Sexual Dysfunction

Female sexual dysfunction is more common than most people realize. Research suggests that around 40% of women experience low sexual desire or another form of sexual concern at some point in their lives. Because these issues are rarely discussed openly, many women assume they’re the only one struggling. You are not. Sexual dysfunction is one of the most frequent and most treatable concerns we see.

Some change in desire over time is normal, and a quieter libido on its own isn’t necessarily a medical problem. If your changing desire doesn’t bother you, then it doesn’t need to be considered a problem. However, if it’s causing you frustration, straining your relationship, or affecting how you feel about yourself, that’s worth evaluating, regardless of your age. Aging or fluctuating hormones does not mean you have to give up a satisfying intimate life.

Medications are one of the most overlooked contributors to sexual changes and dysfunction. Certain antidepressants, blood pressure medications, and hormonal contraceptives can dampen desire, arousal, or the ability to reach orgasm. Fortunately, medications can often be adjusted or switched. We can review your full medication list and explore alternatives, dosing changes, or timing strategies with you. Never stop prescribed medication on your own. Instead, you should bring it to your appointment so we can find a safer balance together.

Vaginismus is the involuntary tightening of the muscles around the vaginal opening, which can make penetration painful or even impossible. It’s not something you’re doing on purpose, and it’s not “in your head.” Vaginismus is a real, physical reflex that often has both physical and emotional roots. The good news is that it responds very well to treatment, especially pelvic floor physical therapy, gradual desensitization techniques, and counseling. Most women see meaningful improvement with the right support.

Menopause is a time of incredible change, and you do not need to simply endure the symptoms of perimenopause. While vaginal estrogen is highly effective for vaginal dryness associated with menopause, it isn’t the only path. Long-acting vaginal moisturizers, high-quality lubricants, and certain non-hormonal prescription treatments can relieve dryness and discomfort. You don’t have to accept dryness or painful sex.

Sometimes sexual dysfunction can be a symptom of a more serious health concern. Changes in arousal or desire can occasionally be an early signal of conditions like diabetes, thyroid imbalance, cardiovascular disease, or hormonal disorders. Pain during sex can point to issues such as endometriosis, infections, or pelvic floor problems. Evaluating your symptoms isn’t just about intimacy, it’s an opportunity to check in on your overall health.

Many women notice changes in libido, dryness, or discomfort after giving birth. This is extremely common and usually temporary. Breastfeeding lowers estrogen, which can cause vaginal dryness, while fatigue, healing tissue, and the demands of new parenthood all play a role. As your body recovers and hormones rebalance, sexual function typically improves. If discomfort or low desire lingers well beyond your recovery or after you have stopped breastfeeding, you have options.

A pelvic floor physical therapist is a specialized therapist who evaluates the muscles of your pelvic floor, the group of muscles that support your bladder, bowel, and reproductive organs, and helps you learn to relax or strengthen them as needed. Treatment may include guided exercises, breathing techniques, gentle manual therapy, and education about your body. It is a private, respectful process designed to reduce pain and restore comfortable function over time.

How quickly treatment for female sexual dysfunction works depends on the cause and the approach. Switching medications or adding a moisturizer could bring relief within days to a few weeks. Pelvic floor therapy, hormonal treatments, or counseling tend to yield results more gradually, typically over weeks to months. Your OB/GYN will set realistic expectations with you from the start and adjust your treatment plan as needed.

As specialists in women’s health, we understand the importance of sexual wellness in the greater picture of your health as a whole. For too long, women’s pleasure has been subject to shame and judgement. Sexual dysfunction can have a profound impact on your whole wellness, and we have the tools, therapies, and compassion to help you achieve comfort and joy. Our providers are trained to create a safe, nonjudgmental space, and what you share here stays confidential. Taking that first step is often the hardest part, and we will always meet you there with care and dignity.

In some cases, particularly when sex therapy and counseling are involved, it can be helpful to involve your partner, but you are by no means required to include your partner in your treatment. This is your care, and you are always in control of who is involved. When emotional or psychological barriers are a part of your sexual dysfunction, it can be helpful to seek individual, private counseling, especially if trauma has been a part of your history.

For women for whom the issue is purely physical or hormonal, there is no need to involve your partner. We will follow your lead and build a plan that respects your relationship, your privacy, and your comfort.