Female Sexual Problems and Treatments Delhi NCR
Female sexual dysfunction (FSD) and infertility represent
significant global health challenges, impacting women's well-being
and quality of life. Globally, up to 43% of women experience some
form of sexual dysfunction, while infertility affects approximately
1 in 6 people worldwide, with an estimated global prevalence of
17.5%. In 2021, over 110 million women globally were living with
infertility, a trend projected to continue rising. These issues are
often multifactorial, stemming from a complex interplay of
physiological, psychological, and lifestyle factors.
Delhi NCR, as a major metropolitan hub, offers a diverse landscape for female sexual problem treatment, integrating both conventional allopathic medicine and traditional systems like Unani. Conventional treatments include pharmacological interventions (e.g., Flibanserin for low libido, hormone therapy), surgical procedures (e.g., for endometriosis, fibroids, fallopian tube blockages), and advanced assisted reproductive technologies (ART) like IVF and IUI. While effective, these can be associated with side effects, high costs, or invasiveness.
The Unani system of medicine, rooted in humoral balance and holistic health, provides a complementary approach. Unani treatments for female sexual problems and infertility involve personalized herbal remedies, regimental therapies (such as hydrotherapy and massage), dietotherapy, and psychological support. These natural approaches are often highlighted for their reported fewer side effects and affordability.
The co-existence and utilization of both conventional and Unani treatments in Delhi NCR reflect a growing patient preference for comprehensive and natural approaches. This creates a significant opportunity for integrated care models that combine the strengths of both systems, offering more patient-centric and potentially more effective outcomes by addressing both the physiological and broader well-being aspects of female sexual health.
1. Introduction to Female Sexual Dysfunction
Female sexual dysfunction (FSD) is a common and often distressing condition that can significantly impact a woman's quality of life and relationships. Understanding its various forms, prevalence, and underlying causes is essential for effective treatment.
Female sexual dysfunction is defined as any issue occurring during the sexual response cycle—which includes phases of excitement, plateau, orgasm, and resolution—that prevents an individual or couple from achieving sexual satisfaction. This encompasses a variety of specific conditions:
Female Sexual Interest/Arousal Disorder: Characterized by a lack or significant decrease in sexual interest or desire, and/or difficulty achieving or maintaining sufficient sexual arousal. This can manifest as diminished vaginal lubrication, decreased genital sensation, or an aversion to sexual contact.
Female Orgasmic Disorder (Anorgasmia): Involves orgasm that is absent, markedly diminished in intensity, or significantly delayed despite adequate sexual stimulation.
Genito-Pelvic Pain/Penetration Disorder (Dyspareunia): Defined by persistent or recurrent difficulties with vaginal penetration, marked vulvovaginal or pelvic pain during intercourse, fear or anxiety about pain, and/or tension of the pelvic floor muscles during attempted penetration.
Infertility: The inability to conceive after at least one year of frequent, unprotected sexual intercourse. This is a significant sexual health issue that often leads to profound emotional and psychological distress.
These conditions can be generalized or specific to certain situations or partners. It is common for women with FSD to experience features of more than one disorder simultaneously.
Sexual dysfunction is a widespread issue globally, affecting up to 43% of women. Infertility, a key aspect of female sexual health, has been experienced by approximately 1 in 6 people worldwide, with an estimated global prevalence of 17.5%. In 2021, an estimated 110,089,459 women globally were living with infertility, and age-standardized prevalence rates for female infertility increased by an average of 0.68% between 1990 and 2021, with projections indicating a continued rise through 2040.
Specific data on the prevalence of FSD in India is less detailed in the provided information, but the high global figures and the general prevalence of sexual disorders in India (male sexual disorders ranging from 10% to 52% ) suggest a significant burden. The increasing rates of infertility globally underscore the growing demand for effective and accessible female sexual problem treatment in regions like Delhi NCR.
Female sexual dysfunction is rarely caused by a single factor; instead, it typically arises from a complex interplay of physiological, psychological, and lifestyle elements.
Physiological Causes:
Hormonal Imbalances: Fluctuations in hormones, such as low estrogen (e.g., during menopause, pregnancy, breastfeeding) or low testosterone, can lead to decreased sexual desire, impaired arousal, and vaginal dryness. Thyroid, pituitary, and adrenal disorders can also contribute.
