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Female Sexual Dysfunction - FSD
What is Female Sexual Dysfunction?
Female Sexual Dysfunction is now readily recognized by physicians, psychologists, marriage counselors and other healthcare workers as a medical condition that can seriously harm a marriage or other relationship.
Female Sexual Dysfunction includes a variety of disorders that are related to desire for sex, arousal during sexual activity, problems with orgasm or pain during sexual activity. If a woman’s sexual concerns are recurring in nature and cause her personal distress, she may indeed have female sexual dysfunction.
Specifically, Female Sexual Dysfunction is divided into categories related to desire, orgasm, arousal and pain. The medical definitions for the types of Female Sexual Dysfunction are found below. All of the disorders have a common component, namely, that the problem causes a woman personal distress.
What Causes Female Sexual Dysfunction?
Many women may think that Female Sexual Dysfunction is a normal consequence of childbirth, aging or menopause. This is not true. Women may have been told that the problem is "just in your head" which is also incorrect. Many times the primary cause of Female Sexual Dysfunction is physical in nature and is not psychological. However, due to the very personal nature of Female Sexual Dysfunction, psychological factors may become involved as well. For example, if a woman has decreased vaginal lubrication or wetness this may lead to painful intercourse. This in turn may become very distressing to both the woman and her partner and result in personal distress.
Some of the physical causes of Female Sexual Dysfunction include:
Pelvic surgery or trauma including hysterectomy, pelvic fractures, difficult childbirth or straddle injuries (such as falling on a bicycle or balance beam).
Arteriosclerosis or hardening of the arteries
Loss of the hormones including both estrogen and testosterone
Spinal cord injuries
Blood pressure medications
Birth control pills
Some seizure medications
Certain sedatives or tranquilizers
Psychological causes of Female Sexual Dysfunction include:
Sexual, emotional or physical abuse
Drug or alcohol abuse
Problems with self-esteem or body image
Problems in your relationship with your partner
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What is Female Sexual Arousal Disorder
Female Sexual Arousal Disorder or “FSAD” is the female’s inhibition or lack of becoming sexually aroused. FSAD is a significant problem that negatively impacts marriages and other relationships.
Like all other female sexual dysfunctions, FSAD may be life long or acquired. Life long means that the woman has never been responsive to sexual stimulation. Acquired means that at some point the women has been responsive to sexual stimulation but is now unresponsive. But it can also be situational or generalized. Situational is when the dysfunction occurs in some situations and not others. Generalized is when the dysfunction occurs regardless of the situation. Therefore a woman can have FSAD that is; life long and situational, acquired and situational, life long and generalized, or acquired and generalized. For example, a woman who has FSAD as life long and situational would have always had trouble becoming aroused, but only with her partner. A woman who has FSAD as acquired and situational would have some period in the past without having trouble becoming aroused, but now does, but only with her partner. A woman who has FSAD as life long and generalized would have always had trouble getting aroused in all situations. And finally, a woman with FSAD as acquired and generalized would have had some period in the past absent of problems but now is unable to become aroused regardless of the situation.
The DSM IV describes Female Sexual Arousal Disorder as the persistent or recurrent inability attain or maintain until completion of sexual activity, an adequate lubrication-swelling response of sexual excitement. Some of the most common causes of this dysfunction are guilt and hostility. Guilt usually involves an internal conflict between a desire to enjoy sexual interaction and an unconscious fear of doing so. Hostility often involves her specific partner.
Female Sexual Arousal Disorder (FSAD) is a persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement. This "response" involves vaginal lubrication, expansion of the vagina, and swelling of the labia minora, labia majora and clitoris. The disturbance must cause marked distress or interpersonal difficulty. The dysfunction is also not better accounted for by another problem and is not due exclusively to the direct physical effects of a substance (i.e. an illegal drug or prescription medication) or a medical condition.
As with all sexual disorders, FSAD can be classified as lifelong (existing for the entirety of the person’s adult life) or acquired (developed after a period of normal functioning). It can also be classified as generalized (occurring across all partners, sexual activities, and situations) or situational (limited to certain partners, sexual practices, or situations). This disorder is not to be confused with hypoactive sexual arousal disorder. In the case of FSAD, the person does have desire, whereas with HSDD, the individual does not. Women with F.S.A.D have sexual desire but for various reasons, have difficulty obtaining sexual satisfaction.
