This is also called female arousal disorder, it is characterized by minimal vaginal lubrication or no lubrication et all during sexual excitation along with absence of feeling of excitation. In one study many women complained of lack of sexual arousal so that they get very little lubrication & vagina does not relaxes so that sexual intercourse is painful. In population many women complain of difficulty in getting excited. Many of such women complain of absence of orgasm & sex may be even be painful. It can be from beginning of sexual life or may start later in life. In some arousal may be absent with one partner whereas it is normal with other partner.
Causes of Lack of enjoyment during intercourse
(1) Hormones Disorder:
Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia,
Ovarian Dysfunctions
Hypothyroidisms
Untreated endocrinopathies & Diabetics
Glucorticoids excess, Cushings disease, Addisons disease
2) Excess asthenia i.e. chronic asthenia is a also a significant cause of low sexual excitation & arousal.
3) chronic vulvo-vaginitis, and chronic urethritis.
4) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.
5) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics, anti-hypertensives, many other drugs.
6) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.
7) Any kind of sexual dysfunction in man leading to non-enjoyment of sexual act by female may lead to absent arousal & excitement.
8) Any cause of painful sexual intercourse (as due to vaginismus or dyspaerunia) will also lead to secondary loss of excitation in women whether married or unmarried.
9) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication, pain during intercourse
10.) Infections: In genital tract or vulvae vestibule, vulvo-vaginitis
11.) Less lubrication due to various reasons as hormone deficiency
12.) Connective tissue diseases leading to dryness
13.) Psychological problems: as depression & other psychiatry disorders
14.) Sicca syndrome
15.) Idiopathic
16.) Any ulcerative lesions of vagina as chronic lichen planus, herpese genitals, Pemphigus vulgaris of vagina
17.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication, pain during intercourse
18.) Vulvar vestibulitis
19.) Restrictive upbringing, Inadequate sexual information, early insecurity in psychosexual role.
20.) Obstructive vaginal lesions: Vaginal stenosis, vaginal scarring, post surgical problems, retroverted uterus, organic diseases of uterus, endometriosis, adenomyosis, tubes or ovaries, chronic pelvic inflammatory diseases, urethral diverticulum
21.) Idiopathic vulvodynia
Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the desire of sex. Sex center has some well-defined portion, which control different component of normal sexuality These are as follows as one part of sex center controls sexual desire other parts controls excitation i.e. lubrication in response to sexual excitation, time taken in orgasm & enjoyment of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to less excitation in response to sexual stimuli. This occurs due to arousal & excitation-controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient does not gets sexually excited. Beside absent excitation patient may be sexually otherwise be fit or may be suffering with some other sexual disorder.
The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of absent excitation. If the absent excitation & arousal is due to immediate causes, a removal of these factors results in adequate excitation & lubrication & enjoyment by women. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.
DIAGNOSIS OF CAUSE
First step in proper treatment of absence of sexual excitation & arousal is accurate diagnosis of cause of her absence of sexual excitation & arousal. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.
DETAILED HISTORY
Onset: We take detailed history, as for duration of absence of sexual excitation & arousal whether it is from the beginning or of recent onset, whether it is mild, moderate or severe. Then we decide whether it occurs all the time or only occasionally. How is the response of previous treatment? Response to previous therapy, pain during sex, Stress (physical or mental), History of precipitation by some drugs any past history of sexual abuse or painful sex.
EXAMINATION OF GENITALS
We examine whether any Sexual Development defect is present or not. The vagina is examined for some local problem. If the vaginal examination is very painful with accompanied spasm is proof of the some local cause. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of vagina is assessed by, palpating texture of vaginal wall. Nerves supplying the female genitals examined by sensation testing & Deep Tendon reflexes.
Then other systems of body are also examined.
Diagnostic Tests:At our centre we have all the facility for complete investigation of cause of absence of sexual excitation & arousal & other difficulties. So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -
Complete sex hormones profile as Estradiol, SHBG etc.
1.Thyroids test
2.Serum prolactins
3.Androgen levels
4.Investigation for systemic diseases
5.Other tests which may be required depending on likelihood of the any of above causes.
6.Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, talking in detail resulting in detection of primary cause leading to absence of sexual excitation & arousal.
7.In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of absence of sexual excitation & arousal confirmed.
Treatment : After the diagnosis of cause of absence of sexual excitation & arousal is made, treatment includes medicines to cure the basic cause.
Understanding of Lack of Enjoyment During Intercourse by Modern Medicine fails to impress most patients. Only AYURVEDIC MEDICINES HAVE PERMANENT CURE FOR Lack of Enjoyment During Intercourse.WE AT Dr.S.K.Jain’s Burlington Clinic (P) Ltd Lucknow in valueable guidance of Dr.Saransh Jain Have Permanent Cure.
Response of Treatment : When treated is started after the diagnosis of cause. After appropriate drug therapy, sex education & sex therapy patient recover in maximum two months time. The sexual excitation & arousal of patient recovers. After return of libido to normal her family relationship also normalizes.