Polycystic Ovary Syndrome (PCOS): This common endocrine disorder significantly impacts female fertility by disrupting hormonal balance and ovulation, often leading to irregular periods, excess hair growth, and weight gain.
Structural and Anatomical Issues: Conditions like uterine fibroids, endometriosis (tissue growth outside the uterus), and fallopian tube damage or blockage can cause pain, interfere with sexual function, or impede conception.
Infections: Sexually transmitted infections (STIs) like chlamydia and gonorrhea, as well as other vaginal infections, can lead to chronic pain, inflammation, and long-term damage to reproductive organs, contributing to dyspareunia and infertility.
Chronic Diseases: Systemic conditions such as diabetes, hypertension, heart disease, and autoimmune diseases (e.g., lupus) can affect blood flow, nerve function, and overall vitality, impacting sexual response.
Medications: Certain prescription medications, including some antidepressants (SSRIs), blood pressure medications, and hormonal contraceptives, can have sexual side effects like reduced libido or difficulty with orgasm.
Psychological Causes: Emotional and mental factors are deeply intertwined with FSD. These include stress, anxiety (especially performance anxiety), depression, low self-esteem, poor body image, feelings of guilt or shame, and relationship conflicts. Past sexual trauma or inadequate sex education can also contribute.
Lifestyle Factors: Unhealthy lifestyle choices and environmental exposures significantly impact female sexual health and fertility. These include smoking, excessive alcohol consumption, illicit drug use, being significantly overweight or underweight, sedentary habits, and exposure to environmental toxins (e.g., pesticides). Chronic stress and inadequate sleep also play a role in disrupting hormonal balance.
Table 1: Common Types of Female Sexual Dysfunction and Their Core Symptoms
|
Type of Dysfunction |
Definition/Core Symptom |
Common Manifestations |
Associated Factors (Physiological, Psychological, Lifestyle) |
|
Female Sexual Interest/Arousal Disorder |
Lack or absence of sexual drive/interest; difficulty achieving or maintaining arousal |
Decreased desire for sexual activity, lack of vaginal lubrication/dilation, decreased genital sensation |
Hormonal changes (low estrogen/testosterone, menopause, pregnancy, breastfeeding), lack of stimulation, anxiety, depression, relationship issues, certain medications |
|
Female Orgasmic Disorder (Anorgasmia) |
Orgasm absent, markedly diminished in intensity, or significantly delayed |
Difficulty achieving climax despite adequate stimulation |
Physical factors, illness, certain medications (e.g., SSRIs), psychological issues, relationship problems |
|
Genito-Pelvic Pain/Penetration Disorder (Dyspareunia) |
Pain experienced during sexual activities |
Inadequate vaginal lubrication, underlying conditions (endometriosis, fibroids), infections, muscle tension |
Inadequate lubrication, hormonal changes, infections, endometriosis, uterine fibroids, pelvic floor dysfunction, psychological factors |
|
Infertility |
Inability to conceive after 1 year of unprotected, frequent sex |
Unsuccessful attempts at conception, psychological distress |
Ovulatory dysfunction (PCOS), fallopian tube damage/blockage, uterine issues (fibroids, endometriosis), hormonal imbalances, genetic factors, lifestyle (obesity, smoking, alcohol, stress), environmental toxins |
2. Conventional Medical Treatments for Female Sexual Problems
Modern medicine offers a range of interventions for female sexual dysfunctions, providing targeted solutions based on specific physiological or psychological diagnoses.
For Low Libido (Hypoactive Sexual Desire Disorder): Treatment often begins with sex education and counseling. For premenopausal women, FDA-approved non-hormonal medications like Flibanserin (Addyi) and Bremelanotide (Vyleesi) are available. For menopausal women experiencing vaginal dryness and discomfort, hormone therapy, including vaginal estrogen creams or suppositories, can improve lubrication and comfort. If antidepressants are contributing to low libido, switching to medications with fewer sexual side effects (e.g., Mirtazapine, Bupropion) may be recommended.
