Female Sexual Health

This page presents information on health issues that affect female sexuality. There are diseases, drugs, and medications that cause women to be unable to experience sexual arousal and orgasm.

Prescription Drugs That Have an Adverse Affect on Female Sexuality

Antihypertensive agents:

"Aldomet (alpha-methyldopa) Used to treat high blood pressure results in decreased libido and impaired sexual arousal in 10 to 15% of women who use it in low dosages, and up to 50% of women who use it in high dosages. Many of the drugs used to treat high blood pressure impair sexual function in women. There are numerous drugs available to treat this illness, a woman may need to try several different ones, or combinations, to find one that doesn't affect her sexuality adversely. "

Source: Masters and Johnson on Sex and Human Loving page 520.

"Traditional blood pressure lowering medications, like reserpine and guanethidine, often cause sexual dysfunction in men, along with dizziness and depression, and for this reason many doctors have moved away from them. Beta-blockers marketed under the names Inderal, Lopressor, Corgard, Blocadren, and Tenormin have fewer side effects, but many people who take them still complain of sexual dysfunction. In recent years calcium channel blockers, marketed as Adalat, Procardia, Calan, Isoptin, Verelan, Cardizem, Dilacor XR, and Tiazac have become more opular, in part because they have less effect on sexual function."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 89, 91

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

Sedatives:

Librium (chlordiazepoxide) and Valium (diazepam) are tranquilizers. They can sometimes cause erectile dysfunction and anorgasmia, inability to orgasm. Source: Masters and Johnson on Sex and Human Loving page 520.

Quaalude (methaqualone) is a barbiturate. Barbiturates can depress the functions of the nervous system impairing sexual function.

Source: Masters and Johnson on Sex and Human Loving page 520.

"Sedatives: These include medications like alprazolam, marketed as Xanax, and diazepam, or Valium. They are prescribed to relieve anxiety, but they can also cause a loss of sexual desire and arousal."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

 

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

 

Antihistamines:

Antihistamines used to treat allergies and sinus ailments can result in drowsiness and a reduction in vaginal lubrication. Drowsiness will result in a decreased ability to stay awake for sex. Reduced lubrication can be perceived as vaginal pain during intercourse.

Source: Masters and Johnson on Sex and Human Loving page 520.

Antidepressants:

Antidepressants: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), and Serzone (sertraline). These are all "selective serotonin reuptake inhibitors (SSRIs)". They can cause decreased sex drive and delayed orgasm. 1 to 25% of people using SSRIs report some sexual impairment. Zoloft and Luzox have the lowest reported side affects, Paxil the highest. Women may need to try one or more of these to find one that doesn't adversely affect her sexually. Antidepressants may improve a woman's desire and enjoyment of sex as she will feel less depressed and more in the mood for it. A new class of antidepressants, the first of which is MK869, are as effective as Paxil without the sexual side affects.

Source: Girlfriends Magazine, December 1998, Page 18. Dr. Beth Brown.

"Antidepressants: Tricyclic antidepressants like clomipramine, marketed as Anafranil, causes sexual dysfunction in nearly half of the patients who take it. Anafranil has actually been used for premature ejaculation in men because it delays orgasm. Other tricyclics, like Elavil, Tofranil, Sinequan, and Pamelor can cause dry mouth, dizziness, constipation, and lethargy. For these reasons, many people prefer Prozac, the first of a new generation of enormously effective antidepressants that have fewer unpleasant side effects. Prozac is a selective serotonin reuptake inhibitor, or SSRI, and works by enhancing the action of the brains chemical serotonin. But Prozac, like the newer SSRI Zoloft, causes sexual dysfunction - usually delay in reaching orgasm, or an inability to reach orgasm - in as many as 60 percent of patients. Paxil, another SSRI, can cause a loss of libido."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

Quote: Letter to the Editor The Journal of Sexual Medicine Volume 2 Number 5 2005 Page 745 regarding Persistent Sexual Arousal Syndrome - A Response by Sandra Leiblum, PhD:

"Although recent reports suggest that the incidence of sexual side-effects is higher than previously recognized (30-40% vs. 5%), delayed rather than enhanced arousal and orgasms are reported. This is predictable, as SSRIs block nitric oxide (thereby decreasing smooth muscle relaxation and genital blood flow) as opposed to Viagra (which increase nitric oxide levels by inhibiting phosphodiesterase type 5 enzyme), and thus enhances arousal and orgasms."

