Female Sexual Dysfunction Is A Thing, So Let's Talk About It

FSD is a serious disorder -- or, more accurately, a serious family of disorders -- and it’s about time people started regarding it with the respect it deserves.

Dec 27, 2012 at 3:30pm | Leave a comment

Female sexual dysfunction (FSD) has finally started hitting the news in a big way thanks to a number of studies on the topic, and it seems like the media are finally starting to take it seriously, which is rather exciting. Because, historically, it was treated as nothing more than a joke or object of nervous guffawing; while male sexual dysfunction was taken extremely seriously, women’s experiences with their own sexuality were written off, despite the fact that a 1999 study showed 43% of women in the US experiencing problems with sexual dysfunction.

That’s a lot of women unhappy with their sex lives, people.

I was rather astounded when even “The Daily Mail” took up the cause with a remarkably sensitive and detailed article on the subject that included interviews with women who’ve struggled with FSD, and medical practitioners who are searching for ways to treat it. Could it be that we’re finally going to acknowledge that women have sex, and that sexual desire is sometimes complicated? Are we finally going to see some gender parity in the coverage and treatment of sexual dysfunction?

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Photo credit: Shelley Carlton.

Defining FSD is actually quite difficult; as the lovely folks at Harvard delicately put it, “Unlike penile erection, which is a quantifiable physical event, a woman’s sexual response is qualitative.”

I’d say that FSD involves an unwanted decrease in libido and/or an inability to have sex; some women might develop a lack of a sex drive, while others might be interested in sex, but could struggle with conditions like vaginismus, which causes incredibly painful vaginal spasms. Those tend, as one might imagine, to put a killer on the mood. On the other end of the spectrum, you have conditions like persistent genital arousal disorder, which can be debilitating for entirely different reasons.

What it definitely isn’t is asexuality, which is an absence of sexual attraction that isn’t associated with an underlying pathology, and sadly, I see asexuality often given the short shrift in coverage of FSD.

Part of the problem here is the lack of understanding about what “normal” sexuality looks like for women, as well as a general lack of asexual visibility. I imagine too that the fact that women have to struggle enough as it is to be seen as independent sexual beings rather than sex objects means some may be reluctant to admit that asexuality exists as it could tangle the conversation even further.

FSD the thing that dare not speak its name, even as people have trouble defining exactly what it is; Harvard helpfully notes a number of conditions that fall under the umbrella of FSD, including sexual arousal disorder, orgasmic disorder, noncoital sexual pain, and hypoactive sexual desire disorder. Researchers there also note that in some cases these conditions don’t qualify as FSD -- they actually have to cause distress in order to be identified as a problem (which is, I suspect, as close as we’re going to get to a nod to asexuality). The nebulous identity of FSD and the fact that it looks different for different women makes it even harder to talk about.

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Photo credit: Marcy Kellar

It's also associated with a lot of different causes. Medications are a frequent offender; antidepressants in particular tend to suppress libido, but so do things like hormonal birth control. In other cases it's associated with neurological disorders, or psychiatric conditions, or a host of other things. Women presenting with FSD have to be carefully evaluated to find out exactly what's going on, why, and whether it can be treated with medications, physical therapy, surgery, or other options. 

Jesse the K notes that her experiences with the medical establishment didn't exactly go swimmingly when she first started developing vulvodynia: 

I first experienced vulvodynia when I was 12, a year after my first period. I was confused, upset, and secretive. I spoke to nobody about it -- including my sexual partners -- until age 23. I mentioned it to several gynecologists and was told, “You have defective psyschosexual adjustment; the pain is caused by your unwillingness to submit to men.” This sadly matched all the info available in medical references.

Here’s the thing about FSD: It really, really sucks. And women feel like they can’t discuss it because there’s such a huge taboo when it comes to discussing female sexuality and arousal. Women aren’t supposed to be sexual, let alone to experience pleasure from sex, and they certainly aren’t supposed to mention these things, so many women with FSD live in silence and shame.

Some may not even realize that what they’re experiencing is abnormal -- at most, they get a sense that their sex lives aren’t like those of the people around them, but they can’t quite put a finger on why, and they feel like there’s no one to talk to. Including, often, doctors, because a lot of medical practitioners don't take it seriously.

And, sadly, FSD is actually really common. In a world where people actually admitted that it’s a thing, people could probably easily connect with patients like them who might even have tips and tricks based on their own experiences, like k, who writes at Feminists with Female Sexual Dysfunction.

At the very least they could find out that they’re not alone, and that what they are experiencing isn’t something that should be happening, nor is it something that they just need to accept as part of life.

Luckily Jesse hooked up with the right gyn eventually:

New gynecologist happened to be someone who was studying vulvodynia. I described my pain; he described how doctors and partners had been disabling me since it began. Required MyGuy to join me in a discussion of a surgical study. He was honest that maybe it would work and maybe it would make things worse. I was scared but hopeful. As with any “elective” surgery, recovery was horrible. It did reduce my vulvar pain, but it was no panacea. The pain waxes and wanes, and wasn’t fixed by menopause.

The increased awareness of FSD has made it somewhat less taboo, but that’s come with some costs, too. As pharmaceutical companies start looking into treatment options for women with FSD, there’s a lot of sneering at patients, who are being cast as “victims of big pharma” for wanting to have fulfilling sex lives.

Having a lack of libido, or being unable to have sex because it causes extreme pain and discomfort, is a big problem for many women; this isn’t about not being in the mood occasionally, but about never being in the mood or viewing sex as a painful and unpleasant task that you need to complete to please a partner, which, ugh.

FSD is a serious disorder -- or, more accurately, a serious family of disorders -- and it’s about time people started regarding it with the respect it deserves. That starts with talking about it openly and in an environment that isn’t designed to shame, and with telling the stories of actual patients who experience the condition -- and with over 40% of women struggling with it, chances are high that at least some of our commenters are among those patients.

So let’s talk about it -- and hey, why not submit an It Happened To Me while you’re at it? You can send your story to pitches@xojane.com.