الفهرس 
Introduction
Chapter 1 : Anatomy and Physiology of Female Genital OrgansOnly 14 pages are availabe for public view
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Abstract
FSD is a disturbed process of normal sexual response cycle and defined as a disorder of sexual desire, arousal, orgasm and sexual pain that leads to personal distress or interpersonal difficulties. It is a multifactorial, age-related, progressive problem.
Despite that FSD is highly prevalent compared to male sexual dysfunction, less attention has been paid to it and few studies have investigated its causes with a little available treatment. Culture and religion, insufficient sex instruction, limited talk with health experts of sexual issues and sensation of shame may complicate women’s chances of accepting help and consultation.
The studies about FSD in Arab world and low-income countries aren’t frequent. In this study, we assessed sexual function among 300 married, Egyptian, sexually active females and determined associated risk factors for sexual dysfunction after an informed consent from participants and approval of the local ethical research committee. Studied females were recruited among women attending dermatology outpatient clinic or their relatives in either Kom Elshokafa or Minia University Hospitals. They were assessed using the Arabic validated FSFI which is a reliable and validated questionnaire measuring all aspects of female sexual functions.
We found that 56.7% of the studied females had sexual dysfunction. On the other hand, we found that arousal (86%), orgasmic (73.3%) and desire disorders (72%) were the most common disorders among our cases. Moreover, 43.3% showed non dysfunction of whom only 4 cases were completely normal (1.3%) indicating that the problem is actually common and serious.
FSD is more likely to be associated with females of older age over 36 years, of longer duration of marriage more than 10 years, multiparous, more with those had vaginal deliveries, living in rural areas, illiterate, not-working, had chronic medical conditions or chronic drug therapy, menopausal, pregnant or lactating, circumcised, with higher incidence among those with chronic skin disease. Regarding their partners, FSD is more likely among those with old age >50 years, illiterate, smokers, having either chronic systemic disease or sexual dysfunction. Most of the females had sexual dysfunction showed no effect on her partners even in those affected, it was mild.
On the other hand, Smoking, contraception use, emotional, psychological stress related problems, history of previous operations, hysterectomy or sexual violence/harassment showed no significant relation to FSD.
These data may not be representative of the community as they related to specific areas and being a cross-sectional hospital-based. However, community-based sampling may not be possible because of topic sensitivity. Either female-related or male-related data might be not accurate or under-reported as a result of shame or shyness.
Although FSD is highly prevalent; it stills a silent problem. Shyness, embarrassment of women and lack of awareness and training of physicians leads to inadequate identification and management of these problems. FSD needs to be recognized as a significant public health problem in Egypt, requiring for further research. Direct questioning about sexual function should be included in the routine checklists in gynecology and family planning clinics to detect these problems among even apparently healthy individuals. Moreover, the patients should be awarded about the suspected risk factors and how to modify it. Certain measures may help; family planning, strict control of chronic medical conditions and skin diseases, stopping smoking, avoidance of type II and III circumcision as well as their health education about sex and related problems.