1) Sexual desire and functioning can vary between individuals and fluctuate over time within an individual due to numerous factors. 2) Female sexual dysfunction (FSD), characterized by low sexual desire and inability to become aroused or orgasm, may be caused by relationship issues, mental health concerns like depression/anxiety, or physical factors like hormonal imbalances or medical conditions. 3) Treatment options depend on the underlying causes but may include addressing stress, relationship dynamics, medical issues, or pharmaceutical interventions in some cases.

1. S
Sexual Challenges
Chapter 8
Katelyn Booth

2. Variations in Desire
S As humans, most of our sexual drive varies
S There is no exact amount of sexual desire
S Our levels of aspiration, in terms of wanting sex and
getting stimulated , can change over the years or even
weeks
S Some change from partner to partner

3. Female Sexual Dysfunction
(FSD)
S FSD-low sexual desire in women -- a medical disorder
worthy of healing
S For some of us, a lack of sexual longing and a failure to
get aroused or to orgasm, are extended ongoing troubles
that seem inflexible and cause us agony
S Some causes of low sexual desire/dysfunction:
relationship issues, depression, anxiety, and sleep
deprivation

4. Addressing the Underlying
Issue
S The body could be trying to get through an extra level of
stress that it’s trying to manage
S It is important for us to give ourselves time to deal with
stress before concluding that there is something
inherently wrong
S If addressing the underlying causes doesn’t help, FSD as
a diagnosis will be considered a possibility

5. The Search for Female Viagra
S Over the past two decades, a number of pharmaceutical
companies have worked to discover medications that
enhance women’s sexual desire.
S Research indicates that the women who have low sexual
desire due to physiological problem might respond well to
medication

6. Painful Intercourse/Penetration
S Conditions that contribute to or cause pain during
intercourse
S Insufficient lubrication
S Local Infection
S Local irritation
S Tightness in the vaginal entrance
S Pain deep in the pelvis

7. Medication Side Effects
S Antidepressants are know to affect sexual functioning.
S SSRI- Selective serotonin reuptake inhibitors (Prozac,
Paxil, and Zoloft) and SNRI- Serotonin-norepinephrine
reuptake inhibitors (Effexor and Cymbalta) may reduce
sexual desire and the ability to orgasm.
S Birth Control (The pill, the patch, injectable contraceptives,
and the vaginal ring)- Hormonal Side Effect

8. Hormone Side Effects
S Estrogen, progesterone, and testosterone are hormones
that affect a woman’s sexual desire and functioning.
S The most influential hormone, when it comes to sexual
desire, is testosterone (libido or male hormone).
Testosterone is found in both men and women, though
the proportions differ between sexes.
S Menstrual and menopausal changes are a normal part of
a woman’s development.

9. Hormonal Side Effects
Continued
S If a hormonal change leads to a drop in sexual desire or sexual
pleasure it could be the cause of a medication such as birth
control. Some women have more sexual desire taking birth
control while others have less desire for sexual intercourse.
S Menstrual Cycle- Many women who menstruate have a peak of
sexual desire before or around ovulation, with a second, less
intense peak during menstruation. The lowest level of libido if
often right before menstruation.
S Pregnancy- Estrogen and progesterone levels are higher
during pregnancy, and blood flow to the genitals increases.
However, for others fatigue, nausea, pain, fears, or issues with
the body changing and self-image may ruin the desire for sex.

10. Hormonal Side Effects
Continued
S Nursing- breastfeeding can suppress ovulation for
months after birth, as a result of the high levels of
hormone prolactin and reduced levels of estrogen.
S Perimenopause/menopause- During the years leading up
to menopause estrogen levels spike and fall erratically
while progesterone levels decline. One year after the last
mentrual period progesterone and estrogen levels are
low. During this time there is a decreased sexual desire
and increased vaginal dryness.
S Adrenal or ovary removal- results in a dramatic decrease
in sexual interest and frequency of orgasm, in part due to
a reduction od testosterone.

11. Sex, Disability, and Chronic
Disease
S Some people have chronic diseases or disabilities they
are born with,
S Cystic fibrosis
S Blindness
S Multiple sclerosis
S Bipolar disorder
S Brain surgery
S People, even health-care providers, often believe that
people with disabilities do not have sex, which is
condescending.
S These beliefs negatively effect people with disabilities'
self esteem

12. Sex, Disability, and Chronic
Disease Continued
S Having a disability can trigger feelings of alienation or
disconnection from our own bodies, causing shame and
embarrassment.
S Lack of knowledge and poorly designed spaces can turn
simple issues into huge barriers.
S Communication: sexual expression involves verbal and
nonverbal communication. If a person is hard of hearing
or can’t see the couple should learn new ways of
communication with each other. Honest discussions
about what makes them feel good can be a model for all
sexually active people, not just those with a disability.

13. Quote- page 190
S “After my brain injury, I couldn’t get spontaneous pictures
of people masturbating in public out of my mind and even
flirted with the idea of lifting my skirt and doing it myself.
These new thoughts were disturbing, and I was afraid to
tell my partner, because I was worried it would damage
our relationship. Then I learned in a support group how a
brain injury can change our ability to maintain appropriate
sexual boundaries. Eventually, my urges were less
frequent, and I became more comfortable with my
sexuality.”

14. Discussion Question
S I chose the quote on the previous slide because it stuck
out to me. While reading it in the text book, I thought it
was an unusual side effect to brain surgery. I also thought
it was interesting that a brain injury can change our ability
to maintain appropriate boundaries.
S What do you think of this person’s experience? --If you
were in this person’s situation, how would you feel and
what would you do?

15. References
S The Boston Women’s Health Book Collective (2011). Our
Bodies Ourselves. New York, NY: Simon & Schuster.