In women, 'Female Sexual Dysfunction' means in simple words, then it is said to have difficulty in having sex. According to a survey, 40% of women worldwide have been a victim of this problem at some point in their life. But because they do not know what is happening to them, they remain silent. Keeps suffering. However, female sexuality is still taboo and sexual concerns are often overlooked, underdiagnosed, and treated

In India, there is talk on sexual issues and treatment of males, but when it comes to females, then there is total silence. That is why it is important that women understand their disease themselves and get its treatment done through expert doctors.

Half (51.8%) of females globally have one or more sexual problems.

Pain during intercourse contributes to 71.8%

Reduced desire contributes to 54.9% were highest among different complaints

Reduced Orgasmic contributes to 43.66%

Sexual Arousal problems contribute to 32.39%

Dr.Kumar Kamble is an expert Psychiatrist, De-addiction Specialist, Sexologist, Speaker, Mental and Sexual Health Educator. He is also associated with the Umang Clinic. He has worked with King Edward Memorial Hospital in the Deaddiction center for 4 years as a Medical Office Coordinator. Based on his rich clinical expertise in de-addiction, we have come up with the next series on De-addiction. 

For over a decade, board-certified obstetrician-gynecologist, Dr. Anuradha Narayanan has been helping women take control of their reproductive health and fertility. She graduated and post-graduated from the prestigious Madras Medical College and presented many papers at various conferences. She has received the 2011 Mr.D’ Silva Memorial Award and H Desa Silver Jubilee awards in 2012.

Currently, she's working as a consultant and chamber attached to Apollo Spectra hospital and Salva Diagnostic Center. She is a member of MOGS, FOGSI,&AMC

Phases of sexual response 

Dr. Kumar Kamble says, “ Female sexual response has following phases- 

Desire: In the desire phase, there are sexual thoughts along with the need to express them with the partner. There are changes in the body causing blood flow, increased breathlessness, there is an increase in blood flow to sexual organs.  Excitement: There is increased blood flow to all the sexual organs in the excitement phase. Orgasm: The orgasm phase is possible through masturbation or intercourse with a partner. This is the peak point in the sexual phase of the cycle of females.  Resolution: This is the stage in which the female is relaxed and it is a refractory period. 

In some females, the refractory period is generally late. This is about the sexual female cycle and response.

Awareness among females about the sexual dysfunction

Dr. Anuradha Narayanan says, “Most patients are shy and they are accompanied by family members. They look out for a chance to meet a doctor alone. The female patients always wish to express themselves which is difficult. The patients understand their needs and think it's taboo to discuss and express them. We try to explain to them that you have to consult properly but they generally refrain from doing so due to less time period. In such cases, they try to look out for treatment in brief contact with the doctor. Medicines along with counseling can help in cases of female dysfunction. This is common in India where most of the women experience the problem but cannot express it.” 

Sexual dysfunction types

Dr. Anuradha Narayanan says, “There are three types of sexual disorders and dysfunction- 

Arousal disorders- In this, there is a lack of disinterest Sexual organisms disorder  Genito-pelvic pain - dyspareunia which is further classified as superficial and deep.  Vaginismus: Involuntary contractions of pelvic muscles. Pathological problems- There can be problems in the pelvis and uterus. Systemic diseases 

Health problems can cause issues with sexual life

Dr. Anuradha Narayanan says, “Uncontrolled diabetes and thyroid problems can cause weight gain which can result in sexual problems. Atherosclerosis can affect the blood vessels of the entire body and can affect sexual problems. Monitoring thyroid and diabetes levels can help in embracing a healthy lifestyle and keep weight gain in check.”

Sexual health is part of our health 

Dr. Kumar Kamble says, “Awareness is important in terms of a healthy sexual life. It is important to give priority to a healthy lifestyle like running, healthy food, and healthy sexual life. Educating and awareness are a must. Discussing sexual life is considered taboo and it is considered that sex is related to reproduction. Sexual life's basic instinct and there should be aware of the same. Just for example if you are not getting sleep, you try to find out a treatment for sleepiness. Just like appetite, thirst, sex should be given importance.”

Causes of Female sexual dysfunction 

Dr. Anuradha Narayanan informs, “There are many causes of female sexual dysfunction- 

Physical causes which includes 

Local causes: Low blood flow, local lesions, diabetes, post-surgical, surgeries due to cancer, medications such as antidepressants, hormonal causes, vaginal dryness, infections

Systemic causes - Gynecological conditions like fibroids, ovarian cyst, pelvic diseases, IBSm alcohol abuse, drug addiction, pain in case of arthritis 

Psychological causes- depression, stress, past history of traumatic abuse, relationship issues, body image issues, lack of interest, obesity 

It is important to treat physical and psychological causes in case of female dysfunction. There is a wide spectrum of diseases which need treatment.”

Identify sexual dysfunction problem

Dr. Anuradha Narayanan says, “Everybody can have a healthy sexual life. A healthy lifestyle with a good diet and exercise, healthy sexual life can be achieved. If a woman has a problem of more than six months related to sexual health and if it causes hindrance and distress, it means they are going through sexual dysfunction problems.”

Treat for sexual dysfunction 

Dr. Anuradha Narayanan states, “A treatment approach is a multidisciplinary approach which requires treatment with a gynecologist and the psychologist. Both the treatments must go hand in hand. 

Identify the cause Life History of patient  Medical history of patient like diabetes, surgery, or any other treatment  Physical examination  Pelvic examination Diagnosis  Treatment  Blood tests and investigations can be done

Treatment for sexual dysfunction is beyond medicines and has a multi-disciplinary approach. Lifestyle modifications are necessary with a healthy diet and exercise. Couple Counselling can also help. Medical devices can be used. Pelvic floor exercises can be done. PAin management can also be taken into consideration and improve quality of life. Medications like HRT can help. Food supplements can help sexual health. Techniques can also be taught to patients. 

A healthy relationship is a must for good sexual health

Dr. Kumar Kamble says, “The relationship between both the partners is important. Intimacy is important for a healthy relationship. The personal and professional life both must be balanced and given importance. Females are more emotionally attracted due to their nature. If any relationship is emotional bonding, then many sexual dysfunction problems can be cured. Couples' consultation is very important. Addiction problems should also be addressed. “

Female sexual dysfunction temporary or permanent 

Dr. Anuradha Narayanan says, “Female sexual problems are temporary in cases of post-pregnancy. However, they may be permanent in case of systemic diseases like cancer or certain medications. Many females think hysterectomy or removal of the uterus can hamper their sexual life. But, it is not true. It is important to address the issue to the doctor who can treat it.”

(Edited by Dr.Rati Parwani)