Female Sexual Dysfunction

Female sexual dysfunction is a complex process that is affected by numerous psychological variables including: religion, family values, social beliefs, etc. The female sexual response must also be coordinated by a series of physiological systems including the neurological, vascular, and endocrine system. Variance in a female's age, health, stress levels, environment, interpersonal relationship, etc can all effect to the female sexual response.

Diagnosing female sexual dysfunction can often be a challenging process. A physician must asses a detailed patient medical history that includes the exact problem encountered during the sexual response, pertinent gynecologic conditions or other medical conditions, contributing psychosocial factors including a female's sexual orientation (female's sexual orientation is significant because female gender conflicts are a frequent cause of female sexual dysfunction). Physicians should also define whether the sexual dysfunction is involved with one partner or involves multiple partners.

Female sexual dysfunction often involves multiple variables i.e. a female who discusses decrease libido with her physician may have an underlying gynecological condition that prevents her from wanting to have sexual relations.

One of the major problem in treating female sexual dysfunction is getting a woman to discuss all of the variables that are affecting her sexual relations in a relatively short office visit. Physicians must be conscientious of this issue and address the situation appropriately. Until the advent of Viagra, millions of men did not seek treatment secondary to the embarrassing nature of the office visit. Now that men know that there is a treatment option that is beneficial they have been actively seeking treatment for male sexual dysfunction. Fortunately, there are now very effective treatment options for women with female sexual dysfunction including low female libido (sex drive).

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More complicated case of female sexual dysfunction are usually divided into four categories including: desire, arousal, orgasmic and sexual pain disorders. Sexual pain disorders include dyspareunia (difficult or painful intercourse) and vaginismus (a prolonged and painful contraction or spasm of the vagina).

Disorders of Desire as a cause of female sexual dysfunction - women who experience sexual dysfunction secondary disorders of desire is often secondary to the monotony of the same sexual routine. Changes in foreplay, sexual positions, sex toys or erotic material can often improve a females desire. Excellent results have also been reported from the use of herbal libido enhancing supplements. Aside from the herbs used to promote an increase in libido, these supplements have herbs that are rich in phytoestrogens that help to restore a natural hormone balance.

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Lifestyle factors often influence pre-menopausal women i.e. changes in careers, financial burdens, presence of children or the fear of conceiving more children, time constraints, etc. can all of a negative effect on a woman's desire resulting in female sexual dysfunction secondary to desire issues..

The lack of desire can also be caused by medical conditions that make sexual intercourse painful or unsatisfying (please see below). If no underlying hormonal or medical etiology can be identified individual and/or couple counseling can be beneficial.

In peri- and postmenopausal women, hormones may be the underlying cause of a decrease in sexual desire. Although the relationship between female hormones and sexual desire has not been well documented. Most physicians agree prescription estrogen replacement therapy has proved to be beneficial.. The mechanism of estrogen's effect on desire is thought to be indirect providing improvement in vasomotor symptoms, urogenital atrophy and mood disorders.

Transdermal herbal creams containing arginine have also proven to be a more milder treatment option. The arginine allows for increased circulation to the clitoral region. Oral herbal supplement have also proven beneficial, individuals should look for the following herbal ingredients in libido formulas: Niacin, Yohimbe, Ashwagandha, Asparagus Racemosus, L Tyrosine, Wild Yam, L Histidine, Ginger, Cayenne Pepper.

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Studies concerning the role of progesterone in sexual enhancement have not been well established. Initial studies show that progesterone may exhibit a negative effect by decreasing the mood and available androgens.
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Over the counter and prescription medication, illegal drugs and alcohol abuse can also contribute to female sexual dysfunction. In addition, cigarette smoking is known to cause erectile dysfunction in men and may cause female sexual dysfunction including both desire and arousal issues.

The following is a list of medications that can cause female sexual dysfunction especially reducing the desire for sexual activity:

• Spironolactone (Aldactone)
• Hormonal preparations
• Danazol (Danocrine)
• GnRh agonists (e.g., Lupron, Synarel)
• Oral contraceptives
• Phenytoin sodium (Dilantin)
• GnRh agonists (e.g., Lupron, Synarel)
• Oral contraceptives
• Histamine H2-receptor blockers and promotility agents
• Indomethacin (Indocin)
• Ketoconazole (Nizoral)
• Lithium
• Psychoactive medications
• Antipsychotics
• Barbiturates
• Benzodiazepines
• Selective serotonin reuptake inhibitors
• Tricyclic antidepressants
• Cardiovascular and antihypertensive medications
• Antilipid medications
• Beta blockers
• Clonidine (Catapres)
• Digoxin

Please note: If you are taking any of the above medications it is important to discuss with your prescribing physician prior to discontinuing the medication.

