What we do as clinicians is determine if the dysfunction is persistent or episodic, how much distress it's causing, and if other medical issues (disease, medications, substance use/abuse) are the problems. The DSM-IV (published by The American Psychiatric Association) provides a framework for diagnosis of Female Sexual Dysfunction, however, the labeling of sexuality as a dysfunction is part of the problem. This labeling may engender a harmful sort of shaming around sex and an idea that women need to be “fixed” because they are broken, when the patient lacks only understanding and healing of the heart, mind and body together.
The truth is that women can and do have active, healthy and satisfying sexual lives, but sometimes our bodies, minds and hearts need a little help to overcome bumps in the road.
Let’s discover the myths and truths about Female Sexual Dysfunction.
• FSD is all in your body. FALSE: Stress from jobs, relationships and life changes can influence sexual desire.
• FSD only happens to older women. FALSE: FSD is common for women in any stage of life, but swift changes in hormonal balances (menopause, post-surgery, childbirth) can often lead to confusing and frustrating experiences with sexual desire and performance.
• Many of the causes for FSD are treatable. TRUE: Medical treatment, mindfulness, and alternative therapies can alleviate or ease the symptoms of FSD.
• Hormone replacement and testosterone will create better libidos and solve FSD. FALSE: None of the current research supports testosterone for better libido or hornier women. Libido is more complex than simply taking a pill. This being said, testosterone may be of benefit for some women with low testosterone; however, some women still do not report increased desire as the testosterone levels increase.
• Hormone replacement therapies can help me. TRUE: Hormones do help with perimenopausal / menopausal symptoms like hot flashes, insomnia, night sweats, moods or joint discomfort. Estrogen can help with vaginal atrophy and painful intercourse.
• Low libido always needs to be “fixed” by someone. FALSE: Sometimes women falsely believe that someone other than themselves needs to fix the problem (like men). The truth is, there is nothing to fix, only to heal and honor and work together as a couple to build healthy sexual habits with intimacy.
If you are concerned about your sexual functioning, consult your physician for a complete physical. This will give you a basic understanding of at least one aspect of the interwoven puzzle that is Female Sexual Dysfunction.