Female Sexual Interest/Arousal Disorder (FSIAD)

What it is

Persistent lack or significant reduction of sexual interest and arousal, causing personal distress.

Symptoms:

• Reduced sexual thoughts or fantasies

• Lack of initiation or receptivity to sexual activity

• Decreased genital sensations during intercourse

• Absent or reduced excitement/arousal in response to sexual cues

Causes:

• Hormonal changes (e.g., menopause, postpartum, thyroid issues)

• Depression, anxiety, stress

• Relationship conflict or body image concerns

• Medications (e.g., antidepressants, hormonal contraception)

Treatment:

• Counseling or Sex Therapy: To explore emotional, relationship, or psychological causes

• Hormone Therapy: Estrogen or testosterone (when indicated, especially postmenopause)

• Flibanserin or Bremelanotide: Medications approved for hypoactive sexual desire disorder (HSDD) in select women

• Couples Therapy: To rebuild intimacy and sexual connection

• Lifestyle interventions: Stress management, exercise, improved sleep

Female Orgasmic Disorder (Anorgasmia)

What it is

Difficulty or inability to reach orgasm despite adequate sexual arousal and stimulation.

Types:

• Primary (never experienced orgasm)

• Secondary (develops after a period of normal sexual function)

Causes:

• Anxiety, trauma, or cultural factors

• Inadequate stimulation or partner dynamics

• Neurological conditions or hormonal changes

• Medication side effects (esp. SSRIs)

Treatment:

• Sex Therapy: Focused on communication, fantasy, sensate focus exercises

• Education: On anatomy and self-stimulation

• Medication Review: Adjust or change medications affecting orgasm

• Pelvic Floor Therapy: For enhanced muscle control and sexual response

Genito-Pelvic Pain/Penetration Disorder (GPPPD)

What it is:

Persistent or recurrent difficulties with one or more of the following: vaginal penetration, pain during intercourse, fear or anxiety about pain, or involuntary tightening of pelvic floor muscles. This includes dyspareunia (painful intercourse) and vaginismus.

➤Dyspareunia

Symptoms:

• Sharp, burning, or aching pain during or after intercourse

• Superficial or deep pelvic pain

• Pain that causes sexual avoidance

Causes:

• Vaginal infections, endometriosis, pelvic inflammatory disease

• Hormonal deficiencies (especially postmenopausal)

• Scar tissue from childbirth or surgeries

• Emotional factors like fear or abuse history

Treatment:

• Medical Treatment: Address underlying infections, hormonal deficiencies

• Lubricants and Vaginal Estrogen: For dryness and atrophy

• Pelvic Floor Physiotherapy

• Cognitive Behavioral Therapy (CBT) for anxiety and fear response

• Couples Counseling

➤ Vaginismus

What it is:

Involuntary contraction of the pelvic floor muscles surrounding the vaginal entrance, making penetration painful or impossible.

Symptoms:

• Difficulty or inability with vaginal penetration (e.g., intercourse, tampon, pelvic exam)

• Burning, stinging, or tightness during attempted penetration

• Fear or avoidance of sex

Causes:

• Past sexual trauma or abuse

• Fear of pain or misconceptions about sex

• Strict cultural or religious attitudes

• Anxiety disorders

Treatment:

• Pelvic Floor Therapy with graded vaginal dilators

• Cognitive Behavioral Therapy (CBT) to address fear and past trauma

• Sex Therapy focused on trust, intimacy, and relaxation

• Mindfulness and Breathing Techniques

Sexual Aversion Disorder (Severe Phobia/Disgust Towards Sex)

What it is

A profound aversion to or avoidance of sexual contact due to fear, trauma, or deep-rooted psychological distress.

Symptoms:

• Disgust or panic at the idea of sexual activity

• Avoidance of intimacy or physical touch

• High anxiety or even physical symptoms when sex is anticipated

Causes:

• Past sexual trauma or abuse

• PTSD, depression, anxiety

• Negative cultural conditioning

Treatment:

• Trauma-Informed Psychotherapy (e.g., EMDR, CBT)

• Gradual Exposure Therapy

• Sex Therapy in a safe, accepting environment

• Couples Therapy (with partner education and involvement)

Postpartum Sexual Dysfunction

What it is

Sexual issues (e.g., low desire, pain, fear, dryness) following childbirth.

Symptoms:

• Vaginal dryness

• Fear of intercourse due to past labor pain or tearing

• Body image concerns

• Hormonal mood changes (e.g., postpartum depression)

Treatment:

• Counseling and Psychoeducation

• Topical Estrogen or lubricants

• Pelvic Floor Rehab

• Supportive Therapy for Postpartum Depression

Menopausal Sexual Dysfunction

What it is

Sexual problems arising due to hormonal shifts during and after menopause.

Symptoms:

• Vaginal dryness and atrophy

• Painful intercourse

• Decreased libido

• Sleep disturbances, mood swings affecting sexual interest

Treatment:

• Hormone Replacement Therapy (HRT) when appropriate

• Vaginal Estrogen Creams

• Testosterone in select women

• Lubricants and Moisturizers

• Sex Therapy to rebuild intimacy