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Arousal disorders as a cause of female sexual dysfunction – the most popular treatment of arousal orders are topical gels and lotions. These commercial gels contain a a wide variety of herbs and amino acid complexes. When purchasing these products an individual should look for two key ingredients arginine and menthol. Arginine when applied transdermally to the clitoris will increase the blood flow to the region. The menthol aids in the local absorption of the arginine and provides an increase in sensitivity to the region.

Often arousal disorders can be secondary to a lack of adequate stimulation. This is especially the case in postmenopausal women who may need more stimulation than they did in previous years to achieve the same level of stimulation. Stress can also play a role in the arousal phase, similar to performance anxiety in men, often when a women has a new partner she may experience decreased arousal.

Women should encourage their partners to slow down and engage in longer foreplay. The use of vibrators in women who have decreased sensitivity in the clitoral region can also be helpful. Atrophy of the urogenital region is another common cause of arousal disorder especially in postmenopausal women. Estrogen treatment combine with the topical herbal supplement creams have proven to be a beneficial treatment option. However, long-term use of local estrogen therapy is considered an unopposed-estrogen treatment in women with an intact uterus, requiring progesterone opposition.

There are several medications that have shown to inhibit the arousal phase including the following:

• Benzodiazepines
• Selective serotonin reuptake inhibitors
• Monoamine oxidase inhibitors
• Anticholinergics
• Antihistamines
• Antihypertensives
• Psychoactive medications
• Tricyclic antidepressants

Please note: If you are taking any of the above medications it is important to discuss with you prescribing physician prior to discontinuing the medication.

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Orgasmic disorders as a cause of female sexual dysfunction – the inability to achieve an orgasm during masturbation and/or intercourse can often be treated with positive results. Most often the condition is caused be sexual inexperience by one or both of the partners. Usually it is secondary to lack of stimulation, however it may be due to psychological etiologies, medication, and/or chronic disease.

Certain medications can also influence a woman's ability to achieve an orgasm. The following list of medications can influence the ability of a women to achieve an orgasm:

• Selective serotonin reuptake inhibitors
• Narcotics
• Trazadone (Desyrel)
• Tricyclic antidepressants*
• Methyldopa (Aldomet)
• Amphetamines and related anorexic drugs
• Antipsychotics
• Benzodiazepines

Please note: If you are taking any of the above medications it is important to discuss with you prescribing physician prior to discontinuing the medication.

Treatment for orgasmic disorders varies amongst different physicians, psychologists and sexual therapists, however, most therapies include prolonged stimulation often in excess of an hour along with use of local herbal creams and vibrator. Therapist also recommend Kegel exercises.
Dr. Arnold Kegel originally developed Kegel exercises in 1948 as a method of controlling incontinence in women following childbirth. These exercises are now recommended for women with urinary stress incontinence, some men who have urinary incontinence after prostate surgery, and individuals who have fecal incontinence.

The principle behind Kegel exercises is to strengthen the muscles of the pelvic floor, thereby improving the urethral and rectal sphincter function. The success of Kegel exercises depends on proper technique and adherence to a regular exercise program.

Some people have difficulty identifying and isolating the muscles of the pelvic floor. Care must be taken to learn to contract the correct muscles. Typically, most people contract the abdominal or thigh muscles, while not even working the pelvic floor muscles. These incorrect contractions may even worsen pelvic floor tone and incontinence. Several techniques exist to help the incontinent person identify the correct muscles.

One approach is to sit on the toilet and start to urinate. Try to stop the flow of urine midstream by contracting your pelvic floor muscles. Repeat this action several times until you become familiar with the feel of contracting the correct group of muscles. Do not contract your abdominal, thigh, or buttocks muscles while performing the exercise.

Another approach to help you identify the correct muscle group is to insert a finger into the vagina. You should then try to tighten the muscles around your finger as if holding back urine. The abdominal and thigh muscles should remain relaxed. Women may also strengthen these muscles by using a vaginal cone, which is a weighted device that is inserted into the vagina. The women should then try to contract the pelvic floor muscles in an effort to hold the device the place.

For those people who are unsure if they are performing the procedure correctly, biofeedback and electrical stimulation may be used to help them identify the correct muscle group to work. Biofeedback is a method of positive reinforcement. Electrodes are placed on your abdomen and along the anal area. Some therapists place a sensor in the vagina to monitor contraction of the pelvic floor muscles. A monitor will display a graph showing which muscles are contracting and which are at rest. The therapist can help you identify the correct muscles for performing Kegel exercises.

