FEMALE sexual dysfunction can involve a decrease in sexual arousal or in rare cases, an increase in sexual responsiveness. Many physical and psychological factors can lead to sexual dysfunction in women. Physical causes can include certain medicines (such as oral contraceptives and chemotherapy drugs), diseases (such as diabetes or high *lo** pressure), excessive alcohol use or vaginal infections.

Psychological factors include depression, relationship problems, abuse (current or past abuse), and everyday stresses of life.

Some women may have less sexual desire during pregnancy, right after childbirth or when they are breastfeeding. It has also been shown that after menopause, many women feel less sexual desire, have vaginal dryness or have pain during intercourse. This is due to a decrease in oestrogen.

There are five major categories of decreased responsiveness and one of increased responsiveness (persistent genital arousal disorder):

1. Desire disorder: This occurs when women are not interested in having sex or have less sexual desire than they are used to. It is the absence of, or a decrease in sexual interest, desire and an absence of responsiveness.

2. Arousal disorder: This is when women don't feel a sexual response in their body or when they cannot stay sexually aroused. It is a lack of subjective or genital arousal or both.

3. Orgasmic disorder: This is when you can't have an orgasm despite high levels of stimulation, or you have pain during orgasm.

4. Vaginismus: This is reflexive tightening around the vagina when vaginal entry is attempted or completed. Gynaecologist Dr Errol Daley explained that approximately one in every 5,000 Jamaican women are affected by this disorder.

5. Dyspareunia: This is pain during attempted or completed vaginal penetration or intercourse.

6. Persistent genital arousal disorder: This involves excessive genital arousal.

Fortunately, these conditions can be treated with the help of therapy and support.

"[A problem like] vaginismus is treatable and requires that the therapist work with the woman and her partner where possible, to help overcome the psychological fears associated with intercourse. The process is a gradual one but results are usually rewarding and the couple can be helped to enjoy the benefits of a healthy and satisfying sex life," clinical sexologist Dr Karen Carpenter said.

Some women may not be distressed or bothered by decreased or absent sexual desire, interest, arousal, or orgasm, and so the situation is not a problem for them.