Sexual dysfunction in women

Orgasm disorders in women
Failure of genital response  (isolated insufficient lubrication), or ``inorganic dyspareunia ' are conditions of recurrent or permanent discomfort, even pain during intercourse.

Speeches
Discomfort, pain, itching, burning are typically experienced. The area of ​​occurrence is not only the vagina, but also the urethra and bladder. Conditions can appear during every intercourse or occasionally, during intercourse or after it, during the duration or only during deep penetration of the man's member, also only when using tampons, etc.

Division
According to etiology:
 * Organic causes - urogenital atrophy, menstrual cycle complications, inflammation (vulvovaginitis, cystitis, PID), herpes genitalis, pudendal neuralgia, insufficient lubrication, endometriosis, anatomical abnormalities, injuries (pelvis, symphysis, bladder rupture), precancers, malignancies, consequence of oncological therapy, retroversion of the uterus, adhesions, leiomyomasy, lichen planus ', lichen sclerosus, Sjögren's syndrome, local allergic reaction, pelvic floor hypertonicity, etc.
 * Functional causes - vertebrogenic problems, muscle imbalance, pelvic floor dysfunction, etc.
 * Psychogenic causes - negative attitude towards a partner, sex, partner discord, negative experiences, trauma, rape, stressful situations, etc.

By origin:
 * Primary - arising during the first attempts at sexual intercourse (insufficient lubrication, careless immission, infection);
 * Secondary - arising during sexual life (menopause, endometriosis, inflammation, surgery);
 * Postpartum - even after a natural birth without complications.

By localization:
 * Superficial - skin pathology, vulvodynia, insufficient lubrication, vaginismus.
 * Moderate - vaginal atrophy.
 * Deep - pathology of the pelvic organs, endometriosis, infection of the pelvis and uterus, adhesions, cysts, fibroids, retroversion of the uterus.

Diagnostics and therapy
Diagnosis and therapy consists of the cooperation of a gynecologist, urologist, psychiatrist, sexologist and physiotherapist. In therapy, we try to eliminate the primary cause. In the symptomatic treatment of pain, we indicate artificial lubrication and local anesthetics. If necessary, the treatment should be supplemented by psychotherapy.

Sexual Satisfaction Disorders
Even achieving orgasm and a satisfactory course of sexual excitement does not necessarily mean complete satisfaction with the course of sexual life. Orgasm itself can be a source of very negative feelings. Although such conditions are extremely rare, we must draw attention to them. These include, for example, strong coital and orgasmic headaches of the migraine type'.

During sexual arousal and orgasm, various vegetative problems can manifest. For example hiccups, vomiting, diarrhea.

In women with stress-induced urinary incontinence, ``urination'' may occur during orgasmic contractions. Women can also experience copious orgasmic expulsions of urine during the so-called "female ejaculation".

Vaginal lubrication can also be so abundant that expelling it from the vagina makes the patient uneasy.

The field of ``psychopathology'' includes various described states of depression, exhaustion and weakness during sexual intercourse.

Treatment measures for such conditions must be strictly individualized. For coital migraines, ergoline derivatives, administered preventively, work well, for other vegetative symptoms, vegetative sedatives.

Related articles

 * Sexual Dysfunction
 * Sexual dysfunction in men
 * Psychophysiology of human sexuality

Reference
Author: '''doc. MUDr. Jaroslav Zvěřina, CSc.' (Head of the Institute of Sexology 1. LF and VFN)''