Female Sexual Health

Female Sexual Pain

  • Dyspareunia / Vaginismus
  • Vulvodynia / Vestibulodynia
  • Hypoactive Sexual Desire / Disorder (HSDD)
  • Lax Vagina

Dyspareunia / Vaginismus

Dyspareunia is persistent pain in allowing attempted vaginal entry or penile intercourse.Vaginismus is persistent difficulty in allowing vaginal entry. Should cause personal distress to the individual. Present for a period of more than 6 months. Pain could be either at the outlet, or deeper or it could be a combination of superficial and deep pain. The prevalence is variable and ranges from 2-20%. The reasons could be due to lack of interest in sex, difficulty in achieving orgasm, lubrication difficulties, sex not pleasurable, and pain or a combination of these factors.

Vulvodynia / Vestibulodynia

Refers to pain in the region of the Vulva and Vestibule not related to causes like Infection, Inflammatory, Neoplastic, Neurologic.It could be generalized or localized. Sometimes it could be the result of oral contraceptive pills. It also could be associated with medical disorders like endometriosis, chrons disease, PID and dermatologicsal conditions. Treatment would involve a multidisciplinary approach including a detailed Gynecological examination, Pelvic Floor Therapist, Counseling/Sex therapy.

Hypoactive Sexual Desire / Arousal Disorder

Persistent or Recurrent deficient or absent sexual fantasies and desire for sexual activities causing marked distress. Symptoms usually persisting for more than 6 months. Female Sexual Arousal Disorder (FSAD)happens when there is persistent or absent genital swelling or lubrication in response to sexual stimulation. Psychiatric drugs, Antihypertensives, Oral contraceptives can all cause FSAD. Treatment would involve thorough assessment, detailed history with examination, checking for vaginal infections and drugs, CBT, Sex therapy, mindfulness etc.

Lax Vagina

Many women complain of decreased sexual satisfaction as they are not able to feel their partners penis because of the increased laxity of their vagina. This results as the muscles in the pelvic floor get splayed because of vaginal delivery. Assisted deliveries like forceps/vacuum deliveries create havoc and add insult to injury. This can be corrected by laser repair /laser perineoplasty of the vagina. This is a minimally invasive technique done under regional anaesthesia using a 30 watt holmium laser.