Feminine Sexual Dysfunction, or FSD, is a medical condition, which has been called the "silent epidemic". According to a report published in 1999 in the Journal of the American Medical Association, FSD affects 43% of women. A "sexual dysfunction" condition indicates that there have been changes in a woman's sexual response and that these changes have caused stress. Many women with FSD have revealed that sexual intercourse is not the same as it was before. Many say that they have less lubrication, less arousal or less ability to reach orgasm. The majority complains that their sexual satisfaction has been reduced.

Sexuality is a complex process, which is coordinated by the neurological system, the vascular system and the endocrine system. Sexuality includes the family, social and religious beliefs, and is affected by age, health status, and personal experiences. In addition, sexual activity includes interpersonal relations, as each participant brings different attitudes, needs and responses to the sexual act.

1) desire, which refers to sexual need and the inability to respond to sexual activity
2) stimulation, which refers to sexual arousal, and its response, such as vaginal lubrication, clitoral sensitivity and the enlargement of the clitoris due to increased blood circulation
3) orgasm, which refers to the inability to reach climax
4) pain, which includes dyspareunia or painful sex

These sexual disorders can be interrelated and sexual dysfunction can occur due to a number of causes.

Common conditions that can play a role in FSD are:

vascular diseases
high blood pressure
elevated cholesterol
pelvic trauma
hormone imbalances
chronic illnesses
secondary drug effects, substance abuse or alcohol.

Some gynecological changes related to reproduction, such as puberty, pregnancy, the post-partum period and menopause, are some of the specific problems and possible obstacles to sexuality. Puberty can lead to problems of sexual identity. Pregnancy and the post-partum period are generally associated with a decrease in sexual activity, desire and satisfaction, which can persist if the mother is nursing her baby.

It also has been noted that decreases in estrogen levels during menopause can produce significant physical changes, and mood changes or changes in the sense of well being, which can have a negative impact on sexuality.

Any woman who has noticed a change in her sexual activity, who is experiencing less pleasurable sensations during intercourse, decreased arousal, vaginal dryness, difficulty in reaching orgasm or decreased sexual satisfaction, should consult with a physician. The physician will perform a complete evaluation of the medical and sexual history of the patient, including psychological and social data. Previous experiences and current intra- and interpersonal factors should be discussed. It is important for the patient to provide complete information to her physician, FSD is a complex condition and the physician should investigate every possible cause. In some cases, the patient requires combined treatment from a gynecologist, an urologist, an internist, a psychologist and a sexual therapist. The treatment could include medications, some natural products, hormones and medical devices. The ErosTherapy is a medical device approved by the Food and Drug Administration (FDA) of the United States for the treatment of sexual disorders, related to sexual stimulation and orgasm. The Eros is designed to improve the blood circulation to the genital area.

Even if the physician cannot find a cause for the sexual dysfunction, some basic treatments may be recommended, taking into consideration the preferences and comfort of the patient and her partner.

These basic treatments include

information and education, about normal anatomy and sexual function
new strategies to improve sexual stimulation and to avoid a pattern of routine sex
relaxation techniques
sexual activities that do not require penetration
pain reduction during sexual intercourse

FSD is a very important problem in a woman's health. It is a condition that affects the quality of a woman's life, but which has not been given much attention because it is an embarrassing topic and because there is a lack of knowledge about this issue in the medical community. Women today have a need to talk about it and ask for help.