Frigidity is a sexual dysfunction that manifests itself in the complete absence or decrease of sexual desire (libido), arousal during intimacy and orgasm. In addition to the loss of interest in sex and dissatisfaction with sexual life, patients may complain of pain during or after sexual contact. In the diagnosis of the disorder, a thorough history collection, gynecological examination, ultrasound, hormonal background research and consultations of related specialists play an important role. The treatment is complex with the correction of concomitant diseases, the appointment of hormones, vasoactive drugs, psychotherapy and physiotherapy.
Frigidity (sexual coldness, hypolibidemia) is one of the most common female sexual disorders. According to the results of various studies, the violation is detected in 25-63% of all women and in every second patient who goes to a sexologist. More often, the absence or decrease in intimate attraction is noted in girls and young women under the age of 25. As sensuality matures and positive sexual experience is obtained, there is an increase in libido and an increase in satisfaction with sexual life. Unlike men, the desire for intimacy in women largely depends on the quality of interpersonal relationships and other psychological factors.
Sexual coldness in women is a polyetiological dysfunction that usually occurs with the combined action of several predisposing factors. Experts in the field of female sexopathology distinguish several groups of causes that lead to frigidity:
- Hormonal imbalance. Libido disappears or decreases with increased secretion of prolactin by the pituitary gland, violation of the endocrine function of the ovaries with hypoestrogenemia and a change in the ratio between different groups of sex hormones.
- Concomitant diseases. Temporary or permanent weakening of sexual desire is observed against the background of diabetes mellitus, hypo- and hyperthyroidism, hypertension, angina pectoris, kidney failure, polyarthritis, autoimmune diseases, multiple sclerosis, oncopathology and other serious diseases.
- Diseases of the uterus and appendages. The occurrence of pain during sex with adnexitis, salpingitis, vulvitis, submucous and subserous fibroids, vaginal dryness in postmenopause provokes a partial or complete absence of intimate attraction.
- Taking medications. Treatment with certain antihypertensive and antihistamines, antidepressants, neuroleptics, sedatives, alcohol, amphetamines and other drugs leads to a decrease in libido.
- Violation of the development of the sexual sphere. Frigidity occurs with a delay in the maturation of sexuality in young girls, anatomical defects of the female genital organs associated with underdevelopment or insufficient innervation of the pelvic floor muscles.
- Psychological problems. Sexual desire is completely absent or significantly decreases after severe psychotrauma, including rape or infidelity, against the background of chronic fatigue, conflict relationships with a partner, etc.
When specifying the form, type and severity of dysfunction, a number of factors are taken into account. Currently, a classification of frigidity according to several criteria is proposed.
By the time of occurrence:
- Primary – sexual desire has never arisen in a woman in her life.
- Secondary – dysfunction manifested in a patient who had previously led a normal intimate life.
- Irreversible (organic, true) – causes have been found that cannot be eliminated by modern methods.
- Reversible (functional, temporary) – sexual desire can be restored after eliminating the causes that caused it.
For reasons of formation:
- Symptomatic – temporary dysfunction that occurred against the background of other diseases.
- Constitutional is an innate underdevelopment of female sexuality.
- Retardation is the belated formation of sexual function.
- Psychogenic – decrease or absence of libido under the influence of psychological factors.
- Abstinent – formed against the background of prolonged abstinence.
According to the degree of severity:
- I – the presence of some dissatisfaction with intimate life with preserved sexual needs and the absence of orgasms in most sexual acts.
- II – lack of orgasms in all sexual acts, dissatisfaction with sexual life, lack or low level of need for intimacy.
- III – complete lack of libido with aversion to the partner.
- IV – persistent anorgasmia, complete lack of sexual desire, aversion to both a permanent partner and all men.
Symptoms of frigidity
Patients note that their attraction to a partner occurs extremely rarely or does not appear at all. Often patients lack fantasies and thoughts about sex, which would be accompanied by arousal. Frigid women are not interested or annoyed by conversations on sexual topics. At the initiative of a man, patients with hypolibidemia enter into intimacy, but at the same time they usually perceive sex as a duty (“marital duty”). In most cases, at the moment of intimacy, they cannot get excited – specific pleasant sensations in the genital area do not arise, vaginal lubrication is released in insufficient quantities. Sexual acts and masturbation are completed without orgasm, subjective feelings of satisfaction and relaxation. Since in some cases the cause of frigidity is gynecological diseases, women during or after sex may experience pain in the lower abdomen, vagina, rectum.
