Issues With Arousal​

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Issues With Arousal​

Issues with arousal can significantly impact sexual experiences and intimacy. Arousal refers to the physiological response to sexual stimulation or activity, involving an increase in heart rate, breathing, body temperature, vaginal lubrication, and lengthening of the vagina. However, various risk factors can interfere with the ability to generate this response, affecting sexual arousal.

Risk Factors

Cardiovascular health plays a crucial role in arousal. Conditions such as hypertension (HTN) and atherosclerosis can impede proper blood flow, limiting arousal responses. Endocrine factors, such as obesity, diabetes, and menopause, can also contribute to issues with arousal. Hormonal changes during menopause, as well as the use of oral contraceptive pills (OCPs), may affect sexual desire and lubrication.

Certain surgeries, particularly those involving the pelvis or spine, can disrupt nerve pathways and blood flow critical for arousal. Additionally, cancer and its treatments can have a significant impact on sexual function. Medications used to manage various health conditions, such as antidepressants, antihypertensives, and antipsychotics, may have side effects that interfere with arousal.

One significant condition that affects arousal is genitourinary syndrome of menopause (GSM). This condition occurs due to hormonal depletion during menopause, leading to thinning, atrophy, and dysfunction of vulvar and vaginal tissues. This can cause discomfort and pain during sexual activity, leading to decreased arousal and sexual interest.


It’s crucial to address and manage pain-provoking conditions related to sexual encounters. Experiencing discomfort and pain during sex can create negative associations in the brain, leading to reduced desire for future sexual experiences. Managing underlying conditions and seeking appropriate treatment is essential for enhancing sexual arousal and overall sexual well-being.

Fortunately, there are treatment options available to address issues with arousal. Vaginal estrogens can be prescribed to help restore vaginal tissues’ health and function in menopausal women. Dehydroepiandrosterone (DHEA) suppositories can also be used to improve vaginal health and lubrication. Ospemifene (Osphena) is a non-hormonal estrogen agonist/antagonist that can alleviate vaginal dryness and pain during intercourse.

In recent years, CO2 laser therapy has emerged as a promising treatment option for genitourinary syndrome of menopause. This non-invasive procedure stimulates collagen production in the vaginal tissues, improving elasticity and lubrication. CO2 laser therapy can significantly reduce discomfort and pain, ultimately leading to improved sexual arousal and sexual function.


Overall, addressing issues with arousal requires a comprehensive approach that considers both physical and psychological factors. By managing underlying health conditions, exploring appropriate treatment options, and addressing any discomfort or pain, individuals can enhance their sexual arousal and enjoyment of sexual experiences. 

MEET Dr. Alexandra Dubinskaya

A leader in women’s sexual health

Dr. Alexandra Dubinskaya is a board-certified, fellowship-trained Urogynecologist and Sexual Health specialist whose mission is to enhance women’s quality of life by improving their pelvic and sexual health. Dr. Dubinskaya’s focus is on making a difference in people’s lives through state-of-the-art, compassionate, and personally tailored care.

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