Female Sexual Dysfunction: The Four Types, What Causes Them, and What Actually Helps
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Source currency note: This guide reflects medical information reviewed in October 2024. Always confirm current guidance with your healthcare professional.
Quick Answer
Female sexual dysfunction is a medical term for ongoing sexual problems with desire, arousal, orgasm or pain that upset you or your partner. Hormone changes, major illness, certain medicines, anxiety and stress can contribute. Treatment usually combines partner communication, lifestyle changes, lubricants, counseling and sometimes prescription options, but it is needed only if it bothers you. [4] [5]
What the research says
Flibanserin helps some premenopausal women with low desire, but side effects are more common. A meta-analysis of 8 randomized trials (7,906 women with hypoactive sexual desire disorder) found that premenopausal women taking flibanserin 100 mg had about 0.69 more satisfying sexual events per month than those on placebo (95% CI 0.39 to 0.99). Dizziness, fatigue, nausea, sleepiness, and insomnia were more common with the drug, while serious adverse events were comparable to placebo (Kamrul-Hasan et al., Medicine, 2024).
Talking therapies improve sexual function scores. A network meta-analysis of 45 studies (4,726 women) found that cognitive behavioral therapy, mindfulness-based interventions, sex education, and sexual counseling each improved Female Sexual Function Index scores compared with usual care or control. Mindfulness-based approaches ranked highest for reducing sexual distress (Qiangzhao et al., Journal of Sexual Medicine, 2026).
Mindfulness may help desire and arousal, but not pain. A systematic review of 15 studies found that mindfulness-based therapy improved arousal, desire, and sexual satisfaction in women and reduced fear linked to sexual activity, but did not significantly reduce pain during sex. The studies were small, so conclusions are limited (Jaderek & Lew-Starowicz, Journal of Sexual Medicine, 2019).
What Is Female Sexual Dysfunction?
Female sexual dysfunction is a medical term for ongoing sexual problems that upset you or your partner. Problems may involve sexual response, desire, orgasm, or pain during sex.
Many people have sexual problems at some point. Some have them throughout their lives. Female sexual dysfunction can happen at any stage of life, and it can happen only sometimes or all the time during sex.
Sexual response is complex. It involves how your body works, your feelings, things that happen in your life, your beliefs, your lifestyle, and how you relate to your partner. A problem in any one of these areas can affect sexual desire, arousal, or satisfaction. That is also why treatment often involves more than one approach.
When to see a doctor
If sexual problems affect your relationship or worry you, make an appointment with a member of your healthcare team. There is no need to be shy: you might have a condition that can be treated, or lifestyle changes, therapy, or a mix of treatments might help.
The Four Types of Female Sexual Dysfunction
Symptoms vary depending on the type of sexual dysfunction:
Type | What it looks like |
Low sexual desire | A lack of interest in sex and not wanting to have sex. This is the most common of the female sexual dysfunctions. |
Sexual arousal disorder | Even if you want sex, it may be hard to get or stay aroused during sex. |
Orgasmic disorder | Ongoing trouble having an orgasm even with enough sexual arousal. |
Sexual pain disorder | Pain when having sex. Painful intercourse is called dyspareunia. |
It is also worth stating plainly: sexual dysfunction is a problem only if it bothers you. If it doesn't bother you, you don't need treatment.
What Causes Female Sexual Dysfunction?
