AROUSAL DISORDERS

What is an arousal disorder?

Sexual arousal disorders are characterized by a lack of response to sexual stimulation (e.g., kissing, reading erotic content, touching the genitals, etc.) including mental/emotional stimulation, physical stimulation, or both. As a result, many women with sexual arousal disorders find it difficult or unrewarding to engage in sex.

What causes an arousal disorder?

A variety of factors can contribute to a sexual arousal disorder. Personal factors such as depression, low-self esteem, anxiety, stress, and relationship problems are commonly cited as interfering with sexual arousal. However, many external and physiological factors – such as your body’s reaction to prescription medications – are known to cause arousal disorders as well. It is important to carefully examine all areas of your life when determining both the cause and the treatment for an arousal disorder.

Below is a list of some common causes of arousal disorders:

  • Depression
  • Anxiety
  • Low-Self Esteem
  • Stress
  • Relationship Problems
  • Prescription Medications and Drugs
  • Inadequate Sexual Stimulation
  • Low Estrogen Levels
  • Atrophic Vaginitis – thinning and drying of tissue in the vagina
  • Vaginitis (infection of the vagina)

While treatment options vary by individual and must be discussed with your healthcare provider, arousal disorder is typically treated through a combination of psychological therapy and individual or couple’s exercises.


If you believe you have an arousal disorder, or would like more information about arousal disorders, schedule an appointment with one of our healthcare physicians in Grand Rapids, MI.

DYSPAREUNIA

What is dyspareunia?

Dyspareunia is marked by pain during sexual intercourse or other sexual activities involving vaginal penetration. Pain can range from a superficial irritation at the vaginal opening to a deep, intense pain felt internally near the pelvis. Where the pain is felt depends on the cause of the dyspareunia. Frequently, pain associated with dyspareunia will cause the pelvic muscles to contract during penetration, thus resulting in more discomfort.

What causes dyspareunia?

There are many causes for dyspareunia. By determining where penetration pain is felt, one can gain a better idea as to the underlying cause. An open dialogue with your healthcare team is crucial to your diagnosis and treatment.

Common Causes of Superficial Vaginal Pain:

  • Inflammation or infection of the genital area or vagina
  • Inflammation or infection of the urinary tract
  • Allergic reactions to spermicides, personal lubricants or latex condoms
  • Radiation therapy to the vaginal area
  • Surgery that narrows the vagina

Common Causes of Internal Vaginal Pain:

  • Pelvic Inflammatory Disease
  • Endometriosis
  • Pelvic growths
  • Internal scar tissue due to surgery or radiation therapy

As causes of dyspareunia vary widely, it is difficult to lay out a “typical” treatment plan. That being said, dyspareunia is very treatable. At the Center for Women’s Sexual Health, we will work closely with you to determine a course of treatment that best fits your needs.


If you believe you have an dyspareunia, or would like more information about pain associated with dyspareunia and the options for treatment, schedule an appointment with one of our healthcare providersin Grand Rapids, MI.

FEMALE ORGASMIC DISORDERS

What is Female Orgasmic Disorder?

While it is not uncommon for women to occasionally fail to achieve orgasm due to situational issues such as inadequate foreplay, women with Female Orgasmic Disorder (FOD) consistently cannot achieve an orgasm despite adequate sexual stimulation and arousal. Women with FOD are unable to reach orgasm with their partner or through self-stimulation (masturbation).

What causes Female Orgasmic Disorder?

There are a number of situational, psychological and physiological causes behind FOD. As with all health issues, it is necessary to work closely with your healthcare team to determine both the causes and treatment options available for treating your FOD. In an effort to foster a comfortable dialogue, we’ve listed a few common causes of FOD to start the conversation.

Situational Causes of FOD*:

  • One or both partners lack understanding of how female sex organs function
  • Poor communication as to what kinds of sexual stimulation are preferred
  • Inadequate foreplay
  • Relationship issues

Psychological Causes of FOD:

  • Past sexual abuse, rape, incest or sexual trauma
  • Fear of losing control
  • Fear of becoming pregnant
  • Fear of rejection by partner
  • Body image issues
  • Relationship issues
  • Stress or anxiety issues
  • Depression
  • Guilt about sex and/or sexual pleasure
  • Religious or cultural beliefs about sex and/or sexual pleasure

Physiological Causes of FOD:

  • Side effect of prescription medications or drugs
  • Nerve damage to the spinal cord or pelvic region
  • Female genital mutilation

Your course of treatment will be dependent upon the root causes of FOD. While discussion with your healthcare team is critical to determining the appropriate treatment, some common treatments of FOD include: psychological therapy to acknowledge and reduce feelings of fear, guilt and shame, education about sexual function, exercises in self-stimulation and relaxation, and couple’s therapy.

*Instances of situational FOD are partner or situation specific. Women with situational FOD may be able to achieve orgasm through self-stimulation or with a different partner.


