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Type
Factor
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
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)
Situational factors
Cultural background that restricts sexual expression or activity
Distractions
Relationship problems
Surroundings that are not conducive to sexual activity
Physical factors
Abnormalities in genital organs (such as scarring after surgery or radiation therapy)
Atrophic vaginitis (thinning of tissues of the vagina)
Changes in the skin around the opening of the vagina area (such as lichen sclerosus)
Infections of the genital area (such as genital herpes) or of the vagina
Fatigue
Hyperprolactinemia (high levels of prolactin, a hormone produced by the pituitary gland)
Poor health
Surgical removal of both ovaries in premenopausal women
Thyroid disorders
Some nerve disorders, such as multiple sclerosis
Drugs
Alcohol
Anticonvulsants
Beta-blockers (used to treat hypertension or heart disorders)
Certain antidepressants, particularly selective serotonin reuptake inhibitors
Opioids