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Female Sexual Dysfunction
Female sexual dysfunction (FSD) is a multifactorial disorder or sexual dysfunction that results in personal distress affecting a women’s quality of life and interpersonal relationships.
  • FSD can encompass disorders of desire (lacking interest for sex, low libido), arousal and orgasm (inability to reach or maintain sexual excitation) and can involve sexual pain (painful intercourse, dysparunia, vaginismus).
  • FSD affects 43% of women 18-59 years old and as many as 80% of postmenopausal women.

  • Low libido has been reported as the most common problem associated with FSD (51%) followed by arousal and pain disorders.

  • Etiology of FSD includes biological (medical problems, medications including antidepressants, hormonal factors, surgery), psychological (depression, anxiety, relationship problems, sexual assault, trauma, childhood sexual abuse) and social factors.


Hormonal Treatment for decreased libido
Lab work fractionated estrogens (estradiol, estrone), Progesterone, Free and total Testosterone, DHEA_S, Morning cortisol, TSH

Your lab work will be reviewed and recommendations will be given for hormone treatment, if necessary. Hormonal therapy is controversial and constantly changing.
Non-hormonal Treatment

With any over the counter preparations, care must be taken because rigorous scientific studies have not been done to determine their efficacy, adverse effects and interactions with other medications.

  • Zestra – a non prescription topical agent to improve sexual satisfaction, it is applied before sexual activity to the mons and hair bearing labia, avoiding the introital area. It is not to be used as a vaginal lubricant.
  • Replens, KY Jelly – a non-prescription product for vaginal lubrication
  • L-arginine – a non-prescription topical or oral product to promote vaginal and clitoral vasodilation and smooth muscle relaxation
  • Avlimil – also available over the counter, is a once daily non-hormonal tablet to improve arousal and desire


Sex Therapists
Dr.  Ken DeSeve and Julie Stevens
104 S Freya Street Suite 210 A
Tapio Center/Orange Bldg
Spokane, WA
Stephanie Kuffel
1500 4th Ave
Spokane, WA



Handbook of Sexual Dysfunction (2005, Barlon) – Most comprehensive
Beyond Viagra (1999, Newman)
When Sex Isn’t Good: Stories of Women with Sexual Dysfunction (2007, Goldstein & Arleque)
Sex Starved Wife (2008, Davis) – Addresses issues with sexually inactive husbands
Seven Weeks to Better Sex (2003, Domeena Renshaw)


Sex Therapy is a commitment and both partners must be willing to set aside time for it. Your relationship is what you are trying to improve. There can be an 80% success rate with counseling.