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Am Fam Physician. 2025;111(5):433-442

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Symptoms of female sexual dysfunction are common, affecting 40% to 50% of women. Most patients would like their physician to actively inquire about sexual dysfunction. When symptoms of female sexual dysfunction are chronic and cause the patient distress, they can be diagnosed as female sexual disorders. This clinical diagnosis is based on a thorough history and physical examination; understanding the patient’s symptoms and associated distress is essential. The condition is further categorized into disorders of sexual desire and arousal, orgasmic disorders, and genito-pelvic pain disorders. The Female Sexual Function Index and the Female Sexual Distress Scale–Revised are validated tools that can aid in diagnosis. Treatment should be directed to each patient’s symptoms and depends on the presence of comorbid medical or mental health conditions and any concerns discovered during the interview or physical examination. Evidence supports the use of vaginal lubricants and topical estrogen for genito-pelvic pain related to menopause, and pelvic floor physical therapy remains the first-line treatment for other genito-pelvic pain disorders. Cognitive behavior therapy is first-line treatment for disorders of sexual desire and arousal. Orgasmic disorders are treated with cognitive behavior therapy and sex therapy.

The prevalence of sexual dysfunction among women is high, estimated to be 40% to 50% regardless of age.1 When these symptoms are chronic and distressing, they can be described as female sexual disorders (FSD). Family physicians are well-equipped to assess and treat FSD2 by addressing commonly associated mental health conditions and physiologic life states, including social, cultural, and interpersonal factors.3,4 This article provides evidence-based answers to common questions about the evaluation and management of FSD in cisgender women and other people assigned female sex at birth. Information specific to managing FSD in transgender and gender-diverse groups is beyond the scope of this article.

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