Specifically, the decline in serum estrogens causes these changes in sexual functioning. Androgen depletion may also play a role, but current knowledge about this is less clear. The hormonal changes that take place during the menopausal transition have been suggested to affect womens sexual response through several mechanisms, some more conclusive than others. Aging in women
Whether or not aging directly affects womens sexual functioning during menopause is controversial. However, many studies, including Hayes and Dennersteins critical review, have demonstrated that aging has a powerful impact on sexual function and dysfunction in women, specifically in the areas of desire, sexual interest, and frequency of orgasm. In addition, Dennerstien and colleagues found that the primary predictor of sexual response throughout menopause is prior sexual functioning, which means that it is important to understand how the physiological changes in men and women can affect sexual desire. Despite the apparent negative impact that menopause can have on sexuality and sexual functioning, sexual confidence and well-being can improve with age and menopausal status. The impact that a relationship status can have on quality of life is often underestimated. Testosterone, along with its metabolite dihydrotestosterone, is important to normal sexual function in men and women. Dihydrotestosterone is the most prevalent androgen in both men and women. Testosterone levels in women at age 60 are on average about half of what they were before the women were 40.
There is no known cure or treatment.Dhat syndrome is another condition which occurs in men: it is a culture-bound syndrome which causes anxious and dysphoric mood after sex. It is distinct from the low-mood and concentration problems (acute aphasia) seen in POIS. Sexual pain disorders
Sexual pain disorders in women include dyspareunia (painful intercourse) and vaginismus (an involuntary spasm of the muscles of the vaginal wall that interferes with intercourse). Dyspareunia may be caused by vaginal dryness. Poor lubrication may result from insufficient excitement and stimulation, or from hormonal changes caused by menopause, pregnancy, or breastfeeding. Irritation from contraceptive creams and foams can also cause dryness, as can fear and anxiety about sex. It is unclear exactly what causes vaginismus, but it is thought that past sexual trauma (such as rape or abuse) may play a role. Another female sexual pain disorder is vulvodynia, or vulvar vestibulitis when localized to the Vulval vestibule. In this condition, women experience burning pain during sex, which seems to be related to problems with the skin in the vulvar and vaginal areas. Its cause is unknown. In men, structural abnormalities of the penis like Peyronies disease can make sexual intercourse difficult and/or painful. The disease is characterized by thick fibrous bands in the penis that lead to excessive curvature during erection. It has an incidence estimated at 0.4–3% or more, is most common in men 40–70, and has no certain cause.