1. Kaplan, Clair RN/MSN, APRN(WHNP), MHS, MT(ASCP)

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Problems with sex are sometimes called "sexual dysfunction." Female sexual dysfunction (FSD) can be caused by many things, like changes in your body or stress. Your NP is used to talking about these problems, and can help you with your feelings.


If any of these problems are upsetting you, you may have FSD. Some women only want to be touched, and don't want to have sex. This is not a problem unless it bothers you or is affecting your life. Every woman is different.


There are many kinds of FSD:


* when you don't want to have sex


* when you have trouble feeling aroused


* when you have pain during sex


* when you have trouble having an orgasm or feel pain during an orgasm



What causes FSD?

Menopause is often a cause of FSD, and your NP can help you find a treatment. FSD may also be the first sign of another problem, like high blood pressure or diabetes. Surgery may also be the cause.


Finally, many medications can cause FSD. Antidepressant use is a common cause of FSD, and your NP may be able to give you a different medication if this is the problem. Birth control pills or Depo-Provera can cause FSD as well. Changing these medications may help. Do not stop your birth control method without using an alternative. You NP can work with you to find the right method.


How to talk to your NP

If you suffer from FSD, you are not alone, and your NP may be able to help you solve the problem. Your NP will need to know your history, including any medications that you take. Be sure to include those that you buy at the store or any herbal medicines.


Be sure to talk about any stress in your life, and your current and past partners. Your information will be kept private. You will be asked questions about dryness during sex. If you start to feel uncomfortable, you can make another appointment to talk later. Your NP will also let you know about other people who can help you, like counselors or sex therapists. You have the choice of who you would like to help you.


What happens next?

You will have an exam and some tests. If you are having pain, your NP will try to make you as comfortable as possible. Sometimes it's hard to describe any pain you are feeling. Let your NP know if the pain is inside or outside, what makes it worse, what makes it better, what you have tried to make it better, how much it hurts, how long it lasts, what seems to bring it on, and how often it happens. Tell your NP about any discharge, odor, trouble going to the bathroom, itching, or skin problems. There are many reasons for these problems, and your NP can help you decide the best treatment for you.


Many women want medicine for FSD. Medications may work for some types of FSD, but not for others. Hormones like estrogen may work, but your NP will need to see if they are right for you, and if there are any risks.


For women who can't have an orgasm, there is a medical device available by prescription. It works by increasing blood flow to the clitoris. It is expensive and may not be covered by insurance, so be sure to talk about it with your NP. A vibrator may be helpful as well. You may also want to try changing your sexual routine or different positions.


No matter what is causing your FSD, your NP can suggest ways to help or can send you to a sex therapist or counselor to solve the problem.