Female Sexual Health

Female Sexual Dysfunction

1. Vaginismus

  1. Definition: The vagina rejects insertion in any way, such as tampons, duckbill pliers, fingers, penis, and etc. which cause muscle contraction or vaginismus, and there is a distinction of severity. In severe cases, it is impossible to have sexual intercourse and in mild cases, it hurts.

  2. Diagnosis: The diagnostic criteria for vaginismus are still controversial today, the more often mentioned is Lamont that classified into four levels according to severity:
    Level 1: Patient with vaginismus feel spasms at the bottom of the pelvis, and pain can be controlled by comfort;
    Level 2: Spasms occur throughout the pelvis and can still be relieved by comfort;
    Level 3: Patient raises hips to avoid being examined;
    Level 4: Raise hips and tightly close thighs to refuse to be examined.
    診斷:陰道痙孿 (Vaginismus)的的診斷標準現今仍舊爭議不斷,較常被提及的是拉蒙特(Lamont)依照嚴重的程度分為四級:
    3級: 患者抬高臀部以避免被檢查;

  3. Cause:
    There are many hypotheses for the cause of vaginismus, but it is difficult to propose a clear standard in terms of physical or psychological causes. In the discussion on the psychosocial level, there are some inscriptions, including the protection of self, the reactions from fear of sex, the fear of pain, the lack of sex education and knowledge, the pressure of traditional society, the influence of religion, conservative sex and etc. These factors can be seen more or less in the oral dictation of women with vaginismus, and they are also common psychological effects on physiological reactions

  4. Treatment:
    From the past simply physiological treatment, it has developed into both physical and psychological progress, including expansion exercises, taking medication to reduce anxiety, psychological counseling, and botox injection.
    Sexual happiness self-aid method: Improved through sexual counseling and supplemented with physical behavior training.

2. Pain during intercourse (Dyspareunia)

  1. Definition and diagnosis: In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), painful intercourse (Dyspareunia) and vaginal spasms (Vaginismus) have been integrated into “genito-pelvic pain/ penetration disorder).
    精神疾病診斷準則手冊第五版裡(DSM-5)已將性交疼痛(Dyspareunia)與陰道痙攣(Vaginismus)整合成「骨盆性器疼痛/插入障礙」(genito-pelvic pain/penetration disorder)。

  2. Continue or repeat one or more of the following difficulties for at least 6 months:
    (1) inserted into the vagina during intercourse.
    (2) Significant external vaginal or pelvic pain during vaginal intercourse or attempted insertion.
    (3) Obvious fear or anxiety, vaginal or pelvic pain, before or during vaginal intercourse.
    (4) Pelvic muscles are tightened or contracted during vaginal intercourse.
    (1) 性交時插入陰道口 
    (2) 陰道內性交或企圖插入時顯著外陰道或骨盆疼痛
    (3) 在性交準備插入時,插入期間或插有明顯恐懼或焦慮外陰陰道或骨盆疼痛。
    (4) 在性交插入時骨盆肌肉繃緊或緊縮

  3. Cause: Evaluation prioritizes physiological factors. In fact, most of them are psychological reactions that affect the physiological pain.

  4. Treatment: When the vagina suffers from an acute infection, medication works best. Most intercourse pain is a very complex psychogenic physiological response, so the treatment method focuses on psychological and behavioral changes.

3. Female Sexual Interests/ Excitement Disorders

  1. Definition and diagnosis: lack of or significant reduction of sexual desire, the appearance of three or more of the following symptoms for at least 6 months, the situation caused mild, moderate and severe distress:
    (1) Absent/ reduced interest in sexual activity.
    (2) Absent/ reduced interest in sexual fantasies.
    (3) Absence/ reduction of previous sexual activity and no feelings for sexual partner invitations.
    (4) In most or all (about 75%-100%) of sexual experience, there is absent/ reduced excitement/ pleasure towards sexual behavior
    (5) Absent/ reduced sexual interest/ excitation towards any internal or external sexual implication, such as written, spoken or visual.
    (6) In most or all (about 75%-100%) of sexual experience, there is absent/ reduced feeling towards sexual organs or other parts.
    (1) 對性活動無/降低興趣。
    (2) 對性幻想無/降低興趣。
    (3) 無/降低原先的性行為,且對性伴侶的邀約無感。
    (4) 在大部份或所有(約75%-100%)的性行為經驗中,對性行為無/降低興奮/愉悅感。
    (5) 對任何內在或外在性/色情的暗示,例如:書面、口語或視覺等,無/降低性興趣/興奮。
    (6) 在大部份或所有(約75%-100%)的性行為經驗中,對性器官或其它部份無/感覺降低。

  2. Treatment: Check the physical condition and take the medicine as needed. If it is not a physiological factor, you should consider the effect of cognition, psychology, society and etc. to get improvement.