Sexual Dysfunction
Female sexual dysfunction encompasses a range of concerns affecting desire, arousal, orgasm, or causing pain during sexual activity. Studies suggest that 30-45% of women experience some form of sexual concern at various points in their lives, with prevalence increasing with age. Sexual health is an important component of overall wellbeing and relationship satisfaction. Common presentations include low libido, difficulty with arousal or lubrication, inability to reach orgasm, or pain during intercourse (dyspareunia or vaginismus). Sexual dysfunction often has multiple contributing factors spanning physical, hormonal, psychological, and relational domains that benefit from comprehensive assessment and treatment.
Symptoms
- •Low sexual desire or lack of interest in sexual activity
- •Difficulty becoming aroused or maintaining arousal during sexual activity
- •Inadequate vaginal lubrication despite arousal
- •Inability to achieve orgasm or significant difficulty reaching orgasm
- •Pain during intercourse in the vulva, vagina, or pelvis
- •Involuntary muscle spasms preventing penetration (vaginismus)
- •Reduced genital sensation or numbness
- •Anxiety, distress, or avoidance related to sexual activity
Causes & Risk Factors
- •Hormonal changes including declining estrogen and testosterone during perimenopause and menopause
- •Pelvic floor muscle dysfunction including hypertonicity, trigger points, or pain
- •Medical conditions including endometriosis, fibroids, interstitial cystitis, or vulvodynia
- •Medications including antidepressants, blood pressure medications, and hormonal contraceptives
- •Psychological factors including stress, anxiety, depression, or past trauma
- •Relationship factors including poor communication, unresolved conflict, or intimacy issues
- •Childbirth-related changes including tissue trauma, nerve damage, or body image concerns
- •Chronic health conditions affecting energy, body image, or physical capacity
Naturopathic Approach
Naturopathic treatment for sexual dysfunction takes a holistic, sensitive approach addressing physical, hormonal, and emotional factors simultaneously. Comprehensive assessment identifies specific contributors across multiple domains. For hormonal concerns, supporting testosterone and estrogen balance through botanical medicines, targeted nutrients, and potentially bioidentical hormone therapy helps restore libido and tissue health. Pelvic floor therapy is essential for addressing pain, muscle dysfunction, and improving genital sensation and blood flow. Nutritional support optimizes hormone production, cardiovascular health for arousal, and addresses nutritional deficiencies affecting sexual function. Herbal medicines including maca, tribulus, and ginkgo may support desire, arousal, and sensation. Addressing underlying health conditions including thyroid dysfunction, chronic inflammation, or metabolic issues improves overall vitality. Stress management and nervous system support help women feel safe and present during intimacy. Counseling or referral for relationship therapy may be appropriate. This compassionate, comprehensive approach aims to restore sexual satisfaction, improve intimate connection, and enhance overall quality of life.
Related Modalities
Frequently Asked Questions
Is low libido after menopause just something I have to accept?
Absolutely not. While hormonal changes during menopause commonly affect sexual desire, this doesn't mean you must accept a diminished sex life. Supporting hormonal balance through botanicals, nutrition, and potentially bioidentical hormone therapy, addressing any pain or physical barriers, optimizing overall health, and working through psychological or relationship factors can significantly restore sexual interest and satisfaction. Many women enjoy fulfilling sex lives throughout their postmenopausal years.
Why does sex hurt and what can be done about it?
Painful intercourse can result from multiple causes including vaginal dryness from hormonal changes, pelvic floor muscle dysfunction, endometriosis, vulvodynia, past trauma, or infections. Identifying the specific cause is critical for effective treatment. Pelvic floor therapy, vaginal moisturizers or hormonal support, treating underlying conditions, and working with both body and mind through a comprehensive approach helps most women resolve or significantly reduce pain during intercourse.
Can medications I'm taking affect my sexual function?
Yes, many medications can significantly impact sexual function. Antidepressants, particularly SSRIs, commonly affect libido and orgasm. Blood pressure medications, antihistamines, and hormonal contraceptives may also contribute to sexual concerns. Never discontinue medications without consulting your prescribing physician, but discussing these concerns with both your prescriber and naturopathic doctor can identify strategies to minimize sexual side effects while maintaining necessary treatment.
Is this problem in my head or is it physical?
This is rarely an either/or question. Sexual function involves complex interactions between physical health, hormones, nervous system, emotions, and relationships. Even when psychological factors like stress or past trauma contribute, there are often physical components as well. Addressing both mind and body through comprehensive care provides the best outcomes. Your concerns are valid regardless of their origin, and effective treatment addresses all contributing factors.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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