This is the most common sexual disorder seen in postmenopausal women due to a lack of adequate lubrication. Prior to the advent of new medications, this was treated with vaginal lubricants such as K-Y jelly or others that are commercially available. The most common lubricant used, saliva, is probably the most physiologically compatible and the most reasonable. When this condition is seen in young women, it is almost always related to the side affects from such medications as birth control pills. Diabetes, especially a long-standing case, may cause a decrease in lubrication and may also cause decreased blood flow, which results in a higher risk of developing bacterial and fungal infections in the vagina.
Radiation treatments are another common cause of decreased lubrication.
Women who have had radiation treatments for vaginal or pelvic malignancies will often have difficulty with penetration due to dry vaginas. Women that are being treated for breast cancer with anti-estrogens or medications to prevent recurrence of breast cancer such as the drug Tamoxifen may develop a very dry vagina and have difficulty with penetration as well. Decreased lubrication is also seen during breast-feeding and it is not uncommon in postpartum women due to an elevation of the hormone prolactin, which is stimulated by lactation. Interestingly, men who have elevated prolactin levels also lose interest in sex. The treatment of female sexual arousal disorder is very controversial.