"However it would be temporary in nature, as SSRIs are totally eliminated from the body (e.g., five half-lives) anywhere from 24 hours (Paxil) to two months (Prozac)."

This last statement does not take into account the long term effects of impaired sexual response on sexual performance. Repeated failed attempts at arousal and orgasm are likely to result in a secondary impairment to orgasm that is learned and psychological in nature, ultimately becoming physical in nature. While initially the medication may result in an organic impairment to arousal and orgasm, secondary to this the user may learn they cannot experience orgasm. This learned barrier to orgasm may be difficult to overcome. For those on antidepressants who find they can no longer achieve full arousal and orgasm it may be best not to attempt to achieve this, as difficult and undesired as this may be. They may need to explore pleasure rather than orgasm, and avoid activities that result in sexual frustration. Communicating this to a partner may be even more challenging than the need and means of experiencing orgasm, as orgasm has become a measure of completeness and successfulness of a sexual experience.

"Antidepressants that activate dopaminergic (bupropion, venlafaxine), central noradrenic receptors (mirtazepine, bupropion, venlafaxine) and 5-hydroxytriptamine (5-HT) A1 and 2C receptors (nefazodone, mirtazepine) may augment sexua response. Those that activate other 5-HT receprots, prolactin and gamma-aminobutyric acid reduce sexual response."

Source: Vaginal Anatomy and Physiology by Sohail A. Siddique, MD (J Pelvic Med Surg 2003;9:263-272)

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

Medical Abstract:

Originally Published: June 2009

Genetic and clinical predictors of sexual dysfunction in citalopram-treated depressed patients.

Sexual dysfunction is a major contributor to treatment discontinuation and nonadherence among patients treated with selective serotonin reuptake inhibitors (SSRIs). The mechanisms by which depressive symptoms in general, as well as SSRI exposure in particular, may worsen sexual function are not known. We examined genetic polymorphisms, including those of the serotonin and glutamate systems, for association with erectile dysfunction, anorgasmia, and decreased libido during citalopram treatment. Clinical data were drawn from a nested case-control cohort derived from the STAR(*)D study, a multicenter, prospective, effectiveness trial in outpatients with nonpsychotic major depressive disorder (MDD). Self-reports of erectile dysfunction, decreased libido, or difficulty achieving orgasm based on the Patient-Rated Inventory of Side Effects were examined among Caucasian subjects (n=1473) for whom DNA and adverse effect measures were available, and who were treated openly with citalopram for up to 14 weeks. Of 1473 participants, 799 (54%) reported decreased libido; 525 (36%) reported difficulty achieving orgasm. Of 574 men, 211 (37%) reported erectile dysfunction. Using a set-based test for association, single nucleotide polymorphisms in glutamatergic genes were associated with decreased libido (GRIA3; GRIK2), difficulty achieving orgasm (GRIA1), and difficulty achieving erection (GRIN3A) (experiment-wide permuted p<0.05 for each). Evidence of association persisted after adjustment for baseline clinical and sociodemographic differences. Likewise, evidence of association was similar when the cohort was limited to those who did not report a given adverse event at the first post-baseline visit (ie, those whose adverse events were known to be treatment emergent). These hypothesis-generating analyses suggest the potential for glutamatergic treatment targets for sexual dysfunction during major depressive episodes. Source

Medical Abstract:

Originally Published: November 21, 2008

Better sexual acceptability of agomelatine (25 and 50 mg) compared with paroxetine (20 mg) in healthy male volunteers.

