internet-based information is good for gaining knowledge about sexual functioning and sexual problem but not for self-diagnosis and/or self-management

DyspareuniaPain during or after sexual intercourse is known as dyspareunia. Although this problem can affect men, it is more common in women. Women with dyspareunia may have pain in the vagina, clitoris or labia. There are numerous causes of dyspareunia, many of which are treatable. Common causes include the following:

-> Vaginal dryness

Atrophic vaginitis, a common condition causing thinning of the vaginal lining in postmenopausal women
Side effects of drugs such as antihistamines and tamoxifen (Nolvadex and other brands)
An allergic reaction to clothing, spermicides or douches
Endometriosis, an often painful condition in which tissue from the uterine lining migrates and grows abnormally inside the pelvis
Inflammation of the area surrounding the vaginal opening, called vulvar vestibulitis
Skin diseases, such as lichen planus and lichen sclerosus, affecting the vaginal area
Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases
Psychological trauma, often stemming from a past history of sexual abuse or trauma


Women with dyspareunia may feel superficial pain at the entrance of the vagina, or deeper pain during penetration or thrusting of the penis. Some women also may experience severe tightening of the vaginal muscles during penetration, a condition called vaginismus.


Dyspareunia typically is diagnosed based on your symptoms. Your medical and sexual history and your physical examination will help your doctor to determine the cause of your symptoms.

Distinguishing pain that occurs with touching the genitals or early penetration from pain that occurs with deeper penetration is a clue to the cause of your symptoms. Therefore, your doctor will ask you questions about the exact location, length and timing of your pain. He or she also will ask you:

If there was ever a time you had painless intercourse, or if you have always had dyspareunia
If you have enough natural lubrication, and if your symptoms improve if you use commercially available lubricants
About your sexual history (to help assess your risk for sexually transmitted infections)
If you have ever been sexually abused, or had a traumatic injury involving your genitals

In addition:

If you are middle-aged, your doctor will ask whether you are experiencing irregular periods, hot flashes or vaginal dryness, symptoms suggesting that you may have atrophic vaginitis.
If you are a new mother, your doctor will ask whether you are breastfeeding your baby, because breastfeeding also can lead to vaginal dryness and dyspareunia

During the physical examination, your doctor will check your vaginal wall for signs of dryness, inflammation, infection (especially yeast or herpes infection), genital warts and scarring. Your doctor also will do an internal pelvic examination to look for abnormal pelvic masses, tenderness or signs of endometriosis. He or she also may suggest that you speak with a counselor to determine whether a history of sexual abuse, trauma or anxiety may be contributing to your symptoms.

Expected Duration

How long your symptoms last depends on the cause. If you have vaginal dryness from inadequate lubrication, the symptoms will improve rapidly if you use a commercially available lubricant or if you are more aroused before intercourse. If you have vaginal dryness from atrophic vaginitis, your symptoms will improve with an estrogen cream placed in the vagina. You should discuss this with your physician. Oral estrogen therapy can increase the risk of breast cancer and heart disease, but vaginal formulas are considered safe for most people. If you have a urinary tract or vaginal yeast infection, the dyspareunia typically goes away within one week of antibiotic or antifungal therapy. If you have a sexually transmitted disease, you may need longer, more intensive treatments with antibiotics to clear the condition. Skin diseases, usually will improve with the use of steroid creams, but often require long-term treatment. If you have had symptoms of dyspareunia for months or years, and psychological factors play a role, you may need prolonged counseling before your symptoms are relieved.


Although some causes of dyspareunia, such as a history of sexual abuse or trauma, can’t be avoided, other causes can be prevented:

To decrease your risk of yeast infection, avoid tight clothing, wear cotton underpants and practice good hygiene. Change your underclothes after prolonged sweating. Bathe or shower daily, and change into dry clothing promptly after swimming.
To avoid bladder infections, wipe from front to back after using the toilet, and urinate after sexual intercourse.
To avoid sexually transmitted diseases, avoid sex or practice safe sex by maintaining a relationship with just one person, or using condoms to protect against sexually transmitted diseases.
To prevent vaginal dryness, use a lubricant, or seek treatment if the dryness is due to atrophic vaginitis.
If you have endometriosis, avoid very deep penetration, or have sex during the week or two after menstruation (before ovulation), when the condition tends to be less painful.

-> Irregular Menses

A normal period

A woman will, on average, get her period for three to seven days once a month (every 30 days or so). After menstruating for several years, women tend to settle into a cycle; some women can even predict down to the hour when their periods will come.

The amount of blood shed during a period varies from woman to woman. Some women routinely have heavier periods (losing up to 12 teaspoons of blood each month) while others may experience a period that’s almost non-existent (losing as little as four teaspoons of blood).

