Sexual problems in women
Introduction
Sexual dysfunction in women encompasses a range of symptoms that can affect desire, arousal, lubrication, comfort or pleasure during intercourse. They can take the form of reduced desire, pain, blockage, apprehension or difficulty in reaching orgasm.
⚠️ These disorders are not solely psychological: they may be linked to hormonal, anatomical, urinary, hormonal or emotional causes, or to certain pelvic pathologies.
📌 A medical and functional assessment can determine the origin of the problem and propose a comprehensive treatment plan.
Symptoms and clinical forms
Here are the symptoms most frequently reported in female sexual disorders:
1️⃣ Decreased sexual desire
- Loss of interest or lasting drop in libido
- Difficulty feeling the urge, even in favorable conditions
- Fatigue, stress or associated pain
2️⃣ Pain during intercourse (dyspareunia)
- Sensations of burning, tension or tightness
- Pain on entry or deeper
- Possible link with irritation, hormonal disorder, prolapse or excessive contraction of the perineum
3️⃣ Vaginal dryness
- Insufficient lubrication, impeded penetration
- More frequent following childbirth or hormonal changes
- Source of micro-lesions and discomfort
4️⃣ Difficulty reaching orgasm (anorgasmia)
- Rare or absent orgasms despite stimulation
- Sometimes linked to muscular, nervous or psychological disorders
- May be secondary to pain or apprehension
5️⃣ Involuntary contraction or blocking of the perineum (vaginismus)
- Reflexive or involuntary tension of the perineal muscles
- Discomfort or inability to have penetrative intercourse
- Often associated with previous apprehension or pain
📌 These symptoms can be isolated or associated, making a comprehensive and caring assessment necessary.
Possible causes
Female sexual disorders can have several origins:
1️⃣ Medical or hormonal causes
- Hormonal variations (post-partum, breastfeeding, perimenopause)
- Dryness due to low estrogen levels
- Drug treatments (antidepressants, antihypertensives, etc.)
2️⃣ Urogynecological causes
- Repeated urinary or vaginal infections
- Post-delivery or post-surgery scars
- Genital prolapse
- Pelvic pathologies (endometriosis, chronic pain)
3️⃣ Muscular or neurological causes
- Pelvic floor hypertonia
- Local sensitivity disorders
- Nerve irritation (pudendal...)
4️⃣ Psychological or relational causes
- Stress, fear of pain, anxiety
- Reduced self-confidence
- Tensions in the relationship
- Trauma history
📌 In the majority of cases, disorders are multifactorial, hence the importance of a global assessment.
Diagnosis
Care begins with a detailed assessment in a caring and confidential environment:
1️⃣ Medical maintenance
- Nature and duration of symptoms
- Emotional context
- Triggering factors
- Gynaecological and obstetrical history Impact on quality of life
2️⃣ Physical examination
- Perineum assessment
- Search for dryness, irritation or localized pain
- Checking for infection or inflammation
3️⃣ Further examination
- Samples in case of suspected infection
- Pelvic ultrasound if deep pain
- Hormonal evaluation if dryness or reduced desire
- Urological check-up if associated urinary symptoms
4️⃣ Perineal assessment
- Tone, relaxation, contractility
- Detection of vaginismus or hypertonia
Possible treatments
Treatment depends on the cause identified and follows a global approach:
1️⃣ Medical solutions
- Local hormone treatments
- Vaginal lubricants or moisturizers
- Treatment of infections or inflammation
2️⃣ Perineum rehabilitation
- Release or strengthening work
- Manual or probe therapy as indicated
- Learning muscle control
3️⃣ Pain management
- Perineal relaxation
- Body therapies
- Managing pelvic tension
3️⃣ Pain management
- Accompaniment by a sexologist if necessary
- Work on anxiety, self-confidence or body experience
- Relational approach if required
5️⃣ Specialized medical procedures
- Prolapse treatment
- Surgery for pelvic pathology
- Integrated urogynecological management
📌 The aim is to improve comfort, confidence and the quality of intimate life.
Why consult Pr Haab?
- Prof. François Haab is a specialist in functional urology and pelvic-perineal disorders. I
- He takes a holistic approach: medical, functional, perineal and psychosexual.
- It favors progressive, non-invasive solutions tailored to each patient.
- Kind support can help restore a comfortable, serene sexuality.
Do you have intimate problems?
Requirements
Patient pathway
Each patient benefits from personalized support, from the first consultation to post-treatment follow-up. This includes a precise assessment, a clear presentation of the different treatment options and a progressive approach to treatment, tailored to each patient’s individual situation.
Do you have sexual difficulties?
Don’t be alone in the face of these problems: appropriate treatment can very often improve the situation.
📍 Cabinet Urologie Paris Opéra – Paris 17ᵉ
📅 Face-to-face or teleconsultation consultation
📞 Book an appointment today