Electrical stimulation involves using low-voltage electric current to stimulate the correct group of muscles. The current may be delivered using an anal or vaginal probe. The electrical stimulation therapy may be performed in the clinic or at home. Treatment sessions usually last 20 minutes and may be performed every 1 to 4 days. Some clinical studies have shown promising results in treating stress and urge incontinence with electrical stimulation.

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Dyspareunia (difficult or painful intercourse) – can usually be described as one of the following:

• Deep Dyspareunia - is pain related to thrusting, often associated with pelvic disease or relaxation or a partners penis size.
  
• Superficial Dyspareunia - occurs with attempted penetration and is usually secondary to anatomic or irritating conditions.
  
• Vaginal Dyspareunia - is pain related to lubrication or friction problems, common in arousal disorders.
  
• Vaginismus - represents the involuntary contraction of the muscles of the outer one third of the vagina. Vaginismus is often related to sexual phobias, trauma or past abuse. The condition may occur all the time or occur during specific conditions or situations.

Treatment of individuals with vaginismus consists of a teaching a progressive muscle relaxation exercises and/or dilatation procedures. Progressive muscle relaxation can be taught during an instructional examination by having the patient alternate contracting and relaxing the pelvic muscles around the examiner's finger. Women with vaginismus can achieve vaginal dilatation with the use of commercial tampons or dilators of increasing diameter. These instruments are placed into the vagina for 15 minutes twice daily. Once the female becomes accustomed to the dilator matching her partner penetration with the penis can be initiated.

Gynecological conditions that can cause dyspareunia include the following:

• Cystitis (inflammation of the bladder) – can often result in dyspareunia. Women should always urinate immediately after intercourse to prevent infections.
  
• Herpes simplex virus – herpetic lesions can be very painful during intercourse.
  
• Urethritis – or inflammation of the urethra secondary to a urinary tract infection can cause dyspareunia.
  
• Malignancy - such as breast cancer, cervical, ovarian, etc can present both psychological and medical situations that may result in a decrease in sexual desire.
  
• Endometriosis – is a disease in which abnormal tissue grows in the abdomen and other places in the body. Endometriosis causes internal bleeding, inflammation, scarring, severe pain and fatigue, and sometimes infertility. Endometriosis can be treated with pain medication, hormones, surgery or pregnancy (women with endometriosis should position themselves on top during intercourse to control amount of thrusting and penetration).
  
• Hysterectomy – following a hysterectomy a women may fee less feminine resulting in psychological complications.
  
• Clitoral adhesions – can result in a decrease in sensitivity or pain upon friction in the area.
  
• Human papilloma virus – genital warts can result in painful intercourse depending on their location.
  
• Rectal disease – often complication in the rectal area can result in complications secondary to the close proximity to the vaginal area.
  
• Cystocele -occurs when the bladder herniates or bulges into a woman's vagina, this can result in painful coitus (women with endometriosis should position themselves on top during intercourse to control amount of thrusting and penetration).
  
• Uterine prolapse - falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal which can also result in painful intercourse (women with endometriosis should position themselves on top during intercourse to control amount of thrusting and penetration).
  
• Vaginitis – women experiencing secondary to pelvic inflammatory disease often report dyspareunia.

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Testosterone treatment has shown some promising results in treating decreased sexual desire, specifically following an oophorectomy. However, secondary to the lack of structured clinical trials involving testosterone treatment in female most physicians are apprehensive to prescribe this form of treatment.

Testosterone hormone treatment is not without side effects, common side effects include the following:

• Clitoral enlargement
• Acne
• Decreased levels of high density lipoproteins
• Deepening of the voice
• Hirsutism (a condition in which there is excessive growth of hair on the face or body)

Most physicians, who have been educated in alternative medicine, will concur that herbal supplements are the best initial treatment option for women with most types of female sexual dysfunction. To reiterate transdermal creams or ointments should contain arginine and menthol. While herbal capsules should contain a proprietary blend of the following: Niacin, Yohimbe, Ashwagandha, Asparagus Racemosus, L Tyrosine, Wild Yam, L Histidine, Ginger, Cayenne Pepper. Physicians Select herbal Viagra supplements contain these important ingredients.

Female Libido Enhancement Pills	Female Sexual Enhancement Cream

Please note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. The information should not be construed to indicate that the use of the product is appropriate, safe, or effective for each individuals use. Individuals should consult their healthcare professional prior taking any new female sexual enhancement product.