An irregular period

If you’ve been menstruating for a while, your body will get into a period flow, which is why an irregular period is usually defined as any type of bleeding that’s abnormal when compared to your last few menstrual cycles. It can include everything from a late period to early bleeding, and scant bleeding to extremely heaving bleeding. If you’re not prone to PMS, you can also consider a period irregular if you experience heavy cramping and bloating or headaches.

The causes of irregular periods

Every woman will experience an irregular period from time-to-time, and though, in most cases, they aren’t dangerous, it’s important to figure out what’s causing the irregularity. Here are a few common reasons you may be experiencing an abnormal flow.


When pregnant, the female body produces different levels of hormones that causes menstruation to stop. In some cases, however, women will experience lighter-than-normal flows or late periods before menstruation ends altogether. If there’s a chance you may be pregnant, speak with your doctor.


Stress is the most common cause of irregular periods. Cortisol, the stress hormone, has a direct impact on how much estrogen and progesterone, two sex hormones, gets produced by the body. If you have too much cortisol in your bloodstream, the time and flow of your cycle could change.


Another common reason for a late or missing period is the food you eat and, more specifically, the weight you’re carrying. If you’re eating a diet that’s rich in unhealthy carbs or if you’ve gained weight, your body will produce varying levels of certain hormones, shifting when you ovulate. The same goes for women as they lose weight.


Our bodies need energy to menstruate. If you’re burning too much of your energy in the gym, there will be nothing left for your body to use during that time of the month.

Birth control pills

It can take several months for your body to get used to the dose of hormones birth control pills deliver.

Drinking too much alcohol

The liver helps regulate a woman’s menstrual cycle by metabolizing estrogen and progesterone. Excessive drinking can cause damage to the liver and may interfere with how well it metabolizes both period-normalizing hormones.

Polycystic ovary syndrome

A fairly common complication, this condition causes cysts to form on the ovaries, interfering with regular ovulation. Other symptoms of the condition include hair growth, weight gain, dandruff and infertility. Complications include endometriosis, ovarian cancer and heart disease.


As with pregnancy, this time of life happens when hormone levels in the body begin to shift. Irregular periods can start as early as 10 years before menopause sets in (usually when a woman is in her late 40s or early 50s).

Taking medications

If you were recently sick and had to take prescription or over-the-counter medication, your period may show up a day or two late. That’s largely because most medications interfere with the way your body produces estrogen and progesterone.

Treating Irregular Periods

Depending on the cause of your irregular period, there may or may not be much you can do about it. Speak to your doctor about the symptoms you’ve been having and how irregular your periods have been. Your doctor may prescribe a treatment plan that includes hormonal contraceptives or supplements (both of which help regulate menstrual cycles and keep hormone levels balanced), stress-reducing activities, diet changes, and an exercise plan.

-> Leukorrhea

Leukorrhea is the medical term for a certain type of vaginal discharge that is common during pregnancy as well as at other times during your reproductive years. If you have leukorrhea, you may have a thick and sticky vaginal discharge that is white, yellow, or green. It can vary with a woman’s menstrual cycle as her hormone levels change.

Vaginal discharges are often a sign of vaginal yeast infections, bacterial vaginosis, or sexually transmitted diseases. Leukorrhea may or may not indicate the presence of infection, and it is not usually accompanied by other signs and symptoms, such as itching, pain, burning or irritation, or redness, of the tissue. Only a qualified health professional can tell you whether you have an infection.

If you have any unusual type of vaginal discharge during pregnancy or at any other time, always consult your health professional before trying any over-the-counter treatments or home remedies.


Physiological Leukorrhea:

Physiological Leukorrhea occurs and is emitted in the form of a defense mechanism. The vagina makes use of this particular defense mechanism to steady and maintain its chemical balance. This yellowish vaginal discharge helps preserve the flexibility of the vaginal tissues as well. This particular term “Physiological Leukorrhea” has been introduced while referring to this vaginal discharge or Leukorrhea that is released by the vagina as a result of estrogen stimulation. Under normal circumstances, this yellowish vaginal discharge which we also know as Leukorrhea is emitted during various pregnancy stages. The release of this discharge causes the blood flow to the vagina to increase. This phenomenon occurs as a result of increased estrogen levels. There are also chances that even female infants may sometimes have Leukorrhea. This yellowish vaginal discharge occurs and is emitted because of their in – uterine exposure to estrogen. But, this vaginal discharge goes away in a very short time after birth.