For Dyspareunia (Painful Intercourse): Pharmacological interventions depend on the cause. These can include over-the-counter lubricants for vaginal dryness, antibiotics/antivirals/antifungals for infections, hormone therapy (e.g., topical estrogen, Ospemifene for menopause-related dryness), and antidepressants to manage nerve pain or psychological components.
Surgical Procedures: Surgical interventions address anatomical issues contributing to sexual dysfunction or infertility. These include repairing blocked or scarred fallopian tubes, removing uterine fibroids, or treating endometriosis by destroying or removing cysts or tissue. For women with PCOS unresponsive to ovulation medication, laparoscopic ovarian drilling may be performed.
Assisted Reproductive Technologies (ART): For couples struggling with infertility, ARTs offer significant pathways to conception.
In Vitro Fertilization (IVF): Involves retrieving eggs, fertilizing them with sperm in a laboratory, and then transferring the resulting embryo(s) back into the uterus.
Intrauterine Insemination (IUI): Involves placing specially prepared sperm directly into the uterus.
Egg Donation: For individuals or couples facing severe infertility challenges, donor eggs can be utilized.
Surgical procedures and advanced ARTs can be highly invasive and costly, posing significant financial barriers for many patients in Delhi NCR.
Counseling and Sex Therapy: These are fundamental for addressing the psychological underpinnings of FSD, including stress, anxiety, depression, guilt, and relationship conflicts. Sex therapists use psychotherapy (talk therapy) to help individuals and couples improve communication and modify unhelpful thoughts and behaviors related to sex.
Behavioral Techniques: For female orgasmic disorders, techniques like directed masturbation and sensate focus programs help individuals and couples explore and understand their sexual responses.
Lifestyle Modifications: Modern medicine strongly advocates for lifestyle changes, including maintaining a healthy weight, engaging in regular, moderate exercise, implementing stress management techniques (e.g., yoga, meditation), ensuring adequate sleep, and strictly avoiding smoking, excessive alcohol, and illicit drug use. Preventing STIs is also crucial.
3. The Unani System of Medicine for Female Sexual Problems and Treatments Delhi NCR
The Unani system of medicine offers a distinct and holistic approach to female sexual health, focusing on restoring the body's balance and individualized care.
Unani medicine, also known as Unani Tibb, is a traditional healing system with roots in ancient Greek philosophy, further developed in the Muslim world. Its core premise is that disease is a natural process, and the physician's role is to support the body's innate healing capabilities, known as Tabiyat.
The system is built upon the concept of the four bodily humors (Akhlat): blood (Dam), phlegm (Balgham), yellow bile (Safra), and black bile (Sauda). Health is maintained when these humors are in equilibrium, and imbalances are considered the root cause of disease. Each individual possesses a unique Mizaj (temperament), classified into four primary types (Hot & Dry, Hot & Wet, Cold & Wet, Cold & Dry), and Unani treatment aims to restore this balance.
Unani medicine also recognizes seven basic physiological principles (al-umoor al-tabiyah) essential for human existence and health: elements (arkan), temperament (mizaj), humors (akhlat), organs (aaza), vital spirit (arwah), faculties (quwa), and functions (afaal). Additionally, six essential external factors (Asbab-e-Sittah-Zarooriah)—air, food and drinks, movement and rest, mental work and rest, sleep and wakefulness, and retention and excretion—are crucial for maintaining a balanced existence. This comprehensive framework underscores Unani's holistic perspective on health.
In Unani medicine, female sexual problems, particularly infertility (Uqr or banjhpan), are understood as consequences of imbalances in the body's temperament (Mizaj) and humors (Akhlat), or structural and functional disruptions within the reproductive organs.
Specific Unani explanations for female infertility include:
Congenital Defects: Such as small uterine size, closure of the external os, or small ovaries.
Obesity (furbahi): Can interfere with normal menstruation and ovulation.
Abnormal Uterine Temperament (su'i mizaj-e-Rahem): An imbalance in the uterus's inherent qualities.
Faulty Production of Ovum (fasad e mani): Leading to difficulty in conception.
Humoral Imbalances: Increased phlegm (khilt-e-balgham) and increased coldness are believed to diminish the retentive power (quwa) of the uterus, hindering pregnancy.
PCOS: Unani classical texts describe PCOS under categories such as liver problems, phlegmatic illness, obesity, and amenorrhea, primarily linking it to the predominance of khilt-e-balgham.
