Female Sexual Dysfunction: Causes, Diagnosis & Treatment

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Table of Contents

What is female sexual dysfunction?

Ever felt like you weren’t “in the mood”? You’re not alone! You might be surprised to learn that approximately 40% of women worldwide suffer from sexual dysfunction. 

One out of every eight women experiences  personal distress related to sexual problems. In a US study involving 30,000 women, 43% reported low arousal, low desire, orgasm difficulties, and sexual distress. The number one reported sexual problem was low desire followed by low arousal.

But what exactly is female sexual dysfunction (FSD)?

The American Psychiatric Association (APA) defines FSD as a persistent sexual problem that causes significant distress for at least six months.  They categorized FSD into the following:

  • Female sexual interest/arousal disorder (includes Hypoactive Sexual Desire Disorder)
  • Characterized by reduced sexual interest, FSD manifests itself as absent or reduced erotic thoughts and interest in sexual activity. Some women also become unwelcoming to their partner’s attempts to start sexual activity. If they do become receptive, they may have reduced sensations during sexual encounters.
  • Female orgasmic disorder, characterized by significant delay or absence of orgasm, can also manifest as a decrease in intensity of the orgasm.
  • Genitopelvic pain or penetration disorder,  characterized by significant difficulty in vaginal penetration during sexual activity,  may also refer to marked pelvic pain and anxiety during penetration.
  • Substance/ medication-induced sexual dysfunction refers to sexual problems developed soon after taking a medication. Many medications are known to cause sexual dysfunction as a side-effect.
  • Others/ Unspecified sexual dysfunction applies to other forms of sexual problems that don’t fulfill the other criteria but still causes significant distress.
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What causes sexual dysfunction?

Given its high prevalence, you might be wondering how so many women all over the world develop FSD. To understand,  it is  essential to look at all the factors that affect a woman’s sexual response.

One of the most common reasons for female sexual dysfunction includes relationship factors. In one study involving 1,800 men and women in stable relationships, researchers discovered the longer the relationship’s duration, the lower the sexual satisfaction and frequency. 

They also found  sexual desire declined for women, while tenderness declined in men. These outcomes do not apply to all relationships – however, they do imply a significant general trend. Besides the duration of a relationship, their current relationship status, and erectile dysfunction in men also play a role as risk factors for FSD.

Women with prior physical or sexual abuse may also develop FSD later on in life. Psychological disorders can also affect sexual function, such as side effects of medication and depression and anxiety. Lastly, fatigue and work-related stress can also play a role in affecting sexual desire.

Some medical conditions, like menopause, can make intercourse uncomfortable. Declining estrogen levels in peri- and postmenopausal women can also lead to sexual dysfunction. Lower estrogen levels cause changes in the labia.  The vagina and urethra may become dry, leading to burning sensations and irritation. The pain from these changes, in addition to diminished lubrication, leads to a decline in sexual desire.

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Treatment of Female Sexual Dysfunction

Treatment for female sexual dysfunction depends on the cause. There are several available treatments you can apply.

One method is to set aside time for intercourse. Today, many women are busy and have many responsibilities – such as advancing their career, taking care of family, and doing the housework. As a result, there are many possible distractions and sources of stress. Hence, the first step is to make sex a priority.

Mindfulness is another method for dealing with FSD. FSD is a multifactorial disorder with psychological aspects; focusing on the present can help to decrease stress. Additionally, learning to avoid distractions can help women to achieve greater stimulation during intercourse.

A person’s relationship status also plays a key role. Good communication is a necessity in any healthy relationship. As a result, if you’re having issues with low arousal or low interest in sexual activities, talk to your partner about it. If your partner knows you’re prone to exhaustion at night, then the best time to initiate intercourse would be in the morning. By communicating with your partner about your needs, you can come to a compromise and make everyone happy.

Some women don’t have issues with their partners yet still suffer from FSD. A medical or psychiatric condition may cause this suffering. For cases like these, a more specific therapy type may be needed, such as cognitive-behavioral therapy. If none of these treatments work, medication for sexual dysfunction may help.

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What is Bremelanotide or PT 141?

Bremelanotide – or PT141, is a synthetic peptide discovered from Melanotan II, a product that darkens the skin and induces tanning. One study found that Melanotan II comes with the side effect of increased sexual arousal. Since then, numerous studies have explored the possibility of using Bremelanotide as a treatment for various types of sexual dysfunction.

Bremelanotide is a melanocortin-receptor agonist that binds specifically to type 4 or MC4R receptors in the brain. The exact mechanism of how it improves female sexual dysfunction is unknown. However, its role as a melanocortin receptor agonist allows it to influence brain pathways related to sexual response. As melanocortinergic neurons are involved in dopamine release, they can stimulate improvement in sexual arousal.

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Benefits of Bremelanotide

A group of women with female sexual dysfunction used subcutaneous home-administered Bremelanotide for three months in one study. Compared to the group given a placebo, the women given Bremelanotide scored higher on a questionnaire called Satisfying Sexual Events (SSEs). 

The SSE measures the symptoms of sexual dysfunction, such as arousal, satisfaction, and desire,  discovered to improve with Bremelanotide use. These women also tolerated the medication well.

Another way to administer Bremelanotide is through the nasal passages. A group of premenopausal women with female sexual arousal disorder received one dose of 20 mg intranasal Bremelanotide and reported increased sexual desire. As well, those who attempted to have sexual intercourse on the same day had a higher degree of satisfaction compared to the placebo group.

Many studies further explore the effects of Bremelanotide on sexual arousal not only in women but also in men. Bremelanotide has a well-established safety profile, and a majority of participants tolerate the medication well. The FDA has approved it to treat hypoactive sexual desire disorder.

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Side Effects of Bremelanotide

As with all studies, there are outliers. A minority of women administered  Bremelanotide reported nausea, vomiting, and flushing. The symptoms of nausea usually improved following another dose. No one reported severe injection site reactions, and many women continued administration of the medication despite the side effects.

Additionally, Bremelanotide may cause localized darkening of the skin, as it originates from a tanning agent. We recommend patient’s to stop using Bremelanotide if hyperpigmentation persists. 

Participants in other studies also reported elevated blood pressure levels as a side effect. These events did not occur more than once, and an increase in blood pressure or lowering of heart rate would often resolve after 12 hours. In general,  people with uncontrolled hypertension and cardiovascular disease should not take Bremelanotide. If you are taking Naltrexone for opioid or alcohol addiction, do not take Bremelanotide. It may cause an adverse reaction due to drug-interactions.

Women that suffer from female sexual dysfunction can feel distressed from a lack of sexual arousal. Many have difficulty relaxing due to their responsibilities and external stresses. However, getting control over your sexuality is key to living a life of happiness and satisfaction.

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Here at Well Life ABQ, we offer intranasal Bremelanotide for women suffering from FSD. Our team of healthcare experts can also provide an assessment to determine what form of therapy is best for you. If you’re looking to get back your ‘mood and groove’, get in touch with us today!

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