Inflammatory Leukorrhea:

Inflammatory Leukorrhea is another type of vaginal discharge that is known to occur and is emitted as a result of inflammation or congestion of the vaginal mucosa. The mucosa membrane has an endodermal origin. This membrane is covered in epithelium. The epithelium accentuates the secretion and absorption processes. If the vaginal discharge that has been released is yellowish and gives off a foul odor, you must visit your healthcare professional at the earliest. This type of Leukorrhea or yellowish vaginal discharge with a foul odor may be the cause of several other infections brewing! These infections may include organic bacterial infections or even sexually transmitted diseases (STD). Sometimes, after delivery Leukorrhea along with a severe backache and lochia occurs. Lochia is defined as post – partum vaginal discharge. This vaginal discharge contains mucus, placental tissue and blood. This particular combination of a severe backache and lochia along with Leukorrhea may indicate the failure of involution as a result of certain infections. Involution is a process that occurs after a delivery wherein the uterus of a woman returns to pre – pregnancy size.


Improper hygiene
Hormonal disturbances
Constipation and Indigestion
Wounds caused by severe itching
Anemia and other diseases, such as diabetes


Frequent headaches
Thick and sticky vaginal discharge
Pain experienced in the calves and lumbar region

-> Vaginal Tightening(Vaginoplasty)

Why consider vaginoplasty?
Vaginoplasty is the surgical procedure which tightens the vaginal muscles, perineum and surrounding tissues. This gives more tone, strength and control to your vaginal muscles, enhancing your sensitivity and sexual experience.

Your vaginal muscles may have lost tone as part of the ageing process, which can cause embarrassment and discomfort. The loss of sensitivity can affect sexual satisfaction for both yourself and your partner.

Many women also consider vaginal tightening after having children. During natural childbirth the vaginal muscles expand to form the birth canal for your baby. After several children, or sometimes after having a large baby or a difficult delivery, your vaginal muscles can be left loose and weak and surrounding tissues stretched and torn. Even after exercise, the condition of your vaginal muscles and pelvic floor may not improve.

If you are concerned about a loss of vaginal muscle tone, vaginal tightening is a safe and effective corrective procedure for women at all stages of life. Many patients tell us that they have much more confidence and enjoy a more fulfilling sex life after the procedure.

Discuss vaginal tightening in complete confidence

We appreciate that you may find talking about this subject embarrassing or uncomfortable. We can reassure you that our staff and surgeons have significant experience in helping women to regain their confidence and self-esteem through vaginoplasty.

When you book a consultation you’ll meet with a fully trained, female Patient Care Co-ordinator. You’ll talk about the process, including approximate costs and what happens before and after your procedure. We’ll maintain your privacy at all times and you’ll be under no obligation to go ahead.

We’ll then invite you to meet one of our experienced vaginoplasty surgeons who will discuss the procedure in more detail with you. The focus will be on what you hope to achieve with vaginal tightening, and this is a chance to ask any questions. As you’ll be meeting with the surgeon who will perform your procedure, you needn’t feel embarrassed and can talk about any worries you might have. Some questions you might have could include:

Will I be able to have more children following vaginoplasty?
Will my partner or future partners be able to tell I’ve had vaginal tightening?
Will vaginoplasty affect clitoral sensation?
When can I resume my sex life?
What are the risks?

Vaginal tightening – what the procedure involves

The procedure takes around an hour to perform and your surgeon will advise whether you’ll need a general or local anaesthetic. If you have a general anaesthetic, you may need to stay overnight in one of our Transform hospitals.

Your surgeon will join and shorten the stretched muscles at the back of your vagina with dissolvable stitches and remove any excess skin. This tightens the vaginal muscles and surrounding soft tissues, giving an immediate decrease in the diameter of your vagina. Any scars will be internal and, whilst it’s important to have realistic expectations, you can expect your vagina to regain most of its pre-pregnancy tone.

After surgery you’ll be sore but should be able to walk comfortably after a few days. We’d recommend taking a week off work to make a full recovery, and after 2-3 weeks you should be able to feel the results of your vaginal tightening.

You’ll have a post-op check-up to ensure that everything is healing properly, and your surgeon will advise when you’re able to resume sexual activity.

-> Menopause

Menopause is a normal part of life, just like puberty. It is the time of your last period, but symptoms can begin several years earlier. Some symptoms of menopause can last for months or years after. Changing levels of estrogen and progesterone, which are two female hormones made in your ovaries, might lead to these symptoms.

This time of change is known as the menopausal transition, but it is also called perimenopause by many women and their doctors. It can begin several years before your last menstrual period. Perimenopause lasts for 1 year after your last period. After a full year without a period, you can say you have been “through menopause.” Postmenopause follows menopause and lasts the rest of your life.

The average age of a woman having her last period, menopause, is 51. But, some women have their last period in their forties, and some have it later in their fifties. Smoking can lead to early menopause. So can some types of operations. For example, surgery to remove your uterus (called a hysterectomy) will make your periods stop, and that’s menopause. But you might not have menopause symptoms like hot flashes right then because if your ovaries are untouched, they still make hormones. In time, when your ovaries start to make less estrogen, menopause symptoms could start. But, sometimes both ovaries are removed (called an oophorectomy), usually along with your uterus. That’s menopause too. In this case, menopause symptoms can start right away, no matter what age you are, because your body has lost its main supply of estrogen.

