Female Sexual Dysfunction
WHAT IS FEMALE SEXUAL DYSFUNCTION?
Sexual dysfunction is any kind of problem with a person’s experience of sex. It can affect both men and women. Sexual dysfunction generally affects women in four ways:
- Lack of sexual desire. Some women have no interest in sex or have less interest than they used to.
- Arousal disorders. Some women have no physical sexual response. Others begin to feel aroused, but the arousal then goes away.
- Orgasmic disorders. Some women are unable to have an orgasm or experience pain during orgasm.
- Sex pain disorders. Some women feel pain during or after sex. In some cases, when a woman starts to have sex the muscles at the entrance of the vagina may tighten painfully, so much so that a penis or vibrator cannot penetrate it. Such pain is called dyspareunia. Another type of pain is called vaginismus, which is the involuntary contraction of the outer muscles of the vagina.
About three-quarters of all couples have difficulties with sex at some point in their relationship. Just because you sometimes don’t enjoy sex for some reason doesn’t necessarily mean that you have a sexual dysfunction. However, if you never want to have sex or if you never enjoy the experience of sex, you may have a sexual problem. You are the one who decides whether you have a problem and whether you should seek help for it.
WHAT CAUSES FEMALE SEXUAL DYSFUNCTION?
There are many causes of sexual dysfunction in women. Several of the most common ones are the following:
- Medication side effects
- Physical disorders such as diabetes, cardiovascular disease, breast cancer, arthritis, and high blood pressure
- Hysterectomy
- Gynecological disorders (cystitis, cancer, etc.)
- Gynecological changes (pregnancy, childbirth, and menopause)
- Breastfeeding
- Alcohol consumption
- Recreational drug use
- Cigarette smoking
- Physical abuse
- Sexual abuse
- Depression or sadness
- Sexual identity conflicts
- Guilt over past relationships (e.g., when a widow begins a new relationship)
- Stress at home or at work
- Boredom with sexual routine
- Being in a bad relationship
- Extramarital affairs
- Religious or cultural beliefs and taboos
- Sexual inexperience
- Not enough stimulation by partner
- Poor communication with partner
- Feeling inhibited, anxious or frightened
- Preference for sexual activities different from partner’s
WHAT IS THE TREATMENT FOR FEMALE SEXUAL DYSFUNCTION?
Treatment depends on the diagnosis and the type and cause of dysfunction. The first step toward treatment should be to request a complete examination by your physician. There are no specific tests for sexual dysfunction, but you should tell your doctor what you think might be the causes of your specific problem. Depending on the diagnosis, your doctor may include any of the following in your treatment:
Education.
You may need to learn about sexual functioning and the changes that occur during pregnancy, menopause, aging, etc. Your doctor may suggest specific books about your specific situation for you to read and learn from.
Sex therapy.
Your doctor may refer you to a physician or mental health professional with special training and expertise in sex therapy. The sex therapist may provide reading materials and give you and your partner a variety of assignments to enhance your sexual activity and resolve the problems that you have.
WHAT IS THE TREATMENT FOR LACK OF SEXUAL DESIRE?
Change the sexual routine.
Women who lack sexual desire are sometimes bored with their sexual activities. What may be helpful is changing the way one makes love, including trying new positions and behaviors and using erotic videos and books for stimulation, as well as changing the place where lovemaking occurs. Other ideas include giving one another sensual massages and doing sensate-focus exercises (i.e., touching one another’s bodies and giving feedback about what feels pleasurable).
Counseling.
If the lack of sexual desire is not the result of a physical cause, no medical treatment may be needed. Psychological and relationship issues should be addressed by consulting with a licensed mental health professional. If relationship issues are the cause, it is important to consult with a counselor trained in working with couples.
Estrogen replacement therapy.
Menopause can have a very strong impact on a woman’s sexual functioning. Hormone replacement therapy or other medications can be prescribed to relieve menopausal symptoms.
The inability to reach an orgasm . . . is often caused by sexual inexperience or by not enough stimulation. A woman may also keep herself from reaching orgasm because of her religious beliefs or fears.
WHAT IS THE TREATMENT FOR AROUSAL DISORDER?
Lubricants.
Commercial lubricants, vitamin E, and mineral oils are good choices.
More Foreplay.
More time in foreplay. Many women need more stimulation than their partners realize. This is especially true as women get older. Spending more time on foreplay or using a vibrator to increase stimulation may be helpful. Some women become more aroused when they take a warm bath before they have sex.
Relax.
Looking for ways to relax and eliminate anxiety before lovemaking are also important.
Estrogen replacement.
Many postmenopausal women develop arousal disorders caused by urogenital atrophy. Estrogen replacement therapy can be very helpful and may be supplemented with estrogen-containing vaginal creams. Some women, however, cannot take estrogen replacement therapy.
WHAT IS THE TREATMENT FOR ORGASMIC DISORDER?
The inability to reach an orgasm, known as anorgasmia, is often caused by sexual inexperience or insufficient stimulation. A woman may also keep herself from reaching orgasm because of her religious beliefs or fears. Other causes include medications and illnesses.
Increase stimulation.
The stimulation may involve masturbation or use of a vibrator. Contracting and relaxing the pelvic muscles during foreplay or masturbation can also be helpful in increasing arousal.
Minimize inhibition.
If inhibition keeps a woman from reaching orgasm, the help of a counselor should be sought for addressing the feelings and beliefs causing the inhibition.
WHAT IS THE TREATMENT FOR SEX PAIN DISORDER?
In cases of pain during intercourse, it is critical to have a complete examination to identify the underlying cause. Treatment will depend on the symptoms and the diagnosis. Some examples of possible treatment include the following:
Dyspareunia.
Changing one’s sexual position may help to minimize pain. Other treatments may include using lubricants and topical creams, as well as taking warm baths before intercourse. Biofeedback is another treatment option to consider.
Vaginismus.
The involuntary contraction of the outer vaginal muscles may be caused by an extreme fear of sexual intercourse consequential to sexual abuse or trauma. Treatment may include learning progressive muscle relaxation and contraction of the pelvic muscles. Another treatment option is to use a tampon or dilator of increasing diameter gradually enlarge the vagina.
WHERE CAN I GO FOR MORE INFORMATION?
Barbach, Lonnie. For Each Other: Sharing Sexual Intimacy. New York: Signet, 2001.
Comfort, Alex. The New Joy of Sex. New York: Pocket Books, 1992.
Comfort, Alex. Sexual Positions [The Joy of Sex series]. New York: Crown Publishing, 1997.
Kaplan, Helen Singer. Illustrated Manual of Sex Therapy. New York: Brunner/Mazel, 1988.