Sexual dysfunction (SD) is a common and underestimated effect of antidepressants. Healthy volunteers are the most adequate group to study this adverse event avoiding influence of depression itself. Sexual acceptability of agomelatine (a melatonergic agonist and 5HT2C antagonist) paroxetine and placebo by using the Psychotropic-Related Sexual Dysfunction Salamanca Sex Questionnaire (PRSEXDQ-SALSEX) was explored. A total of 92 healthy male volunteers were randomised to agomelatine (25 or 50 mg), paroxetine 20 mg or placebo for 8 weeks. SD, defined as at least one sexual impairment in one of the following PRSEXDQ-SALSEX items (decreased libido, delayed orgasm/ejaculation, anorgasmia/no ejaculation and erectile dysfunction), was evaluated at baseline and after 2, 4 and 8 weeks. At the last post-baseline assessment, SD was significantly lower in each agomelatine group (22.7% on 25 mg and 4.8% on 50 mg) than in the paroxetine group (85.7%; p < 0.0001). In the placebo group, 8.7% of volunteers reported a SD. The percentages of volunteers with moderate or severe SD were 4.5% for agomelatine 25 mg, 4.8% for agomelatine 50 mg, 61.9% for paroxetine 20 mg and 0% in the placebo group (p </= 0.0001 agomelatine versus paroxetine). There is a much lower risk of having SD with agomelatine than paroxetine in healthy male volunteers, which confirms the better sexual acceptability profile of agomelatine compared with the SSRIs. Source

Medical Abstract:

Originally Published: December 5, 2008

Persistent sexual dysfunction after discontinuation of selective serotonin reuptake inhibitors.

Note: The medical article addresses male sexuality, but the equivalent likely applies to female sexuality.

INTRODUCTION: Sexual dysfunctions such as low libido, anorgasmia, genital anesthesia, and erectile dysfunction are very common in patients taking selective serotonin reuptake inhibitors (SSRIs). It has been assumed that these side effects always resolve after discontinuing treatment, but recently, four cases were presented in which sexual function did not return to baseline. Here, we describe three more cases. Case #1: A 29-year-old with apparently permanent erectile dysfunction after taking fluoxetine 20 mg once daily for a 4-month period in 1996. Case #2: A 44-year-old male with persistent loss of libido, genital anesthesia, ejaculatory anhedonia, and erectile dysfunction after taking 20-mg once daily citalopram for 18 months. Case #3: A 28-year-old male with persistent loss of libido, genital anesthesia, and ejaculatory anhedonia since taking several different SSRIs over a 2-year period from 2003-2005.

RESULTS: No psychological issues related to sexuality were found in any of the three cases, and all common causes of sexual dysfunction such as decreased testosterone, increased prolactin or diabetes were ruled out. Erectile capacity is temporarily restored for Case #1 with injectable alprostadil, and for Case #2 with oral sildenafil, but their other symptoms remain. Case #3 has had some reversal of symptoms with extended-release methylphenidate, although it is not yet known if these prosexual effects will persist when the drug is discontinued.

CONCLUSION: SSRIs can cause long-term effects on all aspects of the sexual response cycle that may persist after they are discontinued. Mechanistic hypotheses including persistent endocrine and epigenetic gene expression alterations were briefly discussed. Source

Medical Abstract:

Originally Published: August 11, 2006

Sexual dysfunction and psychotropic medications.

Psychotropic drugs are often associated with sexual dysfunction. The frequency of antidepressant-associated sexual dysfunction is greatly underestimated in clinical trials that rely on patient self-report of these adverse events. Direct inquiry reveals that delayed orgasm/ejaculation occurs in >50% and anorgasmia in at least one third of patients given selective serotonin reuptake inhibitors. Antidepressant-induced sexual dysfunction can be successfully managed. A different antidepressant without significant sexual effects, such as bupropion or mirtazapine, can often be substituted. Other strategies involve drug holidays or adjunctive therapy with drugs such as sildenafil. Dopamine antagonist antipsychotic drugs are most commonly associated with decreased libido. The newer atypical antipsychotics, with less effect on dopamine, are less commonly associated with sexual dysfunction. Sexual dysfunction is commonly reported with seizure disorders, and many anticonvulsant drugs affect levels of sex hormones. Because sexual dysfunction can be related to many factors, care must be taken to establish the patient's baseline sexual functioning before the initiation of psychotropic drug therapy and to rule out other etiologies before drugs are implicated as causative. Source

Medical Abstract:

Originally Published: November 2004

Vardenafil Reversal of Female Anorgasmia.

