Psychologic factors

Abuse (emotional, physical, or sexual) during childhood or adolescence

Anxiety

Depression

Fear of intimacy

Fear of losing control

Fear of losing the partner

High self-expectations

Low self-esteem

Worry about inability to have an orgasm or about sexual performance in a partner

Worry about unwanted consequences of sex (such as unwanted pregnancy or sexually transmitted diseases)

Physical factors

Abnormalities in genital organs (such as birth defects or scarring after surgery or radiation therapy)

Breastfeeding

Changes in the skin around the opening of the vagina area (such as lichen sclerosus Lichen Sclerosus Lichen sclerosus is a disorder that tends to cause itching and can cause scarring in the area around the anus and genitals. The cause of lichen sclerosis is unknown, but it may involve the immune... read more )

Genital mutilation

Genitourinary syndrome of menopause Menopause is the permanent end of menstrual periods and thus of fertility. For up to several years before and just after menopause, estrogen levels fluctuate widely, periods become irregular... read more (changes in the vagina and urinary tract that can occur at menopause, including thinning of tissues of the vagina and a compelling need to urinate)

High blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more

Infections of the genital area (such as genital herpes Genital Herpes Genital herpes is a sexually transmitted infection caused by the herpes simplex virus that causes recurring episodes of small, painful, fluid-filled blisters on and around the genitals. This... read more ) or infections of the vagina Overview of Vaginal Infections In the United States, vaginal infections are one of the most common reasons women see their doctor, accounting for millions of visits each year. Vaginal infections are caused by microorganisms... read more

Fatigue

Hyperprolactinemia (high levels of prolactin, a hormone produced by the pituitary gland)

Nerve damage (as may result from diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Urination and thirst are... read more , multiple sclerosis Multiple Sclerosis (MS) In multiple sclerosis, patches of myelin (the substance that covers most nerve fibers) and underlying nerve fibers in the brain, optic nerves, and spinal cord are damaged or destroyed. The cause... read more , peripheral neuropathy Overview of the Peripheral Nervous System The peripheral nervous system refers to the parts of the nervous system that are outside the central nervous system, that is, those outside the brain and spinal cord. Thus, the peripheral nervous... read more , or spinal cord disorders Overview of Spinal Cord Disorders Spinal cord disorders can cause permanent severe problems, such as paralysis or impaired bladder and bowel control (urinary incontinence and fecal incontinence). Sometimes these problems can... read more )

Pelvic organ prolapse Pelvic Organ Prolapse (POP) Pelvic organ prolapse involve a dropping down (prolapse) of the bladder, urethra, small intestine, rectum, uterus, or vagina caused by weakness of or injury to the ligaments, connective tissue... read more (dropping down of a pelvic organ such as the vagina or uterus)

Poor health

Premature menopause Premature Menopause Premature menopause is the permanent end of menstrual periods before age 40. It occurs because the ovaries no longer release eggs (ovulation) regularly and become less able to produce hormones... read more (ovarian insufficiency)

Sexually transmitted diseases Overview of Sexually Transmitted Diseases (STDs) Sexually transmitted (venereal) diseases are infections that are typically, but not exclusively, passed from person to person through sexual contact. Sexually transmitted diseases may be caused... read more

Some brain and spinal cord disorders, such as multiple sclerosis Multiple Sclerosis (MS) In multiple sclerosis, patches of myelin (the substance that covers most nerve fibers) and underlying nerve fibers in the brain, optic nerves, and spinal cord are damaged or destroyed. The cause... read more

Substance use disorder Substance Use Disorders Substance use disorders generally involve behavior patterns in which people continue to use a substance despite having problems caused by its use. The substances involved tend to be members... read more (continuing to use a substance despite having problems caused by its use)

Surgical removal of both ovaries in premenopausal women

Thyroid disorders Overview of the Thyroid Gland The thyroid is a small gland, measuring about 2 inches (5 centimeters) across, that lies just under the skin below the Adam’s apple in the neck. The two halves (lobes) of the gland are connected... read more

Urinary incontinence Types of Incontinence Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women... read more