Sexual arousal is the mainstay of female sexual health. Female sexual arousal disorder or FSAD is generally defined as the inability to attain or maintain typical responses to sexual arousal. Contrary to popular belief, this disorder is not always a result of a lack of sexual arousal. It could have various possible causes which include psychological and emotional factors like depression, anger and stress; relationship factors like conflict or lack of trust; and medical factors like depleted hormones, reduced regional blood flow and nerve damage. What is female sexual arousal disorder? Female Sexual Arousal Disorder (FSAD) is described as the inability of a woman to complete sexual activity with adequate lubrication. FSAD is said to result from the body’s inability to undergo specific physiological changes, called the lubrication-swelling response, in response to sexual desire and stimulation. This directly affects a woman’s desire for and satisfaction obtained from intercourse. Normally, a woman in an aroused state experiences an expansion of the blood vessels in the pelvic region; this allows more blood to flow to her genitals, giving a feeling of fullness. Additionally, the increased blood flow also causes the seepage of fluid through the walls of the blood vessels into the vagina to provide lubrication. The increased in blood flow also produces changes in the female genital tissues, causing an expansion in the upper part of the vagina, the uterus, the cervix and the clitoris. These changes together facilitate the entry of the penis into the vagina. A woman with FSAD may lack these physical responses which affects lubrication; regular sexual activity helps maintain these physical responses. The lack of arousal and lubrication therefore result in painful intercourse – and in the long run cause emotional distress and relationship problems. What are the available treatments for female sexual arousal disorder? Treatment for FSAD depends on its cause. While the physical causes are easy to treat, the psychological causes are much more difficult. Many women have difficulty with lubrication because of the naturally decreasing hormone levels that are associated with aging; they are helped with hormone replacement therapy (HRT) or non-prescription preparations that supplement a woman’s natural lubricant. The US FDA has also approved a medical device for the treatment of FSAD. The Eros-Clinical Therapy Device (Eros-CTD) is a small vacuum pump that fits over the clitoral area; the gentle sucking action of the pump stimulates blood flow to the area. During clinical trials, this device safely and effectively helped increase blood flow, sensation and vaginal lubrication. Psychotherapy or counselling is most commonly used to treat the psychosocial aspects of FSAD. Traditional psychotherapy focuses on relationship problems, emotional issues and communication; they also promote problem-solving strategies. As a result of heightened sexual expectations, couples benefit from traditional psychotherapy even when difficulties with sexual arousal are resolved. Sexual pain and its signs Dyspareunia or pain during intercourse is a medical term that simply means ‘painful intercourse’; it is a general term that describes all types of sexual pain that may occur upon penetration, during intercourse, and/or following intercourse. The pain can exist anywhere in the genital area like the clitoris, labia, or the vagina. The pain may be described as sharp, stinging, burning, bumping or cramping. Sexual pain can be divided into two categories, superficial and deep. Typical signs of sexual pain include: * Immediate vaginal pain with attempted penile or finger penetration. * Poor lubrication * Tearing sensation of the vulva or vagina * Deep pain or cramping with pelvic thrusts * Nausea with deep thrusts * Rectal pressure or pain with sexual intercourse * Muscle spasms on anticipated vaginal penetration * Bleeding after sexCauses and treatments of sexual pain Causes of sexual pain include: * Vaginismus * Vaginal infections * Problems with the cervix * Problems with the uterus * Endometriosis * Problems with the ovaries * Pelvic Inflammatory Disease * Ectopic pregnancy * Menopause * Intercourse too soon after surgery or childbirth * Sexually transmitted diseases * Injury to the vulva or vagina Most physical causes of sexual pain can be treated. Some treatments do not require medical intervention like in case of painful sex after pregnancy. However if you do suffer from vaginal dryness due to menopause, a health care professional can prescribe estrogen creams or other prescription medications to resolve the issue. In cases of sexual pain where there is no underlying medical cause, sexual therapy might be helpful; resolving issues like guilt, inner conflicts regarding sex or feelings regarding a past abuse can bring your sex life back on track. You may need to see a doctor for sexual pain if you suffer from bleeding, genital lesions, irregular periods, vaginal discharge or involuntary vaginal muscle contractions. If you have other psychological concerns, they can easily be addressed by a certified sex counselor.