To the Editor: Selective serotonin reuptake inhibiting (SSRI) antidepressants commonly produce iatrogenic sexual dysfunction. It is uncommon for spontaneous remission of this side effect to occur, even after taking the SSRI for years. A variety of augmentation strategies have been proposed to reverse SSRI-induced sexual dysfunction. Sildenafil has been used to reverse SSRI-induced anorgasmia in a woman. Vardenafil, a phosphodiesterase type-5 inhibitor, is indicated in the treatment of male erectile disorder. I report here a case of SSRI-induced anorgasmia in a woman that was reversed by vardenafil.

Ms. A was a 37-year-old Caucasian woman who was successfully treated for panic disorder without agoraphobia and for generalized anxiety disorder with sertraline, 100 mg/day, for over 2 years after difficulty tolerating trials of alprazolam and clonazepam. Unfortunately, she developed anorgasmia from the sertraline within 3 months of reaching this dose. A dose reduction to 50 mg/day led to relapse, although her anorgasmia improved. Sildenafil augmentation 1 hour before sexual activity reversed her anorgasmia but only at the 100-mg dose; the 50-mg dose was ineffective. The anorgasmia persisted if she forgot to take sildenafil. The cost, however, was prohibitive because the drug was not covered by her health insurance. She was interested in trying vardenafil instead because it cost less than sildenafil. She found that vardenafil in the 10-mg strength was not only effective in reversing anorgasmia but was also more affordable because she could break the 20-mg pills in half. Ms. A could not detect any difference in the onset of action, the duration of effect, or adverse reactions from vardenafil compared to what she felt while taking sildenafil. Vardenafil has continued to be effective when she uses it once or twice a week for 9 months to date without any difficulty tolerating it.

This case report describes a woman with SSRI-induced anorgasmia and no other sexual complaints who had this side effect reversed by vardenafil. It is possible that this response was a placebo effect, although it is unlikely since this side effect persisted with a low dose of sildenafil. Larger-scale placebo-controlled studies would be helpful in determining the effect size and whether other opportunities exist for using vardenafil to reverse SSRI-induced sexual dysfunction.

At this point, vardenafil has been approved by the Food and Drug Administration only for use in men. Further studies in women with primary or secondary sexual dysfunction may reveal other populations and medical conditions that are responsive to vardenafil treatment. This report suggests that augmentation with vardenafil may assist some patients with SSRI-induced sexual dysfunction. Source

Patrick had this to say on 2/21/00:

RE: Orgasm difficulties & SSRI antidepressants (both genders)

Although you've probably heard this before, I think it's important, so I'll "repeat." Orgasm can be delayed, difficult, or impossible for people taking SSRI type antidepressants (Prozac, Luvox, Paxil, Zoloft, etc.)

Also:

• Both sex & cuddles can still be great fun for both.
  
• The overall success of these drugs can be so wonderful that it's still worth taking them.
  
• Talking with female friends has let me know that this happens to men & women in very similar ways.

As this points out, sex can be fun and enjoyable even in the absence of orgasm, for both men and women. Placing to much emphasis on orgasm can have an adverse affect on an individual or couple. Sex is much more than just orgasm.

 

Neuroleptics:

"These include antipsychotic drugs, like Thorazine, Haldol, and Zyprexa, which cause sexual dysfunction as well as significant emotional blunting in some patients."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

 

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

 

Anticonvulsants:

"Antiseizure drugs, including phenobarbital, marketed as Luminal, as well as Dilantin, Mysoline, and Tegretol, can cause sexual dysfunction. "

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

 

Medical Abstract:

Originally Published: October 2006

Reversible anorgasmia with topiramate therapy for headache: a report of 7 patients.

OBJECTIVE: To describe 7 patients who developed new onset anorgasmia while using topiramate therapy for migraine prophylaxis.

BACKGROUND: Topiramate is an effective drug for the prevention of migraine headaches. Though it is generally well tolerated, it may be associated with a dose-related anorgasmia.

METHODS: Case reports.

