Female Sexual Dysfunction: Assessment and Treatment

Heather Dahlen, BSN, RN


Urol Nurs. 2019;39(1):39-46. 

In This Article

Abstract and Introduction


Approximately 40% of women experience some type of sexual problem over their lifetimes (Kingsberg & Woodard, 2015). Female sexual dysfunction (FSD) affects almost half of the women in the United States, yet is underdiagnosed and undertreated. This article examines female sexuality from a historical perspective, the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) terminology, and the assessment and treatment of FSD. Since women with urogenital signs and symptoms seek urological services, it is essential for urologic nurses and associates to familiarize themselves with how to empower women with FSD.


Female sexual dysfunction (FSD) is broadly defined as the various ways in which a female is unable to participate in a sexual relationship as she wishes. "Sexual response is a psychosomatic process, and both psychological and somatic processes are usually involved in the causation of sexual dysfunction" (World Health Organization, 2004, p. F52). FSD, a growing problem over decades, negatively affects self-esteem, well-being, and quality of life among women and their partners. FSD has prevalence ranging from 38% to 63% (Jaafarpour, Khani, Khajavikhan, & Suhrabi, 2013), and for women 65 to 79 years old, is as high as 88% with higher rates noted among partnered versus unpartnered women (23.7% vs 5.9%) (Zeleke, Bell, Billah, & Davis, 2017).

Normal sexual functioning is coordinated by the neurological, vascular, and endocrine systems. In addition to biological factors, religious beliefs, health status, personal experiences, ethnicity, and social-demographic conditions also play roles (Avasthi, Grover, & Rao, 2017). Affecting both the women's physiological and psychological wellness, FSD requires a detailed screening history and full physical examination (Dawson, Shah, Rinko, Veselis, & Whitmore, 2017). FSD is under-reported and undertreated, likely because clinicians lack the understanding about how to assess sexual function. A study of primary healthcare physicians found they frequently fail to diagnose and treat FSD or even discuss the issue with their patients (Wimberly, Hogben, Moore-Ruffin, Moore, & Fry-Johnson, 2006). Since women with FSD often have coexisting urologic signs and symptoms, it is essential that urologic practices have processes for assessing sexual function and providing treatment options, or establishing referral patterns for treatment.