Merck Manual

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What Affects Sexual Function in Women?

What Affects Sexual Function in Women?



Psychologic factors

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



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 infections)

Situational factors

A low sexual self-image, as may result from having fertility problems or having had surgery to remove a breast, the uterus, or another body part associated with sex

Cultural background that restricts sexual expression or activity

Distractions or emotional stress

Relationship problems

Surroundings that are not conducive to sexual activity

Physical factors

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


Genital mutilation

Genitourinary syndrome of menopause Symptoms after menopause Symptoms after menopause (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)


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

Poor health

Surgical removal of both ovaries in premenopausal women




Gonadotropin-releasing hormone agonists (used to treat infertility)