According to the scientific literature, sexual dysfunction is more common among physically healthy women than among physically healthy men, with prevalence rates ranging from 25% to 60%. Among women with Type 2 diabetes, the prevalence is approximately 40%, while among women with Type 1 diabetes, it is around 70%.
Causes of Sexual Dysfunction in Women
As with sexual dysfunction in men, psychological factors and relationship conflicts should first be considered and ruled out.
A common physical cause is a lack of vaginal lubrication (lubrication disorder). Lubrication refers to the natural moistening of the vagina during sexual arousal. When lubrication is insufficient, sexual intercourse can become painful. The medical term for painful intercourse is dyspareunia.
Insufficient lubrication may lead to burning sensations or cramp-like pain in the genital area during intercourse, and orgasm is often not achieved. In addition to diabetes, estrogen deficiency during menopause can also reduce the production of vaginal lubrication.
When vaginal dryness is the problem, lubricants may be helpful. During menopause, hormone-containing creams or vaginal suppositories containing estriol are often used. These treatment options should be discussed beforehand with a gynecologist or family physician.
Libido During and After Menopause
Libido develops differently in different women during and after menopause.
For some women, interest in traditional sexual intercourse decreases. Some of these women prefer other forms of sexual stimulation and place greater value on affectionate physical intimacy with their partner.
Other women, however, feel more liberated in their sexuality after menopause. Menstruation has ceased, and concerns about contraception are no longer necessary.
Additional Causes of Sexual Dysfunction
Other causes of sexual dysfunction in women include:
Vaginal infections can contribute significantly to sexual problems. Fungal infections, for example, may be promoted by antibiotic use. Certain diabetes medications prescribed for people with Type 2 diabetes—particularly SGLT2 inhibitors—can also increase the risk of vaginal infections.
Vulvodynia
Apart from pain during intercourse caused by vaginal dryness, some women experience abnormal sensations in the vaginal and vulvar area, including:
These symptoms may occur without any visible physical changes. This condition is known as vulvodynia.
Because conventional pain medications are often ineffective for vulvodynia, other treatments may sometimes help, including:
Lubricants may also be worth trying.
Pelvic Floor Training
Pelvic floor exercises can sometimes provide relief and improve sexual function.
To learn these exercises properly, women should consult specially trained physiotherapists or midwives. Training usually begins with learning to identify and consciously contract the pelvic floor muscles. This is followed by guided exercises designed to strengthen the pelvic floor musculature.
One study confirmed that pelvic floor training can have a positive effect on a woman’s ability to achieve orgasm.