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Female Sexual Dysfunction: Common Questions and Answers

Sarah N. Dalrymple, MD
Laura Hoeg, MD
Hannah Thacker, MD

American Family Physician. 2025;111(5):433-442.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

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.

SARAH N. DALRYMPLE, MD, is an assistant professor in the Department of Family Medicine at the University of Virginia, Charlottesville.

LAURA HOEG, MD, is an assistant professor in the Department of Family Medicine at the University of Virginia.

HANNAH THACKER, MD, is a family physician in Madison, Virginia.

Address correspondence to Sarah N. Dalrymple, MD, at sdalrymple@virginia.edu.

Author disclosure: No relevant financial relationships.

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