RESULTS: Seven patients (5 women, 2 men), between the ages of 40 and 62, developed anorgasmia while using topiramate for headache prevention. Four women and 2 men had migraine without aura, and 1 woman had migraine with aura. None had a prior history of anorgasmia or sexual dysfunction. Doses associated with this side effect ranged from 45 to 200 mg daily. All subjects had symptom resolution. Six patients had resolution within 7 days of discontinuing or decreasing the medication; the exact time frame of resolution for the seventh patient is unknown.

CONCLUSION: In our series, anorgasmia was a reversible, dose-related adverse effect of topiramate. Physicians need to be aware of the potential for topiramate to cause sexual side effects, and should inquire about these symptoms in patients for whom this agent has been prescribed. Source

 

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

 

Antiulcer Drugs:

"Cimetidine, or Tagamet, was the first of a new class of highly effective ulcer drugs that are also used to treat serious heartburn. It works by blocking the secretion of stomach acid. Although side effects are not common, adverse reactions include impotence in men. We do not yet know the sexual function side effect in women."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 90, 92

 

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

 

Anticancer Drugs:

"Tamoxifen, a drug prescribed to delay the recurrence of breast cancer that is marketed as Nolvadex, can cause vaginal bleeding, vaginal discharge, menstrual irregularities, genital itching, and depression. Patients on tamoxifin must be monitored for development of endometrial cancer."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 91, 92

 

Birth Control Pills:

"Many women taking birth control pills enjoy sex far more than before because they have been freed from their fear of pregnancy. But some women who take progestin-dominant pills complain of a loss of libido and vaginal dryness because of the hormone shifts caused by the pills."

Source: For Women Only by Jennifer Berman, M.D., and Laura Berman, PH.D.. Pages 91, 93

The following is from a medical journal article abstract published January 2006 in the Journal of Sexual Medicine titled Impact of Oral Contraceptives on Sex Hormone-Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction by Claudia Panzer, MD, Sarah Wise, MS, Gemma Fantini, MD, Dongwoo Kang, MD, Ricardo Munarriz, MD, Andre Guay, MD, FACP, FACE, and Irwin Goldstein, MD

"Sex hormone-binding globulin [SHBG] values in the "Continued-Users" were four times higher than those in the "Never-User" group... Despite a decrease in SHBG values after discontinuation of OC [Oral Contraceptive] use, SHBG levels in "Discontinued-Users" remained elevated in comparison with "Never-Users""

This says women taking oral contraceptives have four times as much SHBG in their blood, and after some women in the study discontinued their use of an oral contraceptive, their SHBG level did not return to a level consistent with that of women who had never used an oral contraceptive. SHBG attaches itself to the testosterone circulating in a woman's body making it ineffective, and possibly causing a decrease in sexual desire and sensitivity. The final conclusion of this research was stated as follows:

"Based on the preliminary findings of this investigation, further research is need to identify whether SHBG changes induced by OCs may or may not be completely reversible after discontinuation of OC use and whether this leads to long term sexual, metabolic, mental health changes in women."

I have heard rumors of instances of women experiencing adverse side-effects from the use of an oral contraceptive that did not go away when they stopped taking them and this study may lend credibility to those claims.

 

The drugs outlined below have been shown to cause erection problems in men. They are also associated with sexual dysfunction in women, including decreased libido, decreased arousal, and orgasmic disorder.

 

NonSteroidal Anti-Inflammatory Drugs (NSAIDs):

Stacy had this to say about NSAIDs and rheumatoid arthritis:

I've been on a range of medications for rheumatoid arthritis over the past 11-12 years. It's been my experience that all NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) make it more difficult to reach or sustain full arousal, and all reduce natural lubrication, but not all do to the same degree. I've gathered from conversations with other women with RA that this may be a common problem, although with the majority of NSAIDs our experiences of which were worse varied considerably. Some of this was probably due to differential dosages, and to differing med schedules; but in general individual response to NSAIDs varies quite a bit. The one possible exception was Naproxen: almost all the women I've spoken with who've been on it for RA have mentioned not only these side-effects, but also that it appeared to lower desire. This is also the only one I'm aware of that lists potential sexual side-effects in its information sheet, not for women, but for men: impotence and lowered libido.

 

Health Advisory!

