Overview

More than 30 Million women suffer from some form of sexual dysfunction. More than 13 million of them are between the ages of 18 and 35.

Concepts of female sexual dysfunction are controversial, particularly those based on biological causes. The American Psychological Association (APA) classifies female sexual problems as mental disorders: loss of sexual desire or arousal, discomfort during intercourse, diminished blood flow to the vagina, trauma-related aversion to sex, and the inability to achieve orgasm. Historically, psychiatrists and sex therapists have diagnosed and treated these disorders, perhaps, in many cases, according to limited perspectives maintained by psychiatric literature. Urologists and gynecologists now treat female sexual problems that result from medical conditions causing diminished pelvic and vaginal blood flow and nerve damage.

Currently, urologists, behavioral scientists, and psychologists are looking at medical, cultural, psychological, and relational reasons for women's sexual dysfunction, perhaps more accurately termed sexual dissatisfaction. They are emphasizing education and communication between partners. Surveys of women suggest that therapy should focus on women's physiological needs to experience enjoyable sex instead of medical conditions. Under this view, sexual dissatisfaction is symptomatic of an intimacy problem in which one or both partners fail to communicate their needs.

A useful model for exploring disturbances in female sexual response considers traditional and innovative, psychiatric and medical, and psychological and physiological perspectives. For some women, dysfunction or dissatisfaction is defined by a loss of interest in sex and the inability to become aroused or to achieve orgasm when participating in sex. Many are dissatisfied because their partners are uneducated or inattentive and do not understand female arousal and its anatomical basis. For others, a medical evaluation uncovers a physiological problem that impairs sensitivity. The concept of dysfunction, or dissatisfaction, remains poorly defined.

Incidence and Prevalence

The absence of dependable empirical data combined with varying definitions about sexual dysfunction, and even normal sexual practices, prevents a clear understanding of the prevalence of women's sexual problems. While some studies document a prevalence of dysfunction among non-Caucasian women and women of lower socioeconomic status, opponents of these studies point to a lack of diversity in these test populations.

A survey conducted by the American Medical Association in 1999 indicates that sexual dysfunction affects approximately 43% of women in the United States. Age may not be a significant factor, as women under 20 and over 50 experience problems with arousal, orgasm, and satisfaction. However, there is evidence that the majority of female sexual dysfunction happens after menopause, when hormone production drops and vascular conditions are more common.