Sexual dysfunction problems often start when hormones change, such as after having a baby or during menopause. Major illness, such as cancer, diabetes, or heart disease, also can add to sexual dysfunction. The contributing factors fall into three groups:
Category | Contributing factors |
Physical | Medical conditions including cancer, diabetes, kidney failure, multiple sclerosis, heart disease, and bladder problems. Certain medicines can decrease sexual desire and make orgasm harder, including some medicines to treat depression, high blood pressure, allergies, and cancers. |
Hormonal | Lower estrogen after menopause can change genital tissues and how you respond to sex: less blood flow to the pelvis, less feeling in the genitals, and more time needed to become aroused and reach orgasm. The vaginal lining also becomes thinner and less stretchy, and not being sexually active can make this worse, leading to painful intercourse. Sexual desire also lessens when hormone levels drop. Hormone shifts after childbirth and during breastfeeding can cause vaginal dryness and affect desire. |
Psychological and social | Untreated anxiety or depression can cause or add to sexual dysfunction, as can long-term stress, a history of sexual abuse, worries about pregnancy, and the demands of having an infant. Problems with your partner, cultural and religious issues, and problems with body image can also affect your sex life. |
Risk factors
Risk factor | Details |
Depression, anxiety, and other mental health conditions | Mental health conditions that go untreated can both cause and add to sexual dysfunction. |
Heart disease, diabetes, cancer | Major illnesses that can add to sexual dysfunction. |
Neurological conditions | Conditions of the spine and brain, such as spinal cord injury or multiple sclerosis. |
Gynecological conditions | Including infections. |
Certain medicines | Such as those taken for depression or high blood pressure. |
Emotional or psychological stress | Especially stress in your relationship with your partner. |
History of sexual abuse | A significant contributing factor. |
Lack of privacy | An environmental factor that can play a role. |
How Female Sexual Dysfunction Is Diagnosed
To diagnose female sexual dysfunction, your healthcare professional may:
Step | What happens |
Discuss your history | Your healthcare professional will discuss your sexual and medical history and your gender identity. You might feel uneasy talking about such personal matters, but your sexuality is a key part of your well-being, and being open about your sexual history and current problems raises your chances of finding a way to treat them. |
Do a pelvic exam | Your healthcare professional checks for physical changes that can affect how much you enjoy sex, including thinning of your genital tissues, scarring, or pain. |
Order blood tests | These can check for health conditions that might be part of sexual dysfunction. |
Your healthcare professional also may suggest that you see a counselor or therapist who treats sexual and couples' problems.
Treatment Options for Female Sexual Dysfunction
Female sexual dysfunction has many possible symptoms and causes, so treatment varies. Most often, a mix of treatments that includes medical, relationship, and emotional issues works best. It also helps if you tell your healthcare professional your concerns and understand how your body responds to sex and what you want from sex. These help with choosing a treatment and knowing whether it works for you.
Nonmedical approaches
Approach | How it helps |
Talk and listen | Talking openly with your partner, and giving feedback in a way that doesn't threaten, can strengthen your bond as a couple. |
Lifestyle changes | Limit alcohol (too much can blunt your response to sex), stay physically active for more energy and a better mood, and learn ways to lower stress so you can focus on sex and enjoy it. |
Counseling | A counselor or therapist who works with sexual problems. Therapy often includes learning about your body and ways to be closer to your partner. |
Vaginal lubricant | May help during intercourse if you have vaginal dryness or pain during sex. |
Vaginal moisturizer | Can be used anytime to ease vaginal dryness. |
Stay sexually active | By yourself or with a partner. This can ease vaginal discomfort by increasing blood flow to the vagina. |
Devices | Devices such as vibrators help with orgasm by increasing blood flow to the clitoris. |
Prescription treatments
Treatment often involves dealing with a medical condition or hormonal change, and your healthcare professional may suggest changing a medicine you take or lowering the dose. Prescription options might include:
Treatment | What it is and how it works |
Vaginal estrogen | Estrogen applied to the vagina as a cream, tablet, or ring delivers a small amount that the vaginal tissues take in. It can help ease vaginal dryness, pain with intercourse, and some urinary symptoms. |
Ospemifene (Osphena) | An oral selective estrogen receptor modulator (SERM) that treats painful intercourse linked to thinning vaginal tissue. It isn't for people who have had breast cancer or who are at high risk of breast cancer. |
Testosterone therapy | Testosterone plays a role in healthy sexual function in women as well as men, but no testosterone treatments are approved for use in females for sexual dysfunction, because of concerns about how well it works and how safe it is. If you want testosterone therapy, talk with your healthcare team about the risks and benefits. |
Flibanserin (Addyi) | Approved by the FDA for use before menopause to treat low sexual desire. It is a daily pill taken at bedtime. Possible serious side effects include low blood pressure, sleepiness, tiredness, and dizziness, plus nausea and fainting. Mixing it with alcohol can make side effects worse, and experts suggest stopping if your sex drive hasn't improved after eight weeks. |
Bremelanotide (Vyleesi) | FDA-approved for low sexual desire in premenopausal people. It is a shot you give yourself just under the skin in the belly or thigh before sex. Nausea is more common after the first shot and tends to improve with the second. Other side effects include vomiting, flushing, headache, and a skin reaction at the injection site. |
Prasterone (Intrarosa) | An insert or suppository of the human-made hormone dehydroepiandrosterone (DHEA) placed in the vagina. It helps ease vaginal dryness and pain with intercourse. |
Treatments still under research
Researchers are studying these treatments for female sexual dysfunction:
Treatment | Status |
Tibolone | Used in Europe, with both female and male hormone actions. The FDA hasn't approved it for use in the U.S. because of worry that it might increase the risk of breast cancer and stroke. |
Phosphodiesterase inhibitors | This group of medicines has had success for erectile dysfunction in men, but results of studies in women have been mixed. One of them, sildenafil (Viagra, Revatio), may prove useful for some people whose sexual dysfunction comes from SSRI antidepressants. It must never be taken by people who use nitroglycerin for angina. |
Because female sexual dysfunction is complex, even the best medicines aren't likely to work if other emotional or social factors are not resolved.