The following are the diagnostic criteria for FSAD as provided by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV, 1994):
A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The sexual dysfunction is not better accounted for by another disorder and is not due exclusively to the direct physiological effects of a substance (e.g. a drug or medication) or a general medical condition.
The Female Sexual Arousal Disorder and Female Sexual Dysfunction market is expected to reach $12 billion per year at market maturity. This is due to the fact that at least 50% more women suffer from Female Sexual Dysfunction than men with Erectile Dysfunction. Men now have Cialis, Levitra, and Viagra for help with their problem, yet 40 million American women are still suffering from Female Sexual Dysfunction. Sales of these little blue pills reached $4 billion last year. Because women are much more “complicated” than men in terms of sexual function, a “little pink pill” may not be the complete panacea that women require to achieve the same level of sexual satisfaction as the “little blue pill” does for men. If there were a “little pink pill” on the market, it would cost about the same as the little blue pills. Therefore, sales of “little pink pills should be at least 50% more, or soon reach/exceed $6 billion/year. However, there is much more to be discovered about female sexual function and dysfunction and we believe this figure could easily double, very soon to $12 billion/year, once more research and clinical trials, and investigations have been concluded.
According to the Journal of the American Medical Association, more than 43% of American women (about 40 million) experience some form of sexual disorder. Any woman can experience Female Sexual Dysfunction at some point in her life. Sexuality is a crucial component of general health and well-being of women, yet, according to a report published in the February 9, 1999, Journal of the American Medical Association, at least 43 percent of American woman, of all ages, suffer from female sexual dysfunction. This equates to over 40 million American women who are affected by FSD.
The National Health and Social Life Survey, a probability sample study of sexual behavior in a demographically representative sample of US adults ages 18 to 59, found that sexual dysfunction is more prevalent in women (43%) than in men (31%), and decreases as women age. Married women have a lower risk of sexual dysfunction than unmarried women. Hispanic women consistently report lower rates of sexual problems, whereas African American women have higher rates of decreased sexual desire and pleasure than do Caucasian women. Sexual pain is more likely to occur in Caucasians. This survey was limited by its cross-sectional design and age restrictions, since women more than 60 years old were excluded. No adjustments were made for the effects of menopausal status or medical risk factors. Despite these limitations, the survey clearly indicates that sexual dysfunction affects many women.
The Journal of the American Medical Association reported in 1998 that 43% of women of all ages experienced sexual dysfunction, yet only 31% of men did; until now male sexual dysfunction has received all of the attention.
Dysfunction in the United States
Prevalence and Predictors
By: Edward O. Laumann, PhD; Anthony Paik, MA; Raymond C. Rosen, PhD
Context While recent pharmacological advances have generated increased public interest and demand for clinical services regarding erectile dysfunction, epidemiologic data on sexual dysfunction are relatively scant for both women and men.
Objective To assess the prevalence and risk of experiencing sexual dysfunction across various social groups and examine the determinants and health consequences of these disorders.
Design Analysis of data from the National Health and Social Life Survey, a probability sample study of sexual behavior in a demographically representative, 1992 cohort of US adults.
A national probability sample of 1749 women and 1410 men aged 18 to 59 years at
the time of the survey.
Main Outcome Measures Risk of experiencing sexual dysfunction as well as negative concomitant outcomes.
Results Sexual dysfunction is more prevalent for women (43%) than men (31%) and is associated with various demographic characteristics, including age and educational attainment. Women of different racial groups demonstrate different patterns of sexual dysfunction. Differences among men are not as marked but generally consistent with women. Experience of sexual dysfunction is more likely among women and men with poor physical and emotional health. Moreover, sexual dysfunction is highly associated with negative experiences in sexual relationships and overall well-being.
Conclusions The results indicate that sexual dysfunction is an important public health concern, and emotional problems likely contribute to the experience of these problems.
What is Female Sexual Medicine?
