Glossary · Conditions

Female sexual dysfunction

Also called: FSD.

Definition: Female sexual dysfunction encompasses persistent problems with sexual desire, arousal, orgasm, or pain that cause personal distress. Menopause-related causes include genitourinary syndrome (dryness, dyspareunia), declining androgen levels, and the secondary effects of poor sleep and mood. Treatment is targeted to the dominant mechanism.

Detailed definition

Female sexual dysfunction (FSD) is classified into desire disorders (hypoactive sexual desire disorder, HSDD), arousal disorders, orgasm disorders, and sexual pain disorders. The DSM-5 combined some of these into "female sexual interest/arousal disorder" and "genito-pelvic pain/penetration disorder." For diagnosis, symptoms must persist for 6+ months and cause clinically significant distress. In menopausal women, multiple mechanisms typically overlap: GSM-driven dyspareunia and reduced lubrication; declining ovarian testosterone (especially after surgical menopause); secondary effects of insomnia, hot flashes, and mood; relational and life-stage factors. Treatment is mechanism-targeted: vaginal estrogen, intravaginal DHEA, ospemifene, or moisturizers/lubricants for GSM; testosterone (off-label in the US) for HSDD with low androgen; flibanserin or bremelanotide for HSDD; couples therapy or sex therapy when relational factors dominate.

Why it matters in menopause

A meaningful share of "menopause" complaints reaching clinicians are actually downstream effects of treatable sexual pain or relational distress. Naming the components — pain, lubrication, desire, arousal, orgasm — makes it possible to treat them individually rather than calling everything "menopause."

Sources

External references: Wikipedia.

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