If you believe you have an orgasmic disorder, or would like more information about orgasmic disorders and the options for treatment, schedule an appointment with one of our healthcare providers in Grand Rapids, MI.

GENDER NON-CONFORMANCE

What is Gender Non-Conformance?

While for some biological sex and gender identity match, this is not the case for everyone in all situations. Gender non-conformance or gender non-conformity is characterized by behaving or appearing in a way that is considered atypical for one’s gender. There are large and small instances of gender non-conformance. For example, a female who wears facial hair or prefers gender neutral pronouns could be considered gender non-conforming, while so too could a female who prefers “men’s” clothes or dislikes traditionally “female” aspirations. Gender non-conformance is a mode of gender expression.

While some individuals lead happy, healthy lives in the sphere of gender non-conformity, many may experience societal or familial pressures that can make living their true gender identity confusing and, at times, painful. It is not uncommon for gender non-conforming individuals to experience depression, stress or anxiety. Fortunately, these issues can be worked through via psychological therapy and family counseling. Gender non-conformance is perfectly natural.

Gender Non-Conformance and Sexual Orientation

Some individuals may mistakenly equate gender expression to mean the same thing as sexual orientation. However, this is not the case. Gender non-conforming individuals, like their gender conforming counterparts, exist all along the sexual orientation spectrum as gender does not directly influence sexual preference.

HYPOACTIVE SEXUAL DESIRE DISORDER (HSDD)

What is Hypoactive Sexual Desire Disorder? 

Hypoactive Sexual Desire Disorder (HSDD) is denoted by a chronic lack of interest in sex or sexual activity. While it is normal for a woman’s interest in sex to fluctuate due to stress and other situational factors, HSDD is marked by an on-going lack of interest that causes emotional and mental stress in the woman experiencing it. While HSDD can be frustrating for you and your partner, you aren’t alone — Mayo Clinic cites that 40% of women experience HSDD at some point in their lives. HSDD is completely treatable.

What Causes HSDD? 

Like many sexual disorders, HSDD is caused by a number of interlacing physical, social and psychological factors. It is important to us at the Center for Women’s Sexual Health that we work closely with you, our patient, to unravel these various factors to both determine and treat the root causes of your HSDD. Below are some common causes of HSDD to start our conversation.

Physical Causes of HSDD:

  • Illnesses such as cancer, diabetes, arthritis, heart disease, or chronic fatigue syndrome
  • Side effects of prescription medications or drugs
  • Lowered libido due to menopause or changes in estrogen levels
  • Hormonal changes after pregnancy or postpartum depression

Psychological Causes of HSDD: 

  • Depression
  • Anxiety or stress issues
  • Relationship issues
  • Past sexual abuse, rape, incest or sexual trauma
  • Poor body image
  • Poor communication as to what kinds of sexual stimulation is preferred

Treatment for HSDD depends on the woman, though common treatments can include psychological therapy, lifestyle changes and hormonal therapies among other things. Your healthcare provider at the Center for Women’s Sexual Health will work with you to develop a treatment option personalized to your needs.

OVERACTIVE PELVIC FLOOR

What is the Pelvic Floor?

The pelvic floor is the hammock-like, muscular base of the abdomen that spans from the pubic bone at the front of the body to the coccyx at the back. It provides a shelf of support for your internal organs and also aids in urination and elimination through the contraction of the muscle.

When someone has an overactive pelvic floor, this muscular base finds itself contracting with unnecessary frequency and intensity. This can cause an extreme tightening of the vagina which makes sexual activity painful.

How is Overactive Pelvic Floor Disorder Treated?

There are a variety of physical therapies – such as vaginal dilator exercises – that can be practiced to relax these intense contractions of the pelvic floor. While all treatment options will first be discussed with your healthcare provider, patients may expect some form of physical therapy to be used.

PERSISTANT GENITAL AROUSAL DISORDER (PGAD)

What is Persistent Genital Arousal Disorder?

Persistent Genital Arousal Disorder (PGAD) is indicated by excessive, unwanted physical arousal without a desire for sexual activity. Symptoms of physical arousal can include increased blood flow and tingling in the genital area and increased production of vaginal secretions. Women with PGAD may experience symptoms of physical arousal for hours or days at a time despite a complete lack of mental or emotional arousal. The physical symptoms of PGAD often leave women feeling uncomfortable or embarrassed in everyday, public situations.

What Causes PGAD?

Although it is unclear as to what causes PGAD, stress and anxiety about recurrences of the condition may make it worse. Your healthcare provider at the Center for Women’s Sexual Health will work with you to discuss options for managing both the anxiety associated with PGAD as well as the physical symptoms. Some women find identifying PGAD triggers and entering support groups helpful for their on-going management of the condition.

