General Management of Female Sexual Dysfunction for Urologists

Female sexual dysfunctions are grouped into desire, arousal, orgasmic, and sexual pain disorders according to international classification systems. The disorders frequently overlap and coexist, and the pathogenesis is in most cases due to an interaction of biological (body), psychological (mind), and sociocultural (environment) factors. Typical medical conditions are hormonal changes, depression, and drug treatment. Urological problems having a negative impact are incontinence, prolapse, and overactive bladder. Frequent psychological factors are lack of knowledge about the body, traumatic or negative experiences, and performance anxiety. Relationship factors include conflicts and difficulties in communication. The prevalence of the disorders varies over age groups. In adolescents, pain and orgasmic disorders are predominant, and later in life, arousal difficulties may arise accompanied by low desire. Based on the biopsychosocial concept, therapies frequently include concomitant medical and psychotherapeutic interventions in a multidisciplinary approach.