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Sexual Medicine Center Seattle Women’s: Health, Research, Gynecology

Sexual Medicine

Robin Kroll, MD is a leading investigator in the area of female sexual medicine and dysfunction, having been involved in studies for Viagra, testosterone and flibanserin for women. She has appeared on national TV, international symposia and even on Seattle’s KUOW discussing these important concerns. She works closely with sex therapists, couples counselors and physical therapists to provide her patients with options for treatment. Sexual dysfunction in women is complex and multi-factorial. It requires a dedicated team and dedicated patients to make improvements. While we have no “quick fixes,” we work together with you as a team toward optimal sexual functioning.

Areas of expertise include:

  • The diagnosis of sexual dysfunction and differentiation of types of dysfunction
  • Pharmacological expertise related to years of clinical trial experience
  • Extensive knowledge in menopause related sexual issues
  • Expertise in hormonal management


Sexual Medicine Center Seattle Women’s: Health, Research, Gynecology

As one survey has pointed out, up to 43% of women felt they suffered from sexual dysfunction. However, it isn’t always clear what is normal or abnormal when defining the female “sexual response cycle.” No matter how it is defined, it’s an interplay of psychological, social, cultural, hormonal and physical factors.

Female sexual dysfunction is often broken down into four broad categories or types, yet any one category can be influenced by another:

Low Desire or Low Libido (Hypoactive Sexual Desire Disorder):

Defined as “the deficiency or absence of sexual fantasies/thoughts, and/or desire for or receptivity to sexual activity”, such that it causes “personal distress”. In other words, “it bothers me that I don’t have very much interest in having sex” or, “I hardly ever even think about it anymore.” This can be particularly distressing if it is a distinct change from a previously satisfying level of interest. Numerous clinical trials are examining the role of testosterone in this disorder.

Arousal Disorder:

Arousal occurs during the “excitement phase” of the sexual response cycle and involves increased blood flow to the genital area, pleasant body sensations, vaginal lubrication and swelling, and other physical body responses to sexual stimulation. Some women may be just as interested in sex as ever, but their body response is sluggish or absent. “Nothing happens.” This category of sexual dysfunction is currently the subject of intense research, with medication for the disorder being used in clinical trials.

Orgasmic Disorder:

Defined as difficulty with, or inability in attaining orgasm, even after adequate sexual stimulation and arousal. It’s considered a “disorder” only if it also causes personal distress. Because it can be a direct consequence of arousal disorder, therapies treating problems of arousal may be used.

Sexual Pain Disorders:

When women have recurrent or persistent genital or vaginal pain associated with intercourse, it’s important to find the underlying cause. A common cause can be “atrophy” (thinning, dryness and other changes) of the vaginal tissues due to hormonal losses at menopause. Some vaginal infections (yeast, bacterial vaginosis) can also cause painful intercourse.