It has come to my attention that the birth control method Depo Provera can have a negative effect on a woman's health even though doctors do not know or believe it is a possibility. is a progesterone that is injected every twelve weeks to prevent pregnancy. Progesterone inhibits the production of estrogen. This means while a woman or teen is on Depo-Provera her estrogen levels may decrease, perhaps significantly. Estrogen is essential to the normal functioning and health of the vagina, vulva, and urinary tract. When estrogen levels decrease the vagina may develop Atrophic Vaginitis. This is a condition common among postmenopausal women. If you are using Depo Provera and you should experience any of the symptoms given below, see your doctor and make them aware of your use of Depo Provera. They may need to prescribe you estrogen, in cream and/or pill form, and discontinue your use of Depo Provera. Some women have developed serious and chronic side effects as the result of using this medication.

The possible symptoms of Atrophic Vaginitis are:

• Genital Dryness
• Itching
• Burning
• Unexplained Cuts and Tears
• Dyspareunia (Painful Vaginal Intercourse)
• Leukorrhe (Normal vaginal mucus discharge that has a yellowish or whitish color, but in increased amounts)
• Vulvar Pruritus (Vulvar Itching)
• Feeling of Pressure
• Yellow Malodorous Discharge
• Urinary Dysuria (Painful Urination)
• Hermaturia (Blood in the Urine)
• Urinary Frequency (Increased)
• Urinary Tract Infection
• Stress Incontinence

Additonal Antiestrogen medications that may cause atropic vaginitis are:

• Medroxyprogesterone (Provera and Depo Provera)
• Tamoxifen (Nolvadex)
• Danazol (Danocrine)
• Leuprolide (Lupron)
• Nafarelin (Synarel)
• Birth Control Pills containing high dosages of Progesterone.

The onset of a vaginal infection (candidiasis (yeast), trichomoniasis, or bacterial vaginosis) can cause the symptoms of atrophic vaginitis to become more serious.

None of the many websites I looked at that listed the possible side effects of Depo Provera mentioned atrophic vaginitis. Back when Depo Provera was first introduced a lab study involving monkeys uncovered this possible side effect. A subsequent study involving less than twenty women did not support this. Looks like the pharmaceutical companies were so eager to get this product into the market place they failed to do an in-depth study. As a result, many doctors have been misinformed. Other doctors, already knowing the effects of suppressing estrogen, know of the possible consequences or have learned of them as the result of the experiences of their patients.

All prescription birth control medications have potentially serious side effects, including death, as does pregnancy. When the possible side effects are listed, only the most common or likely to occur are usually presented. This means there will be a small percentage of women who suffer side effects that are not listed, except in perhaps the information distributed to doctors. (One percent of one million is 10,000; one tenth of one percent is still 1,000!!!) In addition, millions of women now use prescription birth control methods so the side effects they experience may differ from those of the mere thousands who were involved in the clinical trials. Even barrier methods of birth control have negative side effects, like allergic reactions or sensitivities. Some women are even allergic to semen, its acidic level.

There is no such thing as a perfect birth control method other than abstinence. Abstinence means you do not engage in intercourse but you can have "sex;" mutual masturbation, massage, oral sex, and what are commonly considered to be fetishes like bondage. Celibacy is where you do not have sex with a partner, only engaging in fantasies and masturbation. Keep in mind, if semen comes in contact with a teen's or woman's vulva there is a chance of pregnancy. Vaginal penetration is not necessary; sperm are very mobile and determined.

 

Non-Prescription Drugs That Have an Adverse Affect on Female Sexuality

 

Alcohol can impair female sexual arousal even before intoxication takes place.

Source: Masters and Johnson on Sex and Human Loving page 521.

Addictive narcotics such as heroin and morphine caused 27% of the 85 female addicts surveyed to experience orgasmic dysfunction, and 57% to experience decreased sexual interest. The root cause of these problems is unknown do to numerous factors that could cause addicts to experience sexual dysfunction. The sexual dysfunction could even be the root cause for the addition.

Source: Masters and Johnson on Sex and Human Loving page 521.

Amphetamines and cocaine can cause sexual dysfunction in men when used in large doses or over long periods of time. One would have to assume women would also experience sexual dysfunction under these conditions, do to similar anatomy and sexual physiology.