While a gynecologist or family physician may be knowledgeable and able to diagnose disease and disorders of a woman's vagina, vulva and care for her reproductive and vulvovaginal health, he/she may lack the requisite education as it relates to her sexual health. While men have had their "little blue pills" for ED since 1999, a "little pink pill" is still not ready for women for their ED or Female Erectile Dysfunction.
The fact is, 50% more women than men suffer from "erectile dysfunction" and a woman's erection is just as important as a man's erection.
"Female Sexual Dysfunction" is the generic term applied to the several sexual health problems women have that is one of the fastest growing areas of medicine known as "Female Sexual Medicine."
Female Sexual Medicine treats women and the various ailments and disorders which interfere with female sexual satisfaction, including;
It is important to note that 43% of American women -- about 40 million -- have physical and/or emotional distress relating to enjoying sex. This is manifested in loss of interest in sex, no longer finding sex enjoyable, or providing the enjoyment sex used to bring, or the inability to complete a sexual encounter to orgasm. or it just is not as enjoyable as it used be. Many women also report diminished sexual sensations in their vulva, vagina or clitoris while other women have pain during intercourse.
A woman may not experience anymore excruciating pain, suffering and embarrassment than that caused by a disease called "Lichen Sclerosus."
Lichen Sclerosus (LIKE-in skler-O-sus) or "LS," is a chronic inflammatory skin disorder that is most common in women, but can affect men as well.
Lichen Sclerosus usually affects the vulva, including the labia majora, labia minora, clitoris (clitoral glans), clitoral hood, vagina/vaginal introitus, the vestibule (also referred to as the vulval vestibule, vulvar vestibule, vaginal vestibule and vestibule of the vagina, which is the area in between the labia minora where the urethral opening and vaginal opening are located) and the anal area.
When LS affects the vagina (within the vulva) or vaginal mucosa, which is the lining of the vagina, it is no longer known as Lichen Sclerosus, but Lichen Planus "LP."
Lichen Sclerosus appears predominantly in postmenopausal women. Occasionally, Lichen Sclerosus is seen on other parts of the body, especially the upper body, breasts, and upper arms.
The symptoms are the same in children and adults. Early in the disease, small, subtle white spots appear. These areas are usually slightly shiny and smooth. As time goes on, the spots develop into bigger patches, and the skin surface becomes thinned and crinkled. As a result, the skin tears easily, and bright red or purple discoloration from bleeding inside the skin is common.
More severe cases of Lichen Sclerosus produce scarring in the vulvovaginal area which may cause the inner lips of the vulva to shrink and disappear and the clitoris could become covered with scar tissue. In addition, the opening to the vagina (vaginal introitus) may narrow significantly making intercourse painful, if not impossible. Urination is also very painful.
Lichen Sclerosus is not only a painful disease
and very serious health concern, left untreated,
Lichen Sclerosus may lead to Vulvar Cancer.
Vulvar cancer is a cancer that forms in or on a woman's vulva.
Vulvar cancer can be found in and around a woman's labia majora, labia minora, and/or clitoris, as well as within the vagina, which is then called vaginal cancer. The cancer usually develops slowly over several years. In the beginning stages of vulvar cancer, precancerous cells grow on/within the vulva. This is called vulvar intraepithelial neoplasia (VIN), or dysplasia. Not all VIN cases turn into cancer, but it is best to treat it early and when diagnosed early, prognosis is good, with 90% (+) survival rates.
Typically, there are few if any indications or symptoms in the early stages of vulvar cancer.
However, you should IMMEDIATELY see your doctor if you notice any of the following from your vulvovaginal area:
A lump in/on/around the vulvovaginal area
Itching in/around the vulvovaginal area
Tenderness in/around the vulvovaginal area
Swelling in/around the vulvovaginal area
Bleeding that is not menstrual or period bleeding
NOTE: Older women (over 40) with human papillomavirus (HPV) infection are a risk factor for vulvar cancer.
Treatment for vulvar cancer varies depending on your overall health, age and how advanced the cancer is.
Treatment for vulvar cancer may include; laser therapy, surgery, radiation or chemotherapy.
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