With a prolonged course and emotional attitude of a woman to the dysfunction that has arisen, frigidity is complicated by psychological disorders – a decrease in self-esteem, irritability, subjectively perceived deterioration in the quality of life, neurotic and depressive states. Organic disorders are rarely observed, although according to the observations of specialists in the field of gynecology, low sexual activity is one of the predisposing factors in the development of a number of diseases of the female genital sphere. Suppression of libido can provoke disharmonious relationships in a marriage and lead to its disintegration.
When making a diagnosis of frigidity, careful collection of anamnestic information plays an important role – determining the degree and duration of libido decline, orgasmic function disorders, identifying situations and factors that provoked the development of sexual dysfunction. Of the physical, laboratory and instrumental methods, the most informative are:
- Consultation of a gynecologist. During a bimanual examination and examination in mirrors, signs of gynecological diseases accompanied by a violation of attraction may be revealed.
- Ultrasound of the uterus and appendages. Ultrasound examination of the pelvic organs allows you to confirm or exclude gynecological pathology that led to the development of frigidity.
- The study of hormone levels. To assess the influence of neurohumoral factors, the content of estradiol, progesterone, testosterone, prolactin, adrenal and thyroid hormones is evaluated.
Differential diagnosis of sexual coldness is carried out with other types of sexual dysfunctions (anorgasmia, sexual aversion or anhedonia, etc.), neuroses (hysteria, neurasthenia, anxiety-phobic disorder). In order to clarify the diagnosis and determine the causes of symptomatic suppression of sexual desire, in addition to a gynecologist, a sex therapist, a urologist, a therapist, an endocrinologist, a neurologist, a psychologist, a psychiatrist can be involved in diagnostic measures.
Treatment of frigidity
Therapy of sexual coldness is aimed at eliminating the causes that caused the dysfunction. Depending on the etiology of frigidity , it may be recommended for its treatment:
- Therapy of the underlying disease. Improvement of well-being and reduction of clinical manifestations of the disease or condition, against which libido was disturbed, is accompanied by the restoration of sexual desire.
- Correction of drug therapy. If the patient takes medications that can affect libido, their replacement or cancellation is carried out.
- Estrogens. They are effective for dysfunction that has arisen against the background of pathological or age-related hypoestrogenemia. In the absence of contraindications, estrogens are prescribed in the form of skin patches, vaginal creams, tablets, rings, etc.
- Androgens. To enhance intimate attraction, male sex hormones can be used, which stimulate the areas of the brain responsible for arousal.
- Vasoactive drugs. In the course of randomized trials, the effectiveness of the treatment of patients with frigidity with drugs based on sildenafil, which are used in the therapy of erectile dysfunction in men, has been proven.
- Sedatives and antidepressants. Medications may be prescribed to reduce or eliminate emotional tension, anxiety, and improve mood.
Since psychogenic factors lead to libido suppression in more than half of cases, working with a psychologist or psychotherapist makes it possible to harmonize relationships, eliminate stressful or conflict situations or change the reaction to them. In the complex therapy of frigidity, exercise therapy is also used (exercises to strengthen the pelvic floor muscles are shown), mud procedures, sedentary baths, vaginal irrigation and other physiotherapy techniques that enhance blood flow to the genitals, aromatherapy, stimulating dietary supplements, auto-training, stimulation of erogenous zones and meditative techniques.
Prognosis and prevention
The prognosis is favorable. In 93-95% of cases, complex therapy of sexual dysfunction allows to restore or increase sexual desire, only in 5-7% of women with true frigidity, treatment is ineffective. For the prevention of sexual coldness, a healthy lifestyle with sufficient physical activity, a rational work and rest regime, a balanced diet, timely treatment of diseases that reduce libido, reasonable prescription of medications, calm and quick resolution of problems in interpersonal and working relationships is recommended.