Lifestyle and Home Remedies
To boost your sexual health, find ways to be OK with your sexuality, improve your self-esteem, and accept your body. Healthy habits that help include:
Habit | Why it matters |
Don't drink too much alcohol | Drinking too much gets in the way of sexual response. |
Don't smoke | Smoking restricts blood flow, so less blood reaches your sexual organs. This could lower arousal and keep you from having an orgasm. |
Be physically active | Regular aerobic exercise can give you more energy, help you feel better about your body, and improve your mood, which can help you feel more romantic more often. |
Learn to relax | Lowering stress helps you focus during sex, and being relaxed may help improve arousal and help you have an orgasm. |
Complementary Approaches
More research is needed, but therapies that may help improve sex include:
Cognitive behavior therapy. This type of therapy can help you change thoughts, feelings, and behaviors that aren't healthy. It has been shown to reduce how much menopause symptoms bother you.
Mindfulness. A type of meditation used to increase awareness and help you accept the present. You focus on one thing, such as the flow of your breath, and let thoughts and emotions pass without judging them.
Yoga. A series of postures and controlled breathing exercises that helps you move your body better and calms your mind. Some types of yoga aim to improve sex.
One caution: herbal supplements and topical oils sold to increase sex drive and sexual pleasure haven't been studied well, and one product with estrogen-like action may spur the growth of breast tumors that feed on estrogen. Talk to your healthcare professional before trying any herbal or topical oil products.
Preparing for Your Appointment
If you have sex problems that upset you, make an appointment with your healthcare professional. Don't be shy about discussing sex. Your main healthcare professional will either diagnose and treat the problem or refer you to a specialist.
What you can do
Make a list of the following:
Your symptoms. Any sexual problems you're having, including when and how often they occur.
Your sexual history. Your relationships and the sex you've had since you started having sex, including any history of sexual trauma or abuse.
Your medical history. Medical conditions you have, including mental health conditions, and all medicines you take or have taken recently, with doses.
Questions to ask your healthcare professional. For example: What might be causing my sexual problems? Do I need medical tests? What treatment do you suggest? What can I expect from treatment? Do you think my partner and I should talk to a sex therapist? Are there printed materials or websites you suggest?
What to expect from your doctor
Your healthcare professional might ask personal questions and may want to include your partner in the interview. Questions might include:
How much do your sexual problems bother you?
How is your relationship?
Do you become aroused during sex with your partner?
Do you have orgasms, and have you had them in the past but no longer can?
Do you have pain with intercourse?
What form of birth control or hormones, if any, do you use?
Do you use alcohol or recreational drugs, and how much?
Have you ever had surgery that involved your reproductive system?
What you can do in the meantime
Talk with your partner and be honest about the problem. Think about other ways to be close to each other, and make time to be intimate.
Conclusion: A Common Problem With Real Solutions
Female sexual dysfunction is more common than most people realize, can begin at any stage of life, and sits at the intersection of hormones, health conditions, medications, emotions, and relationships. That complexity is exactly why a single fix rarely works, and why the evidence supports combining approaches: an honest conversation, lifestyle changes, simple comfort measures like lubricants and moisturizers, and counseling or prescription treatments when needed.
The most important takeaway is that this is a medical issue, not a personal failing, and that treatment is only needed if the problem bothers you. If it does bother you, or if it is straining your relationship, an open appointment with a healthcare professional is the single best first step.
Want more evidence-based health explainers like this one? Explore our library of women's health and wellness articles, and tell us what to cover next in the comments.
