Sexual Dysfunction in Women: Introduction
The most crucial moment in sexual dysfunction diagnosis in women is initial assessment of her sexual constitution (temperament) and adaptation level in marriage (partner couple). Unlike men whose sexual dysfunction in most cases means reduction in primary level of sexual functioning, whether it is decrease in libido, inadequate erection, ejaculation acceleration, or reduction in attempts at sexual intercourse, sexual disorders in women are largely shaped by type of delay in sexual development from one of preceding stages.
Studying dynamics of this process in marriage allows us to identify several typical stages in partnership relations development. The inhibition of female sexual adaptation at stage of primary adaptation (premarital sexual life) forms inactive type of sexual disorders, delay at stage of progressive adaptation (the first years of marriage) is hypo-adaptive type in which female sexuality realization is achieved with difficulty and requires considerable efforts of spouses. The disintegration of sex stereotype that has developed in marriage is denoted as disadaptive type. At the same time, situation of family-sex disharmony is typical.
To classify syndromes that occur in female sexology, is the most convenient for primary lesion of one or another component of copulatory interval. The implementation of women’s recreational functions depends on activity of sexual partner, compatibility of intimate relationships with this couple – sexual disorders treatment almost always requires matrimonial factor account.
Libido Problems in Female
Libido problems are polyethic, it should be remembered that sexual dysfunction in women in primary psychogenic lesion of sexual sphere largely depend on form of the neurotic breakdown, which either underlies violation, or often, and almost always joins again. The role of neurohumoral component lesion in clinic of sexual dysfunction in women is quite significant.
The importance of neurohumoral component of copulatory interval as direct causative agent of sexual development in women is much more modest, therefore, for example, moderate sexual delay in puberty, on equal terms leading to earlier end of hypersexuality period in men, is manifested in women by later sexuality awakening.
In case of hypothalamic lesions in men, as a rule, there is decrease in sexuality, while women are more likely to have hypersexuality syndrome. The defeat of gonads and adnexal glands in men has significant effect on sexual activity, while one of the most frequent female diseases – adnexitis out of other pathogenic factors has weak effect on sexuality.
In clinical picture, three degrees of anorgasmia are distinguished:
- At the first, libido safety and possibility of satisfaction without orgasm are noted.
- At the second, there is indifferent attitude to sexual intercourse;
- At the third – negative attitude, aversion to sexual intercourse.
Total anorgasmia in women with experience of sexual life is rare, more often there is decrease in:
- orgasmicity level;
- smoothness of orgasm.
The dynamics of sexual sphere disintegration in women makes it possible to identify the following variants of anorgasmia in order of increasing lesion depth:
- relative decrease in orgasmicity (hypoorgasmia relativa – hor), i.e. decrease in steady level of orgasmicity. There are three hyposurgy degrees to distinguish: light, characterized by decrease in orgasmicity level to 50-79%; average, characterized by decrease in orgasmicity level to 20-49%; pronounced, with decreased orgasmicity to single cases with regular sexual life;
- absolute decrease in orgasmicity (hypoorgasmia absoluta – hoa), i.e. joining to previous form of sustained reduction in acuity of orgasmic sensations;
- relative absence of orgasm (anorgasmia relativa – aor), i.e. absence of orgasm during closeness with possibility of its occurrence out of sexual intercourse. Depending on source of existing model of orgasm, the following options should be distinguished: for dry hump (h), for masturbation (m), for unusual affect (a) and during sleep (s);
- absolute absence of orgasm (anorgasmia absoluta – aoa), when orgasm does not occur under any circumstances;
- false absence of orgasm (anorgasmia spuris – aos), i.e. incompleteness of orgasmic series in multi-orgastic women, accompanied by feeling of dissatisfaction and sexual frustrations.