Physical causes include disorders of the genitalia and the urinary system, such as endometriosis, cystitis, vaginal dryness, or vaginitis. Other conditions such as hypothyroidism, diabetes, multiple sclerosis, or muscular dystrophy can have an impact on sexual desire and ability. Surgical removal of the uterus or of a breast may contribute psychologically to sexual dysfunction if a woman feels her self-image has been damaged.
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