A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the individual or couple from experiencing satisfaction from the sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
The medical history should address the following:
The female sexual response is mediated primarily via spinal cord reflexes under the tonic descending inhibitory control of the brainstem. Afferent signals from clitoral stimulation are transmitted via the pudendal nerve. Signals from vaginal stimulation are transmitted via the pelvic nerve alongside the pudendal and hypogastric nerves.
The Global Study of Sexual Attitudes and Behaviors (GSSAB) found that for women aged 40-80 years, decreased libido and inability to achieve orgasm were the most common types of sexual dysfunction across world regions, with reported frequencies of 26-43% and 18-41%, respectively.