The causes of female sexual dysfunction are poorly defined. Many different factors can impair the sexual response cycle, which requires physical and psychological stimulation:

• Anxiety
• Alcohol
• Depression
• Emotional problems, distractions
• Nausea
• Negative body image
• Stress

Recently, controversy has produced two different medical perspective on the causes (and treatment) for female sexual dysfunction. A concept that is known as the vascular theory, that diminished blood flow to the pelvic region, because of various health conditions, age, stress, or hypoactive sexual desire, which reduces sensitivity (especially the clitoris) and dry, and impairs arousal. Decreased blood flow associated with medical conditions such as diabetes and atherosclerosis. This concept has fuelled clinical studies and led to topical creams that cause vascular dilation, increased blood flow and vascular congestion associated with the excitement, when applied. Sensitivity increases and can cause arousal.

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Another concept is the hormone theory that focuses on decreased levels of sex hormones, such as oestrogen and testosterone, because of age. For some women, hormone therapy may lead to increased sexual desire. Oestrogen is the primary female hormone associated with sexual desire. Testosterone is the primary male sex hormone that plays a role in women’s sexual development and function, including the breasts and clitoris sensitivity. Some women experience a decrease in sexual desire, lack of sexual fantasies, and impaired sensitivity after menopause or hysterectomy because of decreased oestrogen levels.

Other medical causes include the following:

• Cycling (long narrow seats associated with perineal pressure and reduced blood flow)
• Drugs and medications; pill
• Smoking
• Spinal cord injury (can cause nerve damage; paralysis)
• Surgical (or near reproductive and urinary organs or abdomen, may damage the nerves)
• Urinary incontinence (can cause embarrassment: an avoidance behavior)
• Vaginal atrophy (slemhinneförtunning)

Antidepressants and bezodiazepiner are used to treat depression and anxiety are the drugs most commonly associated with sexual desire and inability to achieve orgasm. Buproprion (Wellbutrin, an antidepressant) is sometimes prescribed to those experiencing drug-related loss of sexual desire. Some evidence suggests that it restores libido. Chemotherapy drugs used to treat cancer are also associated with lack of sexual desire. Some evidence suggests that extended use of oral contraceptives leads to reduced libido. Spinal cord injury, pelvic trauma, and other conditions that affect the peripheral nervous system, such as diabetes, can weaken the genital sensitivity, as surgery involving the pelvic floor, bladder, abdomen, and genitals.

A third approach might be called the dissatisfaction theory, is neither psychological nor medical. A lot of women’s sexual dysfunction is not due to hormonal deficiency or diminished pelvic blood flow, but on insufficient genital stimulation. The fact that young, healthy women experience sexual dysfunction is evident. Poor communication from both parties can result in men not knowing how to stimulate a woman so that she gets excited. This leads to unsatisfactory sex and can cause arousal, loss of sexual interest, depression and aversion to sex.