Other Conditions: Metritis, uterine inversion, salpingitis, amenorrhea, polymenorrhoea, vaginal discharge, and anemia are also recognized as contributing factors.
This detailed etiological framework allows Unani practitioners to identify and correct deeper constitutional and humoral imbalances, offering a distinct diagnostic and therapeutic pathway, especially for cases deemed "unexplained" in conventional medicine.
Unani treatments for female sexual health are comprehensive and personalized, aiming to restore humoral balance and strengthen vital faculties.
1. Herbal Remedies (Pharmacotherapy): Unani medicine extensively uses various herbs and plants to regulate hormonal balance, improve reproductive function, and enhance fertility. These herbal formulations are carefully selected and customized for each patient.
Ashwagandha (Withania somnifera): An adaptogenic herb known to reduce stress, balance hormones, and improve overall vitality, enhancing fertility. It is believed to improve egg quality and possesses anxiolytic and antioxidant properties.
Shatavari (Asparagus racemosus): Highly regarded for female reproductive health, nourishing organs, supporting hormonal balance, stimulating ovulation, improving egg quality, and strengthening the uterine lining.
Gokshura (Tribulus terrestris): Enhances libido, strengthens reproductive tissues, and improves ovarian health.
Shilajit: Boosts overall vitality and improves reproductive function.
Triphala: A blend of three fruits, known for detoxifying and digestive benefits, indirectly supporting reproductive health.
Lodhra (Symplocos racemosa): Supports the endometrial lining and has anti-inflammatory properties beneficial for PCOS and endometriosis.
Bala (Sida cordifolia): Enhances energy, rejuvenates the reproductive system, and can regulate menstrual cycles.
Kapikachhu (Mucuna pruriens): Balances hormones and enhances reproductive health.
Amalaki (Emblica officinalis): Detoxifying, improves digestion, boosts immunity, and enhances ojas (vital energy).
Compound Formulations: Unani literature describes various compound formulations for infertility, such as Habb-e-Hamal (a uterine tonic and ovulation-inducing agent) , Nuskha Mu'īn-i-Ḥaml and Ma'jūn mocharas (used for ovulation induction and as uterotonics, showing success in unexplained infertility) , Majune Moine Hamal Ambari, Dawa-ul-Misk Motadil, and Majune Suparipak. Local applications like Phittakri Biriyan, Roghan-e-Chambeli, and Poste Anaar are also used for uterine and cervical factors.
2. Regimental Therapies (Ilaj-Bit-Tadbeer): These non-pharmacological procedures support the healing process, detoxify the body, improve circulation, and strengthen defense mechanisms.
Hydrotherapy (Abzan, Sitz bath): Therapeutic use of water, such as warm baths or steam treatments, to promote relaxation, improve circulation, and address conditions like uterine pain, leucorrhea, and vulvitis.
Massage (Dalak): Systematic manipulation of body tissues to disperse morbid matter, alter organ temperament, and enhance blood circulation.
Cupping (Hijama): Application of cups to the skin to create suction, used to draw out stagnant blood and toxins, and improve localized blood flow.
Purging (Ishaal) and Enema (Huqna): Detoxification procedures to cleanse the body and remove superfluities from the intestine, relieving pain in kidneys and bladder.
Other therapies: Include Riyazat (exercise), Takmeed (fomentation), Nutool (pouring medicated lukewarm water), Zimaad wa Tila (ointments and liniments), and Tareeq (sweating).
3. Dietotherapy (Ilaj Bil-Ghiza): Diet is a fundamental component of Unani treatment, aiming to restore humoral balance and support reproductive health.
Nourishing Foods: Dairy proteins (milk, lassi, paneer), soaked almonds or walnuts, sweet juicy fruits (mangoes, peaches, plums, pears), and spices like ajwain, cumin, turmeric, and black cumin are recommended for enhancing fertility.
Foods to Avoid: High-fat foods and those containing preservatives are generally advised against.
4. Psychological Support: Unani medicine recognizes the significant emotional toll of female sexual problems and infertility. It incorporates stress management techniques and herbal remedies to alleviate anxiety and promote overall emotional well-being, which can positively influence fertility outcomes.
