Science of Sex: Female Sexual Dysfunction

Welcome to my latest installment of Science of Sex. I’ve officially be doing these for more than a year and have more planned! If you want to check out my archives, click here. Otherwise, enjoy this month’s post!

Today we’re venturing into the realm of female sexual dysfunction, just what it is, and why that title might not actually be helpful.

At its heart, female sexual dysfunction is an issue with sexual functioning in a woman. This can include a number of conditions and concerns, but four of the main ones are:

• Desire : Many women and sometimes their partners describe their lack of spontaneous desire as a dysfunction. However, studies show that women are more likely to have responsive desire than men. This is not a dysfunction as much as it is a difference in sexual function. Furthermore, some have suggested that the traditional stages of arousal may not apply as well to women whose arousal process is more cyclical. It’s also important to understand that a woman’s sexual brakes are often quite touchy (learn more about this). Finally, low desire often corresponds to relationship issues, so it’s not so much a sign of sexual dysfunction as it is one of relationship dysfunction.
• Arousal: Female sexual dysfunction can also present as a lack of physical arousal. This highlights further incorrect assumptions or beliefs about female sexuality. First, it doesn’t take into consideration that women are much less likely to experience concordance – an alignment between mental desire and physical arousal – than men and, secondly, it ignores the variance in a woman’s natural lubrication.
• Orgasm: Some women may describe their inability to orgasm through sexual intercourse as dysfunction, but multiple surveys have found that the majority of women need clitoral stimulation to orgasm and very few achieving orgasm solely through penetration. At least one study reports a group of women who prefer penetration/sex with their clit stim as a way to get off.
• Pain: Too many women experience pain during intercourse (in fact, at least one study has found that the bar for good sex for women is so low that they simply describe it as sex that is not painful). This is often remedied by increasing foreplay to encourage arousal, using lube and improved sexual communication. While conditions such as vaginismus and endometriosis can lead to pain during sex, painful sex can also be a symptom of poor technique and can often be ameliorated by changing the script.

Of course, there are other types of dysfunction, including those that center on physical issues and are not rooted in psychological or romantic distress. But the solution or treatment to any one of these “dysfunctions” may not be at all alike to the treatment for any other dysfunction.

The problem is that the term sexual dysfunction itself is not well-defined, and female sexual dysfunction is even more poorly defined because the umbrella term lumps together so many potential issues, including those that may be easily rectified by a better understanding of female sexuality. Furthermore, having a stronger grasp on female sexuality would show that some so-called dysfunctions are simply functions of sexuality in women that do not need to be pathologized. Of course, it’s not like men don’t suffer from this. It’s not a dysfunction if men ejaculate within ten minutes — it’s the norm — but the deep-seated misunderstanding of female sexual function had led to a lot of suffering.

Fortunately, doctors have devised questionnaires such as the aptly-named Sexual Function Questionnaire, and other tools to more readily diagnose sexual dysfunctions and focus on the root of the problem, whether it may be physical, relational, or a combination of factors. Sex therapists and educators are also making great strides in adjusting public and personal views of normal and healthy sexual function. For example, Dr. Emily Nagoski has written about desire and arousal in her book Come As You Are, Dr. Laurie Mintz shed light on clitoral stimulation in her own book Becoming Cliterate, and Dr. Lori Brotto helps women experience greater sexual function in her recently-released book Better Sex Through Mindfulness.

It should come as no surprise that women working on sexual research and providing sex therapy offer unique insight into female sexuality and what truly is dysfunction. If you’re interested in that topic, check out my post on  about the Women of Sexology

Further Reading

• Women’s Experiences With Genital Touching, Sexual Pleasure, and Orgasm: Results From a U.S. Probability Sample of Women Ages 18 to 94.
• Taking a Closer Look at Basson’s Model of the Sexual Response Cycle
• Female Sexual Dysfunction: Therapeutic Options and Experimental Challenges
• The Effects of Gender and Relationship Context Cues on Responsive Sexual Desire in Exclusively and Predominantly Androphilic Women and Gynephilic Men.
• The desire disorder in research on sexual orientation in women: contributions of dynamical systems theory.
• Do women with endometriosis have to worry about sex?
• Women’s use and perceptions of commercial lubricants: prevalence and characteristics in a nationally representative sample of American adults.
• [Assessment of painful sexual intercourse occurrence among women in gynaecological practice].
• Talking About Sex When Sex Is Painful: Dyadic Sexual Communication Is Associated With Women’s Pain, and Couples’ Sexual and Psychological Outcomes in Provoked Vestibulodynia.
• The Use of the Sexual Function Questionnaire as a Screening Tool for Women with Sexual Dysfunction
• THE BIG DISCONNECT: AROUSAL NONCONCORDANCE
• Female Orgasm: Time To Stop Shoulding on Ourselves
• The Biggest-Ever Orgasm Study Tells Us More About How Women Come
• Girls & Sex: Navigating the Complicated New Landscape
• I drew this graph about sexual desire… and I think it might change your life.
• Agreement of Self-Reported and Genital Measures of Sexual Arousal in Men and Women: A Meta-Analysis
• Female sexual problems