Biological factors

Biological factors that can negatively affect female sexual function include:

DECLINING HORMONE LEVELS

• Declining oestrogen and androgen levels.
• It has been proposed that oestrogen and androgens stimulate sexual desire through dopaminergic pathways.
• Following surgical menopause, loss of libido can be more prominent.
• Women with premature ovarian insufficiency have a 2.8-fold increased risk of sexual dysfunction.

MENOPAUSAL SYMPTOMS

• Menopausal symptoms including poor sleep, mood changes and hot flushes can negatively affect libido.
• The vulvovaginal and urinary symptoms caused by loss of oestrogen can cause dyspareunia, altered arousal, reduced lubrication, urinary infections and detrimental effects on partner intimacy.

HEALTH CONDITIONS AND MEDICATIONS

• Cancer. All primary modalities of cancer treatment (surgery, radiotherapy, chemotherapy and hormone therapy) have the potential to alter sexual function.
• Cardiometabolic disorders.
• Gynaecological or urological conditions.
• Neurological disorders.
• Diabetes or thyroid disorders.
• Psychiatric disorders.
• Complications from female genital mutilation.
• Prescribable medications, examples include oral oestrogen treatments (elevates SHBG levels), SSRIs, SNRIs, some antipsychotic medications and some antihypertensives.

Other causes exist beyond the scope of this list.