Delhi NCR is home to numerous Unani clinics and practitioners specializing in female sexual health and infertility.
Dr. Aslam Javed and Unani Herbal: Dr. Aslam Javed is a prominent Unani Sexologist Doctor for both male and female sexual health in Delhi NCR. He graduated with a BUMS from Ayurvedic & Unani Tibbia College, University of Delhi, in 1989, and has over 33 years of experience. Dr. Javed is the founder of Shifa Clinic, also known as Unani Herbal, established in New Friends Colony, Delhi, in 2005. His approach is personalized, focusing on natural balance, lifestyle and dietary guidance, and addressing root causes of sexual dysfunction. Unani Herbal offers personalized Unani treatments for infertility, often as a complementary therapy. Dr. Javed has received various awards for his contributions to Unani medicine.
3.5. Reported Success Rates and Patient Experiences in Unani Treatment
Unani treatments for female infertility have shown positive outcomes in reported cases. A 25-year-old nulligravida with unexplained infertility conceived after just two menstrual cycles of Unani treatment, leading to an uneventful pregnancy and healthy delivery. Another case study reported conception within two months for female infertility with no reported side effects. A pilot study on infertility due to cervical factors showed that 7 out of 12 patients (58.33%) conceived with Unani treatment.
Patient testimonials for Unani clinics in Delhi NCR frequently highlight "effective" and "simple" treatments, often leading to "speedy recovery" and "positive vibes". Patients often praise Unani doctors for being "friendly," "humble," "compassionate," and for dedicating ample time to explain health issues. A significant aspect emphasized in patient feedback and Unani promotional materials is the natural approach and reported absence of side effects, distinguishing it from some conventional treatments.
4. Comparative Analysis and Integrated Care
The treatment landscape for Female Sexual Problems and Treatments Delhi NCR is characterized by the co-existence of conventional modern medicine and the traditional Unani system. A comparative analysis reveals distinct strengths and limitations for each, highlighting the potential for synergistic integrated care models.
Conventional Medicine:
Strengths: Offers evidence-based efficacy for many FSDs, providing targeted and often rapid symptomatic relief. It provides advanced diagnostic techniques for precise identification of underlying causes and offers sophisticated surgical and ART options for severe cases, such as IVF for infertility or surgical correction of anatomical issues.
Limitations: Can involve significant side effects from pharmacological treatments (e.g., SSRIs, hormonal therapies). The high cost of ART procedures can be a substantial barrier to accessibility for many patients. Conventional approaches can sometimes be less holistic, potentially focusing on isolated symptoms rather than fully addressing the complex interplay of psychological and lifestyle factors as primary interventions.
Unani System of Medicine:
Strengths: Adopts a holistic approach, aiming to address the root causes of sexual problems and promote overall well-being by restoring humoral balance and strengthening vital faculties. Its emphasis on natural remedies is often associated with reported fewer side effects, which is a significant appeal to patients. Treatment is highly personalized, based on the individual's unique temperament and humoral profile. Unani treatments can also be more affordable compared to high-tech ARTs. The system integrally addresses stress and anxiety, recognizing their profound impact on sexual health.
Limitations: A notable limitation is the general lack of robust scientific evidence from large-scale randomized controlled trials to definitively support the efficacy of many Unani formulations and therapies in a Western medical paradigm. There can also be inconsistencies due to a perceived lack of standardization and quality control in practice and manufacturing. Additionally, access to pure Unani clinics may be limited to certain areas.
Unani medicine is increasingly recognized as a valuable complementary therapy that can be used alongside conventional treatments for infertility and other female sexual problems. This approach acknowledges that Unani interventions can potentially enhance the effectiveness of conventional treatments by addressing underlying imbalances, promoting overall reproductive health, and mitigating the side effects associated with conventional medications. Some clinics in Delhi NCR already practice integrated healthcare, combining modern medicine with traditional approaches.
For optimal patient outcomes in an integrative setting, collaborative care and open communication between healthcare providers are paramount. Qualified Unani practitioners can work in conjunction with patients' conventional healthcare providers (e.g., gynecologists, reproductive endocrinologists) to develop comprehensive, tailored treatment plans that leverage the strengths of both systems. This synergy ensures coordinated care, minimizes the risk of contraindications, and prevents adverse interactions between different therapies. Patients are also advised to actively participate in their care by consulting qualified practitioners, maintaining realistic expectations, and diligently monitoring their progress.
