Marital sexual dysfunction: female dysfunctions.

The diagnosis, treatment, and referral of married women with sexual dysfunctions require information about the current physiologic deficit, previous sexual capacity, level of sexual desire, masturbatory experience, means of orgasmic attainment, preferred sexual partner, quality of marriage, husband's sexual capacities, and method of contraception. For classification purposes, the three basic physiologic deficits--excitement phase dysfunction, orgasmic phase dysfunction, and vaginismus--are subdivided into primary and secondary types. Primary dysfunctions represent longstanding developmental problems and are usually purely psychological in origin. Secondary dysfunctions occur after a period of normal sexual functioning and may be organic or psychological in origin. The actual determinants of dysfunctions are not well understood, but those factors commonly associated are discussed. The lack of knowledge about the nature of sexual desire, prevalence of dysfunctions, and significance of the inability to attain orgasm with coitus is emphasized. The physician's role in giving advice and treatment is defined.