Source: Masters and Johnson on Sex and Human Loving page 522.

Marihuana caused some women to report temporary vaginal dryness resulting in painful intercourse.

Source: Masters and Johnson on Sex and Human Loving page 523.

 

Illnesses That Adversely Affect Female Sexuality

 

Illnesses that affect the thyroid and adrenal glands can impact a woman's sexuality, mainly by reducing her sex drive and affecting sexual function. 40% of women with under active thyroid, and adrenal glands will experience difficulty-experiencing orgasm. Under active pituitary glands cause problems for an even greater number of women. These problems can be correct by hormonal therapy. Source: Masters and Johnson on Sex and Human Loving page 513.

 

A visitor had this to say:

Thought I'd put in my $0.02 worth on Repetitive Stress Injuries and masturbation. I've had bilateral tendonitis (both wrists and both elbows) for almost two years, and most anything I do with my hands can be difficult and/or painful. Sometimes I can't physically sustain repetitive motions without pain (which makes masturbation difficult), and the lovely fountain of sensation I get from some orgasms becomes painful when the sensations reach my arms. I suppose that's because the tendons in those areas are near major nerves.

This information applies to those with disabilities and illnesses. Since masturbation and partnered sex most often require some form of repetitive motion, any illness or disability that impairs or prevents this motion will impact a woman's sexuality and pleasure. A woman in the above situation either has to rely on her partner to provide the repetitive motion, if she has one, or adapt non-sexual household items to meet her needs.

What would likely work best for her would be an electric vibrator, since it provides repetitive motion while allowing her to remain relatively motionless. A wand style vibrator may work best because of its long handle. A rechargeable vibrator may be necessary when a power cord would get in the way. She can either hold the vibrator against her body or rest the vibrator on a pillow while straddling it with her hips, allowing her body to press against the vibrator and pillow. Water spray in a shower or tub is another option.

As discussed on the page about disabilities, a woman's disability or illness may have little impact on her sexuality and need for physical affection and sexual release, orgasm. If a woman loses control over her muscles as the result of injury or disease, her sexuality is most likely still intact. Even in severe cases a woman or teen may still need and crave physical intimacy and orgasm. These needs can be met through simple acts like bathing, body massage, and sleeping in the accompany of another. An electric vibrator can be placed in her hands or placed on a pillow for her to press against, allowing her to experience sexual pleasure and orgasm. In some cases though someone may need to hold the vibrator for her. While controversial in our society, sex can be an instrument of healing, physically and emotionally.

 

Chronic Kidney Disease:

Medical Abstract:

Originally Published: April 2009

The sexuality and quality of life of hemodialyzed patients--ASED multicenter study.

INTRODUCTION: Chronic kidney disease (CKD) strongly affects sexual function (SF) and quality of life (QoL). The relations between CKD, SF, mental health, and QoL remain poorly understood in dialyzed patients.

AIM: To correlate sexuality to QoL in hemodialysis patients.

METHODS: One hundred twelve patients (69 males and 43 females) aged 20-60 years at six dialysis units were interviewed, and their medical records were reinvestigated and supplemented with completed Beck's Depression Inventory, Self-Evaluation Questionnaire, Mell-Krat Scale, International Index of Erectile Function-5, Arizona Sexual Experience Scale, and health-related Quality of Life (Short Form [SF]-36) questionnaires.

MAIN OUTCOME MEASURES: Prevalence of different levels of measurable aspects of sexual life, mental health, QoL, as well as their correlations, was assessed.

RESULTS: Only 55.4% of the patients were sexually active (79% in the age-matched general population) and 24.1% has ever before spoken to a doctor about their sexual life. The patients perceived sexual activity as important and were not satisfied with the performance. The predominant sexual dysfunctions were loss or diminished sexual needs (84.7% males and 48.8% females); in men, also erectile dysfunction (44.5%) and inhibited or lack of ejaculation (51.5%); in women, arousal dysfunction and anorgasmia (67.8% and 80.7%, respectively). The rate of depression was extremely high (80.5%). The patients self-assessed their QoL as low in both the physical and the mental health domains. Multiple regression analysis revealed that anxiety in men and depression in women independently predicted the lower quality of sexual life (P = 0.017 and 0.04, respectively). The general QoL, mental health, and physical health negatively correlated with the presence of depressive symptoms (P = 0.011, 0.013, and 0.011, respectively).