5. Recommendations
Addressing female sexual problems and infertility effectively in Delhi NCR requires a multi-pronged approach that considers the diverse needs of individuals and the strengths of various medical systems.
Individuals experiencing female sexual health concerns are encouraged to seek professional assistance, as these issues are common and often treatable. It is advisable to consult a primary care provider or OB-GYN initially to understand the nature of the problem and rule out any underlying physical causes.
If considering Unani medicine, it is important to consult a qualified and experienced Unani practitioner who specializes in female sexual health or infertility. A thorough discussion of potential underlying causes with the Unani practitioner is crucial to tailor a treatment approach based on Unani principles and the individual's unique constitution. Patients should approach their treatment journey with realistic expectations, understanding that individual results may vary, and improvements may take time.
A combined approach, where Unani medicine is used as a complementary therapy alongside conventional treatments, is often beneficial. Maintaining open communication between all healthcare providers involved in one's care is essential to ensure coordinated treatment, prevent contraindications, and avoid drug interactions.
Furthermore, adopting healthy lifestyle choices is paramount. This includes maintaining a balanced diet, engaging in regular, moderate exercise, practicing stress management techniques (such as yoga and meditation), ensuring adequate sleep, and strictly avoiding smoking, excessive alcohol consumption, and illicit drugs.
Foster Integrative Approaches: Healthcare providers and policy makers should actively encourage collaboration between conventional and Unani practitioners. This will facilitate the provision of comprehensive and patient-centric care, leveraging the distinct strengths of both systems to achieve optimal outcomes.
Promote Research and Validation: Investment in rigorous scientific studies, particularly large-scale randomized controlled trials, is crucial to further validate the efficacy and safety of Unani formulations and therapies for female sexual dysfunction and infertility. This will help bridge the existing evidence gap, enhance the credibility of Unani medicine, and facilitate its wider acceptance and integration into mainstream healthcare.
Ensure Standardization and Quality Control: Addressing the current lack of standardization and quality control in certain aspects of Unani medicine is vital to ensure consistency and reliability of treatments. This may involve developing clear guidelines for practice, manufacturing processes, and quality assurance of Unani products.
Enhance Education and Training: Supporting educational initiatives for both conventional and Unani practitioners is essential to foster mutual understanding, improve inter-system communication, and facilitate the seamless implementation of integrated care models. This could include cross-training programs or joint conferences.
Address Affordability and Accessibility: Continued efforts are needed to make fertility treatments, encompassing both conventional and traditional approaches, more affordable and accessible to a wider population in Delhi NCR, as cost remains a significant barrier for many couples.
Public Health Awareness: Developing comprehensive public health campaigns is important to raise awareness about the multifactorial causes of female sexual dysfunction and infertility. These campaigns should promote early detection, encourage healthy lifestyles, and inform the public about the full spectrum of available treatment options across all recognized systems of medicine.
6. Conclusion
Female sexual problems and infertility represent complex, widespread health challenges in Delhi NCR, influenced by a myriad of interconnected physiological, psychological, and lifestyle factors. The comprehensive analysis reveals that both conventional modern medicine and the traditional Unani system offer distinct yet often complementary approaches to treatment. While conventional methods provide targeted interventions, rapid symptomatic relief, and advanced technologies, Unani medicine emphasizes a holistic, personalized approach with natural remedies, regimental therapies, and lifestyle modifications, often with reported fewer side effects.
The growing interest in traditional therapies and positive patient experiences highlight the value and perceived efficacy of Unani medicine within the local healthcare landscape. Moving forward, an integrated care model, characterized by collaborative practice between conventional and Unani practitioners, robust scientific validation of traditional therapies, and enhanced patient-practitioner communication, holds immense promise for providing comprehensive, effective, and patient-centered solutions for Female Sexual Problems and Treatments Delhi NCR. This approach respects diverse medical philosophies while striving for optimal health outcomes for the population.
Researched and written by: Museb Rafeeq founder of Wind Song Enterprises.
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