Presenting Complaints

• Patients may be reluctant to discuss sexual matters and may sometimes instead complain of physical symptoms, depressed mood or marital problems.
• There may be culture-specific sexual disorders.

Diagnostic Features

• Common sexual disorders presenting in the female are:
  • low sexual desire (more of a problem if the couple want children or if the male partner has greater sexual need)
  • vaginismus or spasmodic contraction of vaginal muscles on attempted penetrations (often seen in nonconsummated marriages)
  • dyspareunia (pain in the vagina of pelvic region during intercourse)
  • female anorgasmia (women does not experience orgasm or climax )

Differential Diagnosis

• If low or sad mood is prominent, see section on Depression.
• Problems in marital relationships often contribute to sexual disorders, especially those of desire.
• Vaginismus rarely has a physical cause.
• Factors that may contribute to dyspareunia include vaginal infections, pelvic infections, (salpingitis) and other pelvic lesions (tumours or cysts).
• Anorgasmia in intercourse is very common. The etiology is unknown but in some cases medication may contribute.