Female sexuality is more complex and diverse than male sexuality. We discuss here the following issues
1. Female sexual dysfunction
2. Premenstrual syndrome

Female sexual dysfunction

Sexual desire can naturally fluctuate over the years. Statistics suggests that somewhere between 25 – 60% of women suffer from FSD (FEMALE SEXUAL DYSFUNCTION)
Symptoms

  • Vaginal dryness
  • Low libido
  • Arousal issues
  • Painful sex
  • Difficulty reaching orgasm

Causes of FSD include:

  • Mental and emotional stress (fatigue ,sexual abuse, loss of loved ones, financial stress etc)
  • Chronic disease/ medical conditions (liver / kidney disease, heart disease,diabetes)
  • Sex hormonal deficiency (breast feeding, menopause)
  • Medications (chemotherapy, anti-depressants, high blood pressure medication)

 

Remember your sexuality is a key part of your wellbeing. Having an understanding and caring physician helps you to open up with these sensitive issues. Diagnosis is by detailed history and examination.
Management depends on the cause and is multifactorial ranging from

  • Healthy life style education (avoid smoking and alcohol, regular exercise, relaxation techniques)
  • Alternative medicine (mindfulness , acupuncture , yoga etc)
  • Sexual counseling
  • HRT
  • Medications (viagra)

Premenstrual Syndrome (PMS)

PMS is an array of physical and emotional symptoms occurring one to two weeks before a woman’s menstrual period. these symptoms usually stop when the period starts. Common emotional symptoms include:

  • low libido
  • depression
  • fatigue
  • bloating
  • irritability
  • aggressive behaviour
  • anxiety

Common physical symptoms include:

  • weight gain
  • food cravings
  • headaches /migraines
  • bloating
  • breast tenderness
  • worsening of acne

 

Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS and can be debilitating and occurs in 3-5% OF women. Diagnosis depends on detailed history and no tests are needed .it is important to maintain a symptom diary for 2 menstrual cycles at least to see if the symptoms are cyclical.

PMS and PMDD Treatment:

  • Exercise regularly at least 3 times a week
  • Avoid alcohol and smoking ( at least 2 weeks prior to period)
  • Alternative therapy-Relaxation therapy, meditation, cognitive behavioural therapy.
  • Supplements -calcium, vitamin D ,Gingko biloba, evening primrose oil, curcumin, vitamin B6, isoflavones, have been shown to provide some benefit.
  • Medications and hormonal therapy-SSRI s (selective serotonin reuptake inhibitors) fluoxetine, sertraline, paroxetine and escitalopram) -either taken only in premenstrual phase or continuously.
  • Ocpills – especially YAZ has found to be beneficial in PMS