For a female emotional, mental and spiritual health is more important than physical sexual health.Physical health is important for the achievement of good healthy sex.Many women have sexual disorders at some time in their life.Common Sexual Disorders1. Sexual interest/arousal disorderThis is defined as reduced or absent sexual interest, responsiveness, erotic thoughts and sexual pleasure.2. Female orgasmic disorder (absence, infrequency, reduction, delay of orgasm):Lifelong anorgasmia may suggest unfamiliarity or discomfort with self-stimulation or sexual communication with her partner.Delayed or less intense orgasms may be a natural process of ageing, due to decreased genital blood flow, atrophy and reduction in sensitivity.3. Genito-pelvic pain/penetration disorder (problem in vaginal penetration, marked vulvovaginal or pelvic pain during penetration, fear or anxiety about pain in anticipation of, during, or after penetration, and tightening or tensing of pelvic floor muscles during attempted penetration):Genito-pelvic pain/penetration disorder involves fear or anxiety, marked tightening or tensing of the abdominal and pelvic muscles, or actual pain associated with attempts toward vaginal penetration that is persistent or recurrent for at least six months.Causes:1.Getting older:A woman's sex drive often decreases with age.2.Perimenopause and menopause:A woman has less estrogen as she gets older.3.Illnesses such as cancer and infections can cause problems with sex.4.Some medicines:Medicine for blood pressure, depression, and chemotherapy can decrease the sex drive or make it hard to have an orgasm.5.Stress and anxiety6.Depression7.Relationship problems with the partner8.Having been sexually abused in the past9.Cigarette smokingDiagnosis:The doctor will:1. Do a physical exam, including a pelvic exam.2. Ask the woman about her relationships, present sexual practices, attitude towards sex, other medical problems she might have, medicines she is taking, and other possible symptoms.A gynecological exam is always advised and should focus on:1.Any changes or abnormalities in vulvar anatomy2.Signs of inflammation3.Skin color and quality4.Appearance of vaginal mucosa (estrogenized and moistened or atrophic)5.Signs of myogenic or referred pain or linked urogenital and rectal pain6.Inspection of pelvic floor trophism, muscular tone and strength7.Scarring8.Determination of pH9.Sampling and culture of dischargeLaboratory Tests1.Testosterone status2.Plasma levels of estrogens3.Prolactin levels4.Thyroid-stimulating hormoneTreatmentThe patient should get treatment for any other medical disorders.This may help with disorders with sex.The doctor may be able to change or stop a medicineHormonal treatment options are:1.Topical or systemic estrogen therapy2.Tibolone3.Topical vaginal dehydroepiandrosterone4.Testesterone for arousal5.Flibanserin is used as treatment for low sexual desire6.Selective serotonin reuptake inhibitors antidepressant are useful for depression and stimulating sexual self esteem5.Oral estrogen for vaginal lubrication and muscle tone6.Sildenafil (Viagra), may prove advantageous for some women who have sexual dysfunctionNon-medical Treatment1.Vaginal lubricants/moistures2.EROS-CTD devicePsychological TreatmentSexual therapyMindfulnessRelationship therapyCognitive Behavior therapyCommunicationOthers:Antibiotics for infectionMinimizing painWarm bath before intercourseLove and intimacy is important than the physical act of sexTABLE OF CONTENTIntroductionChapter 1 Woman Sexual DisordersChapter 2 Female Sexual DysfunctionChapter 3 VulvovaginitisChapter 4 Vaginal AtrophyChapter 5 VaginismusChapter 6 DyspareuniaChapter 7 Female Orgasmic DisorderChapter 8 Sexual AbuseEpilogue