Maintaining proper overall health is essential for enjoying a satisfying sexual life. Just like men, women also need to be in good health to fully embrace their sexuality. When a woman’s health deteriorates, it can lead to sexual problems, resulting in various dysfunctions in this area.

Female sexual dysfunctions can prevent a woman from experiencing pleasure and satisfaction during sexual intercourse. These difficulties can stem from health issues and lifestyle factors (such as diabetes, heart disease, and alcoholism), psychological factors (such as low self-esteem), social influences (such as a very strict upbringing that often creates distorted beliefs about the opposite sex, sexuality, and masturbation), or through the use of certain substances (such as high doses of sedative hypnotics).

Menopause is a period that is also associated with sexual dysfunction in women, as it marks the end of the reproductive cycle and leads to a decrease in hormone production, including a drop in testosterone. Although generally associated with men, testosterone is equally important for the female body and is linked to sexual desire.

The most common female sexual dysfunctions include:

- Anorgasmia (difficulty in achieving orgasm);

- Vaginismus (involuntary contraction of the vaginal muscles, causing pain);

- Dyspareunia (pain during sexual intercourse);

- Low sexual desire (reduced libido or hypoactive sexual desire).

Vaginismus is defined by the involuntary contraction of the muscles around the vaginal opening, resulting in pain and difficulty, which can even make penetration impossible, even in the absence of physical causes. The most common symptoms include: involuntary spasms of the pelvic muscles during sexual intercourse, pain, difficulty touching the area, low self-esteem, and elevated levels of anxiety.

Vaginismus is not limited to penile penetration but also encompasses any act involving the insertion of objects into the vagina, making activities such as using tampons and undergoing gynaecological exams impossible.

Causes of Vaginismus

The causes of vaginismus are often multifactorial. However, some reasons can be highlighted, such as:

- Lack of information about sexuality;

- Unawareness of one’s own body;

- Absence of dialogue between partners regarding the fear of pain (among other aspects);

- Fear of the possibility of pregnancy;

- Traumatic experiences.

Dyspareunia refers to the discomfort that a woman experiences during sexual intercourse, which can hinder and make this experience painful. The pain can be superficial, located in the area of the vaginal opening (vulva), or deep, felt internally in the pelvis during penetration. This discomfort may manifest as a burning sensation, intense pain, or cramping. The pelvic muscles often become tense, which intensifies the pain, whether it is superficial or deep. It is important to note that this pain can be significantly influenced by emotions; for instance, mild discomfort can escalate into severe pain following a traumatic sexual experience.

The causes of dyspareunia can be organic, psychological, or psycho-emotional. Among the organic causes, we can cite infections, hormonal imbalances, menopause, surgical interventions, urogenital diseases, and irritations caused by the use of barrier contraceptive methods (such as condoms, diaphragms, and spermicides) or intrauterine devices (IUDs).

Psychological Causes

Psychological causes may be related, for example, to inadequate stimulation or lack of arousal, especially when sexual intercourse is undesired or generates conflicting feelings. Additionally, dyspareunia can also have roots in the psycho-emotional sphere, manifesting through:

- Denial of success, love, and pleasure;

- Accumulation of fatigue;

- Unbalanced lifestyle;

- Fear of rejection from the partner;

- Difficulty expressing one’s individuality;

- And other factors.

This condition is primarily triggered by organic factors.

It involves a decrease in sexual desire, characterised by a lack of erotic feelings and interests. It is quite a common issue and can range from a brief episode to a more serious problem that requires professional evaluation. The absence of sexual desire can lead to dissatisfaction and depression, prompting a woman to generate various justifications to avoid sexual intercourse, often related to the fear of negatively impacting her relationship with her partner.

The causes are predominantly of an organic nature, such as hormonal changes (deficiency in oestrogens and testosterone), childbirth, breastfeeding, menopause, and the use of antidepressants. However, they can also be linked to daily life and stress.

The treatment should involve both partners.

Women facing such issues should seek a Women's Sexual Health Consultation as soon as possible, to be assessed and monitored by a specialist.

Generally, it is recommended that therapy involves both members of the couple, as the relational aspect is one of the most common factors associated with this type of dysfunction. The treatment consists of the implementation of various therapies, which may include: low-intensity laser therapy, hormonal optimisation, lifestyle and dietary changes, as well as other interventions deemed necessary and appropriate.