CONCLUSIONS: This pilot study is the first to present, in a multicenter design, the complex relations of sexuality and QoL in hemodialyzed patients, which are strongly underevaluated by medical professionals. It supports a thesis that sexual disability correlates with depression and anxiety, and seriously impacts the QoL in dialyzed patients.

General Health

Medical Abstract:

Originally Published: June 2009

Sexual Dysfunction Is Frequent in Premenopausal Women with Diabetes, Obesity, and Hypothyroidism, and Correlates with Markers of Increased Cardiovascular Risk. A Preliminary Report

Introduction. Female sexual dysfunction (FSD) is characterized by reduced sexual appetite and altered psychologic and physiologic response to sexual intercourse; it is reported to be frequent in diabetes mellitus, but no data have been reported in thyroid disorders.

Aims. To compare the prevalence of FSD in diabetic, in obese, and in hypothyroid women vs. healthy women, and to correlate FSD with endocrine and metabolic profiles.

Methods. We evaluated, through a questionnaire (Female Sexual Function Index [FSFI]), the prevalence of FSD in 91 women affected by diabetes mellitus, obesity, or hypothyroidism, and in 36 healthy women, all aged 22-51 years and in premenopausal state.

Main Outcome Measures. FSFI score, endocrine and metabolic parameters (triglycerides, high-density lipoprotein [HDL] and low-density lipoprotein [LDL] cholesterol, free-triiodothyronine (FT3), free-thyroxine (FT4), thyroid stimulating hormone [TSH], 17-beta-estradiol, testosterone, glycated hemoglobin 1c (HbA1c), thyroid autoantibodies, E-selectin, P-selectin, intercellular adhesion molecule-1 [ICAM-1], plasminogen-activator inhibitor-1 [PAI-1]), and anthropometric parameters (body mass index, waist, blood pressure [BP]).

Results. A reduced FSFI score was more frequent in diabetic, obese, and hypothyroid women vs. healthy women (P < 0.01). In the different groups of women, FSFI score was inversely correlated (pairwise correlation) with at least one of the following: HbA1c, TSH, LDL-cholesterol, PAI-1, diastolic BP, presence of thyroid Ab, and directly correlated with HDL-cholesterol (always P < 0.05 or less). At stepwise regression analysis, HDL-cholesterol (protective) and HbA1c, LDL-cholesterol, PAI-1, and diastolic BP (negatively) predicted reduced FSFI score.

Conclusion. These data indicate an increased prevalence of sexual dysfunction in diabetic, in obese, and in hypothyroid women, associated with markers of cardiovascular risk. [Source]

 

Pregnancy & Delivery

Medical Abstract:

Originally Published: July-August 2005

Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study.

This study was conducted to evaluate the effects of pregnancy and childbirth on postpartum sexual function. Nulliparous, English-literate women were enrolled who had presented to the UNC Hospital's obstetrical practice; these women were 18 years of age and older and at 30-40 weeks' gestation. Questionnaires were completed regarding sexual function prior to pregnancy, at enrollment, and at 2, 6, 12, and 24 weeks postpartum. Demographic and delivery data were abstracted from the departmental perinatal database. One hundred and fifty women were enrolled. At 6, 12, and 24 weeks postpartum, 57, 82, and 90% of the women had resumed intercourse. At similar postpartum timepoints, approximately 30 and 17% of women reported dyspareunia; less than 5% described the pain as major. At these times, 39, 60, and 61% of women reported orgasm. Orgasmic function was described as similar to that prior to pregnancy or improved by 71, 77, and 83%. Delivery mode and episiotomy were not associated with intercourse resumption or anorgasmia; dyspareunia was only associated with breast-feeding at 12 weeks (RR = 3.36, 95% CI = 1.77-6.37). Most women resumed painless intercourse by 6 weeks and experienced orgasm by 12 weeks postpartum. Function was described as similar to or improved over that prior to pregnancy. Source

 

 

 

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