Female Sexual Dysfunction

Female sexual dysfunction can affect desire, arousal, orgasm, and comfort during intercourse, and it is especially common around menopause, after childbirth, or when pelvic floor or hormonal changes are present. Issues may include low libido, difficulty with arousal or orgasm, or painful intercourse.

Because sexual health is influenced by physical, hormonal, emotional, and relationship factors, the specialists at The Medical Group of New Jersey offer compassionate, personalized care that may include medical treatment, pelvic floor therapy, counseling support, and hormone options when appropriate.

Symptom Onset & Initial Evaluation

Sexual dysfunction may develop gradually or occur suddenly following childbirth, surgery, a change in relationship dynamics, or a transition into menopause. Many women wait years to discuss symptoms, even though effective treatment is available.

Common symptoms include:

• Low sexual desire or decreased interest in intimacy
• Difficulty becoming aroused or maintaining arousal
• Reduced vaginal lubrication
• Pain with penetration or deep pelvic pain
• Burning, irritation, or tearing during intercourse
• Difficulty achieving orgasm
• Pelvic floor tightness or spasms
• Emotional distress, frustration, or relationship strain

Evaluation

The initial evaluation focuses on understanding the physical, hormonal, emotional, and relationship factors that may be contributing to sexual symptoms.

During your visit at The Medical Group of New Jersey, your urogynecologist will:

• Ask about your specific concerns, including desire, arousal, lubrication, pain, and orgasm
• Review medical history, pregnancy and delivery history, and menopause status
• Discuss medications, mental health history, relationship factors, and stressors
• Evaluate for post-menopausal changes or GSM
• Conduct a pelvic exam to assess pelvic floor muscle tone and trigger points, vaginal tissue health, areas of tenderness or pain, and evidence of vestibulodynia or vulvodynia
• Identify symptoms like pelvic floor spasm or vaginal atrophy

Diagnosis & Testing

Sexual dysfunction is diagnosed by reviewing your symptoms, performing a gentle physical examination, and ruling out other medical causes. Most testing is simple and only done when needed.

Pelvic Examination

During a pelvic examination, your healthcare provider will check for pelvic floor muscle tension or tightness, vaginal dryness or signs of atrophy, tender areas consistent with vestibulodynia, anatomical concerns, and changes in clitoral or vaginal sensitivity.

Hormone Evaluation (when appropriate)

Some patients may need bloodwork to assess estradiol levels (especially after menopause), testosterone levels (if low libido is a main concern), and thyroid function.

Assessment for Coexisting Conditions

Your provider will also look for other issues that may contribute to sexual symptoms, such as post-menopausal genitourinary syndrome (GSM), painful bladder syndrome, pelvic floor dysfunction, depression, anxiety, or medication side effects.

Brief Relationship or Psychosocial Assessment

If helpful, your provider may explore emotional or interpersonal factors that could benefit from counseling or support.

Treatment & Ongoing Management

Treatment is personalized based and may include medical, physical, hormonal, and behavioral strategies. Because sexual function is multifactorial, addressing all contributing areas is key to success.

Lifestyle & Conservative Approaches

Many women benefit from simple, supportive strategies that improve comfort and reduce stress around intimacy:

• Education & Communication: Understanding normal sexual response patterns and discussing needs openly with partners can reduce pressure and improve connection.
• Stress Reduction: Chronic stress affects desire and arousal. Mindfulness, movement, and good sleep can make a meaningful difference.
• Addressing Contributing Factors: Your provider may recommend adjusting medications that affect libido, treating mood disorders, or improving relationship communication.

Pelvic Floor Physical Therapy

Pelvic floor therapy helps women with pelvic pain, tight muscles, or painful intercourse. Treatment focuses on releasing muscle tension, improving coordination and relaxation, addressing trigger points, and using breathing and stretching techniques to reduce pain.

Hormonal Therapy

Some patients benefit from hormone-based options. Vaginal estrogen improves lubrication and reduces pain, especially after menopause. DHEA or testosterone may be considered in select cases to support desire or arousal. Your provider will help determine the safest and most appropriate option.

Medical Therapies

Medications and topical treatments can support sexual comfort and desire:

• Lubricants & Moisturizers: Reduce friction and improve comfort during intercourse.
• Medications for Low Libido: Includes Flibanserin and Bremelanotide. These options are used for premenopausal women with hypoactive sexual desire disorder (HSDD).
• Pain-Targeted Treatments: Lidocaine creams for localized pain, neuromodulators for nerve-related vulvar pain, and anti-inflammatory treatments for sensitive areas.

Behavioral & Psychological Therapies

Because emotional and relationship factors can affect sexual health, some patients benefit from counseling, couples therapy, sex therapy, or cognitive-behavioral approaches. Our team can help connect you with trusted specialists when appropriate.

Monitoring & Follow-Up

Ongoing follow-up ensures improvements are sustained and treatment plans remain aligned with patient goals.

Follow-up visits may include:

• Assessment of desire, arousal, lubrication, and comfort
• Review of pain levels and pelvic floor function
• Evaluation of hormonal therapy benefits
• Adjustment of medications
• Coordination with pelvic floor therapy
• Discussions about intimacy and relationship needs

Progress is often gradual but meaningful over time. Many women report that treatment significantly improves quality of life and relationships.