What Are the Signs of Menopause?

Women may have different signs or symptoms at menopause. That’s because estrogen is used by many parts of your body. So, as you have less estrogen, you could have various symptoms. Here are the most common changes you might notice at midlife. Some may be part of aging rather than menopause.

Change in your period. This might be what you notice first. Your periods may no longer be regular. They may be shorter or last longer. You might bleed less than usual or more. These are all normal changes, but to make sure there isn’t a problem, see your doctor if:

Your periods come very close together

You have spotting

Your periods last more than a week

Hot flashes. Many women have hot flashes around the time of menopause. They may be related to changing estrogen levels. Hot flashes may last a few years after menopause. A hot flash is a sudden feeling of heat in the upper part or all of your body. Your face and neck become flushed. Red blotches may appear on your chest, back, and arms. Heavy sweating and cold shivering can follow. Flashes can be very mild or strong enough to wake you from your sleep (called night sweats). Most hot flashes last between 30 seconds and 10 minutes.

Problems with your vagina and bladder. Changing estrogen levels can cause your genital area to get drier and thinner. This could make sexual intercourse uncomfortable. Or, you could have more vaginal or urinary infections. Some women find it hard to hold their urine long enough to get to the bathroom. Sometimes urine leaks during exercise, sneezing, coughing, laughing, or running.

Sleep. Around midlife, some women start having trouble getting a good night’s sleep. Maybe you can’t fall asleep easily, or you wake too early. Night sweats might wake you up. You might have trouble falling back to sleep if you wake during the night.

Sex. You may find that your feelings about sex are changing. You could be less interested. Or, you could feel freer and sexier after menopause. After 1 full year without a period, you can no longer become pregnant. But remember, you could still be at risk for sexually transmitted diseases (STDs), such as gonorrhea or even HIV/AIDS. You increase your risk for an STD if you are having sex with more than one person or with someone who is having sex with others. If so, make sure your partner uses a condom each time you have sex.
Mood changes. You might find yourself more moody or irritable around the time of menopause. Scientists don’t know why this happens. It’s possible that stress, family changes such as growing children or aging parents, a history of depression, or feeling tired could be causing these mood changes.

Your body seems different. Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Are these a result of having less estrogen or just related to growing older? Experts don’t know the answer.

What About My Heart and Bones?

Two common health problems can start to happen at menopause, and you might not even notice. Osteoporosis. Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis. Talk to your doctor to see if you should have a bone density test to find out if you are at risk. Your doctor can also suggest ways to prevent or treat osteoporosis.

Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may gain weight and develop other problems, like high blood pressure. These could put you at greater risk for heart disease. Be sure to have your blood pressure and levels of triglycerides, fasting blood glucose, and LDL, HDL, and total cholesterol checked regularly. Talk to your health care provider to find out what you should do to protect your heart.

How Can I Stay Healthy After Menopause?

Staying healthy after menopause may mean making some changes in the way you live.

Don’t smoke. If you do use any type of tobacco, stop—it’s never too late to benefit from quitting smoking.

Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, and whole-grain foods, as well as all the important vitamins and minerals.

Make sure you get enough calcium and vitamin D—in your diet or with vitamin/mineral supplements.

Learn what your healthy weight is, and try to stay there.

Do weight-bearing exercise, such as walking, jogging, or dancing, at least 3 days each week for healthy bones. But try to be physically active in other ways for your general health.

Other things to remember:

Take medicine if your doctor prescribes it for you, especially if it is for health problems you cannot see or feel—for example, high blood pressure, high cholesterol, or osteoporosis.

Use a water-based vaginal lubricant (not petroleum jelly) or a vaginal estrogen cream or tablet to help with vaginal discomfort.

Get regular pelvic and breast exams, Pap tests, and mammograms. You should also be checked for colon and rectal cancer and for skin cancer. Contact your doctor right away if you notice a lump in your breast or a mole that has changed.

Menopause is not a disease that has to be treated. But you might need help if symptoms like hot flashes bother you. Here are some ideas that have helped some women:

Try to keep track of when hot flashes happen—a diary can help. You might be able to use this information to find out what triggers your flashes and then avoid those triggers.

When a hot flash starts, try to go somewhere cool.

If night sweats wake you, sleep in a cool room or with a fan on.

Dress in layers that you can take off if you get too warm.

Use sheets and clothing that let your skin “breathe.”

Have a cold drink (water or juice) when a flash is starting.

You could also talk to your doctor about whether there are any medicines to manage hot flashes. A few drugs that are approved for other uses, for example, certain anti-depressants, seem to be helpful to some women.