Decreased arousal or decreased orgasm

Arousal is a physiological response to internal or external sexual stimuli.  Genital arousal involves an increase in vulvovaginal lubrication, engorgement due to increased blood flow, and sensitivity.  Female Sexual Arousal Disorder (FSAD) describes the inability to develop or maintain adequate genital responses with sexual activity for a minimum of six months and causing distress.  Decreased arousal may occur with conditions or medication that decrease blood flow to the genitals or with neurological injury or dysfunction.  Determining the cause or factors associated with decreased arousal often leads to a treatment plan.

Female orgasmic disorder is defined as a change in frequency, intensity, timing, or pleasure of orgasm associated with sexual activity for at least six months and causing distress.  Problems with orgasm increase with age, and have been associated with surgical menopause, arthritis, and urinary incontinence.  Orgasmic dysfunction may be associated with cultural pressures, relational problems, depression, anxiety, certain medication, and underlying medical conditions.  There are a number of physiological factors that are essential in the female orgasm, including hormones, blood flow, and brain activity.

Treatment

Management may involve education, identification of contributing factors, cognitive behavioral therapy, pelvic floor physical therapy, hormonal treatments, and pharmaceutical agents such as flibanserin, bupropion, or buspirone.

Conditions we treat