RECURRENT VAGINITIS

An Introduction to Vaginitis:

An inflammation of the vagina, vaginitis is denoted by vaginal discharge, itching and pain. While vaginitis is frequently caused by a change in the normal balance of vaginal bacteria, lowered estrogen-levels after menopause have also been known to cause vaginal inflammation. There are 4 many types of vaginitis:

  1. Bacterial Vaginosis (BV) – BV is caused by an overgrowth of the normal bacteria found within the vagina. While there are no clear causes for BV, some factors have been known to make an occurrence of BV more likely. These include: sex with a new partner, sex with multiple partners and douching.
  2. Yeast Infections – A yeast infection is normally caused by an overgrowth of the naturally occurring fungus Candida albicans. Yeast infections are normally characterized by vaginal itching and soreness. A yeast infection may cause pain or a burning sensation during urination or sex. Additionally, some women have a thick, odorless white discharge that looks like cottage cheese.
  3. Trichomoniasis (Trich) – Trich is a commonly transmitted STD caused by the parasite Trichomonas vaginalis. It is important to note that 70% of those infected with Trich do not exhibit symptoms. However, for those who do show symptoms of the infection, symptoms can range from vaginal inflammation, itching, burning and redness of the genital area. Some women experience burning during urination and may experience an unusual smelling discharge that can be clear, white, yellowish or greenish. While Trich can cause serious complications if not treated, it can be cured with a single dose of a prescription antibiotic.
  4. Vaginal Atrophy (Atrophic Vaginitis) – Atrophic Vaginitis is an inflammation of the vagina caused by the thinning of internal vaginal tissue as a result of decreased estrogen levels. This is common in postmenopausal women.

What is Recurrent Vaginitis?

While the occasional occurrence of vaginitis is not uncommon in women of all ages, recurrent vaginitis is characterized by recurring or persistent vaginal inflammation that causes frequent discomfort.

How do I treat Recurrent Vaginitis?

In order to treat recurrent vaginitis, it is first necessary to determine the root cause of your vaginal inflammation. After this has been determined, your healthcare provider at the Center for Women’s Sexual Health will work with you to create a personally tailored treatment plan. Common treatments for Recurrent Vaginitis include: oral or vaginal antibiotics, lifestyle changes such as changes to diet or hygiene habits, and temporary sexual abstinence until the vaginal inflammation has been reduced.

SEXUALITY AFTER CANCER

A cancer diagnosis prompts many large, life-altering questions about treatment options, next steps, and survival. Yet, after months or even years focused purely on the question of surviving, gradually other more everyday questions of daily life begin to come back into focus. One of the most common and yet most difficult of these questions to ask is: What does sex and sexuality look like after cancer?

Many cancer survivors do not feel they have the right to ask about sex after their treatment is through. They think, “I survived, I should be grateful.” Yet, questions about sex are completely normal. In fact, the return of sexual desire after cancer is a natural indicator that the survivor is returning to a place of health. Here at the Center for Women’s Sexual Health, we work closely with cancer survivors to normalize questions about sexuality after cancer and to create a dialogue on how sex can function moving forward.

VAGINISMUS

What is Vaginismus?

Vaginismus is characterized by the involuntary contraction of the muscles around the vaginial opening. While women with vaginismus do become emotionally/mentally and physically aroused, they often find sexual intercourse extremely painful or even impossible due to the muscular contraction. Some women with vaginismus find themselves unable to insert a tampon due to the pain and discomfort associated with this disorder.

What causes vaginismus?

It is sometimes quite difficult to determine the root cause of vaginismus. As with many sexual disorders, some women develop vaginismus as the result of a variety of physiological and psychological factors. However, some women are unable to identify any cause at all. As such, it is crucial to keep the line of communication open with your healthcare provider when discussing vaginismus. In an effort to make the initial conversation more comfortable, we have listed a few common causes of vaginismus below:

Common Psychological Causes of Vaginismus:

  • Fear of pain
  • Fear of getting pregnant
  • Past sexual abuse, rape, incest or sexual trauma
  • Fear of rejection by partner
  • Body image issues
  • Relationship issues
  • Stress or anxiety issues
  • Depression
  • Guilt about sex and/or sexual pleasure
  • Religious or cultural beliefs about sex and/or sexual pleasure

Common Physiological Causes of Vaginismus:

  • Side effect of prescription medication or drugs
  • Inadequate foreplay
  • Inadequate lubrication due to lowered estrogen-levels
  • Injuries to the pelvis or pelvic area
  • Sexual assault including rape, incest or sexual trauma
  • Child-birth
  • Illnesses including cancer, endometriosis, pelvic inflammatory disease and more

Given the complex factors that may contribute to vaginismus, all treatment methods will be personally tailored to your unique needs. If is not uncommon for treatment methods to incorporate a mixture of talk therapy as well as at-home exercises and dilator therapy.