Further Reading
Frequently Asked Questions
What is female sexual dysfunction?
It's a medical term for ongoing sexual problems that upset you or your partner, involving sexual response, desire, orgasm, or pain during sex. It can happen at any stage of life, and only sometimes or all the time during sex.
What are the four types of female sexual dysfunction?
Low sexual desire (lack of interest in sex, the most common), sexual arousal disorder (difficulty getting or staying aroused), orgasmic disorder (ongoing trouble having an orgasm even with enough arousal), and sexual pain disorder (pain when having sex, called dyspareunia).
Is low sexual desire the most common type?
Yes. Low sexual desire, a lack of interest in sex and not wanting to have sex, is the most common of the female sexual dysfunctions.
What causes female sexual dysfunction?
Problems often start when hormones change, such as after having a baby or during menopause. Major illness (cancer, diabetes, heart disease), certain medicines (including some for depression, high blood pressure, allergies, and cancers), untreated anxiety or depression, long-term stress, a history of sexual abuse, and relationship problems can all contribute.
Does menopause affect sexual function?
Yes. Lower estrogen after menopause can change genital tissues, reduce blood flow to the pelvis, lessen feeling in the genitals, and require more time to become aroused and reach orgasm. The vaginal lining becomes thinner and less stretchy, which can lead to painful intercourse. Not being sexually active can make this worse.
Do I need treatment if sexual problems don't bother me?
No. Sexual dysfunction is a problem only if it bothers you. If it doesn't bother you, you don't need treatment.
How is female sexual dysfunction diagnosed?
Through a discussion of your sexual and medical history and gender identity, a pelvic exam (checking for thinning genital tissues, scarring, or pain), and sometimes blood tests to check for underlying health conditions. A counselor or therapist who specializes in sexual and couples' problems may also be suggested.
What nonmedical treatments help?
Talking openly with your partner, limiting alcohol, staying physically active, lowering stress, counseling, vaginal lubricants, vaginal moisturizers, staying sexually active (alone or with a partner), and devices that increase blood flow to the clitoris.
What prescription treatments are available?
Vaginal estrogen (cream, tablet, or ring), ospemifene (an oral SERM for painful intercourse), flibanserin (a daily bedtime pill approved before menopause for low desire), bremelanotide (a self-injection before sex for premenopausal low desire), and prasterone (a DHEA vaginal insert). Testosterone plays a role in women's sexual function, but no testosterone treatments are approved for females for sexual dysfunction.
Is flibanserin safe to take with alcohol?
No. Mixing flibanserin with alcohol can make side effects worse. Its possible serious side effects include low blood pressure, sleepiness, tiredness, dizziness, nausea, and fainting, and experts suggest stopping if your sex drive hasn't improved after eight weeks.
Do medications always work?
Not by themselves. Because female sexual dysfunction is complex, even the best medicines aren't likely to work if other emotional or social factors are not resolved, which is why treatment usually works best as a mix of medical, relationship, and emotional approaches.
References
Kamrul-Hasan ABM, Hannan MA, Alam MS, et al. Role of flibanserin in managing hypoactive sexual desire disorder in women: a systematic review and meta-analysis. Medicine. 2024;103(25):e38592. PMID 38905407. https://doi.org/10.1097/MD.0000000000038592
Qiangzhao L, Qiong L, Bohong G, et al. Psychological therapies for female sexual function: a systematic review and network meta-analysis. The Journal of Sexual Medicine. 2026;23(3):qdag040. PMID 41718740. https://doi.org/10.1093/jsxmed/qdag040
Jaderek I, Lew-Starowicz M. A systematic review on mindfulness meditation-based interventions for sexual dysfunctions. The Journal of Sexual Medicine. 2019;16(10):1581-1596. PMID 31570137. https://doi.org/10.1016/j.jsxm.2019.07.019
Mayo Clinic Staff. Female sexual dysfunction: symptoms and causes. Mayo Clinic. October 30, 2024. https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/symptoms-causes/syc-20372549
Mayo Clinic Staff. Female sexual dysfunction: diagnosis and treatment. Mayo Clinic. October 30, 2024. https://www.mayoclinic.org/diseases-conditions/female-sexual-dysfunction/diagnosis-treatment/drc-20372556
Medical disclaimer
This article was prepared for general information only and is not a substitute for professional medical advice.
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