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Disfunção sexual em mulheres

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 21 Jul 2025
Last updated: 29 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • sintomas sexuais que causam sofrimento
  • interesse ausente/reduzido pela atividade sexual (TIES)
  • ausência/redução de pensamentos ou fantasias sexuais/eróticas (TIES)
  • ausência/redução de excitação/prazer sexual durante a atividade sexual (TIES)
  • ausência de excitação subjetiva por estímulos eróticos ou sexuais (TIES)
  • ausência/redução da consciência de sensações genitais ou não genitais durante a atividade sexual (TIES)
  • iniciação da atividade sexual ausente/reduzida (TIES)
  • ausência de orgasmo ou orgasmo de intensidade mínima (TOF)
  • atraso acentuado no orgasmo (TOF)
  • infrequência do orgasmo acentuada (TOF)
  • congestão genital espontânea, incômoda e desagradável e sentimento de orgasmo iminente (PGAD/GPD)
Full details

Other diagnostic factors

  • estressores atuais
  • emoções negativas durante o sexo
  • atrofia vulvovaginal
  • galactorreia
Full details

Risk factors

  • depressão
  • uso de antidepressivos
  • transtorno da ansiedade comórbida
  • aspectos psicológicos do câncer
  • câncer de mama
  • câncer ginecológico e outros cânceres pélvicos
  • doença neurológica
  • endometriose
  • hiperprolactinemia
  • histerectomia radical (sem preservação nervosa)
  • cistectomia ou proctectomia
  • fatores da personalidade e atitudes
  • dificuldades com relacionamentos
  • disfunção sexual do parceiro
  • atividade androgênica reduzida
  • deficiência de estrogênio
  • insuficiência ovariana prematura
  • pós-parto
  • envelhecimento
  • diabetes
  • insuficiência renal
  • doença cardiovascular
  • síndrome do ovário policístico (SOPC)
  • uso de medicamentos ou substâncias
  • doença do eixo hipotálamo-hipofisário
  • infertilidade
  • sintomas do trato urinário inferior (STUI)
  • condição socioeconômica
  • abuso sexual e trauma no desenvolvimento
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo
  • nível de glicose sérica
  • função renal
  • testes da função tireoidiana
  • nível de prolactina sérica
Full details

Treatment algorithm

ONGOING

transtorno do interesse/excitação sexual (TIES)

transtorno orgástico feminino (TOF)

disfunção sexual induzida por substância/medicamento

Contributors

Authors

Miriam Driscoll, MD, FRCP(C)

Clinical Assistant Professor

Department of Psychiatry

Associate Member Department of Obstetrics and Gynaecology

University of British Columbia

Physician

BC Center for Sexual Medicine

Vancouver Coastal Health Authority

Vancouver

Canada

Disclosures

MD declares that she has no competing interests.

Leah Rosetti, MD, FRCP(C)

Fellow

Department of Psychiatry

University of British Columbia

Physician

BC Centre for Sexual Medicine

Vancouver Coastal Health Authority

Vancouver

Canada

Disclosures

LR declares that she has no competing interests.

Acknowledgements

Dr Miriam Driscoll and Dr Leah Rosetti would like to gratefully acknowledge Dr Lori Brotto and Dr Rosemary Basson, previous contributors to this topic.

Disclosures

LB is an author or co-author of several references cited in this topic. RB is an author or co-author of several references cited in this topic. RB's department has received research funding from the Canadian Institutes of Health Research (CIHR).

Peer reviewers

Holly N. Thomas, MD, MS

Assistant Professor of Medicine

University of Pittsburgh

Pittsburgh

PA

Disclosures

HNT received a research award from the North American Menopause Society that was funded by AMAG Pharmaceuticals, who originally developed bremelanotide alongside Palatain Technologies.

Philip Kell, MBBS, FRCOG, FRCP

Consultant Physician

Archway Sexual Health Clinic

Whittington Hospital

London

UK

Disclosures

PK has undertaken research studies for Boehringer Ingelheim.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022.

Basson, R. The Circles of Sex: Basson’s Sex Response Cycle. In: Lykins, A. (ed) Encyclopedia of Sexuality and Gender. Cham: Springer; 2020:1-11.

Chivers ML, Brotto LA. Controversies of women’s sexual arousal and desire. Eur Psychol 2017;22(1):5-26.

Cappelletti M, Wallen K. Increasing women's sexual desire: The comparative effectiveness of estrogens and androgens. Horm Behav. 2016 Feb;78:178-93.Full text  Abstract

American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 213: female sexual dysfunction. Jul 2019 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Aversão sexual
    • Fatores interpessoais (por exemplo, discórdia no relacionamento, violência íntima do parceiro, outros estressores significativos)
    • Transtornos mentais não sexuais (por exemplo, depressão)
    More Differentials

  • Guidelines

    • Female sexual dysfunction
    • The International Society for the Study of Women's Sexual Health process of care for the identification of sexual concerns and problems in women
    More Guidelines

  • Patient information

    Ansiedade: quais são as opções de tratamento?

    Ansiedade: o que é?

    More Patient information
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