Female Sexual Dysfunction

Lawrence S. Hakim and Giovanna M. DaSilva

Sexual dysfunction is a couple's disease, and is common in both women and men. With the introduction of effective oral therapies for the treatment of erectile dysfunction (ED) in men, increased media attention has brought "female sexual dysfunction" (FSD) into the limelight. Epi-demiologic studies have demonstrated that whereas more than 50% of men aged 40 to 70 years have sexual dysfunction, this problem may in fact be even more prevalent in women. Whereas psychological and interpersonal relationship issues had been thought to be the primary causative factors of FSD, we are now learning that, similar to sexual dysfunction in men, FSD can often be attributed, at least in part, to pathophysiologic changes, such as chronic disease states, aging, and medications, as well as other physical factors, such as pelvic and colorectal surgeries. In addition, FSD has been shown to respond to treatment of the underlying condition and to other specific therapies. In this chapter, we will look at the various classifications, causative factors, diagnostic evaluations, and therapeutic alternatives for women with sexual dysfunction, with a special emphasis on the impact of pelvic floor disorders and col-orectal surgery (CRS) on FSD.

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