What is Sexuality?
Sexuality encompasses a broad range of physical activities and psychological experiences. These activities fulfill important physical and emotional needs for intimacy and closeness. Sexuality doesn't just include sexual activities - it also include feelings about yourself, how you relate to other people, previous sexual partners, and feelings about sex.
Women's interest in sex vary widely. Most women experience a sexual responsiveness peak in their late 30's or early 40's, but a woman can have a satisfying sex life throughout her life. The quality of her experiences is affected by individual preferences, life circumstances, age, hormone levels, as well as health and well-being.
What is Female Sexual Dysfunction?
A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents satisfaction from sexual activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
Female sexual dysfunction isn't uncommon - many women experience problems with sexual function at some point in their lives. Female sexual dysfunction can be a lifelong problem, or it can happen later in life after you've experienced a period of satisfactory functioning.
Female sexual dysfunction has many possible symptoms and causes. Fortunately, they're almost all treatable. Communicating your concerns and understanding your body and its normal response to sexual activity are important steps toward gaining sexual satisfaction.
Sexual Response Cycle:
To properly understand sexual dysfunction, it's important to understand the sexual response cycle, which is the same for both men and women. Each woman passes through these phases at her own rate. A sexual problem may occur if one (or more) of these stages do not happen.
Desire (excitement) Phase - Desire is the sexual charge that increases interest in and responsiveness to sexual activity. This would be "in the mood" for sex. Heart rate and breathing increase and skin flushes.
Arousal Phase - sexual stimulation brings about more physical changes. The vagina expands, the clitoris enlarges and nipples become hardened. The vagina secretes fluids to moisten the labia, vagina and vulva. These fluids provide lubrication for intercourse.
Orgasm Phase - during the peak of arousal, the muscles around the vagina contract, causing a pleasurable sensation.
Resolution Phase - the vagina and clitoris return to their unaroused state, leaving one relaxed, content and sleepy.
Symptoms of Female Sexual Dysfunction:
Types of sexual dysfunction are correlated to the stages of the sexual response cycle. Inability to reach any of these stages can interfere with sexual satisfaction and cause the woman great distress. Everybody deserves a satisfying sex life.
These are the three types of sexual problems:
1) Lack of Desire - lack of interest in sex is common in both men and women, but more women report a low interest in sex. Lack of desire stops the sexual response cycle before it even starts. Lack of desire can be a transient problem for some and an ongoing problem for others.
2) Difficulties Becoming Aroused or Achieving Orgasm - inability to become sexually aroused can be related to lack of desire in some women. In others, a woman feels sexual desire but cannot become aroused. An orgasm may be delayed or not occur at all (called "anorgasmia"). This can be extremely upsetting for a woman who feels desire, becomes aroused and cannot achieve orgasm. In fact, this may create a vicious cycle in which a woman loses interest in sex entirely because she cannot attain orgasm.
3) Pain During Intercourse (also called dysparenunia) is not uncommon, however, like the above sexual problems, it can cause a woman to lose interest in sex.
Causes of Female Sexual Dysfunction:
The causes for female sexual dysfunction can be interrelated. They are also as complex as each of us. Some problems have a simple physical cause and others may be caused by difficult life circumstances, serious medical conditions, or emotional problems.
Physical. Physical conditions such as arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems, and neurological disorders such as multiple sclerosis can lead to sexual dysfunction.
Medications - including certain antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease sex drive and your body's ability to experience orgasm.
Relationship Problems - problems in other areas of a relationship - money, raising children, etc - may cause sexual problems. Abuse or control in a relationship is very harmful to sexual satisfaction, as they may prevent a woman from expressing her desires to her partner.
History of Abuse - a woman who has been sexually abused may have trouble relaxing and trusting her partner enough to become aroused. Feelings of guilt, fear and resentment may get in the way of a satisfying sexual experience.
Attitudes about Sex - many people (for many reasons) don't view sexual experiences as a normal, enjoyable part of life. Sexual feelings may bring about shame, guilt, fear or anger.
Insufficient Stimulation - a woman or her partner may not know enough about how to properly stimulate (or be stimulated) in order to achieve a satisfying sexual experience. Poor communication between partners may be to blame for this sexual problem.
Gynecologic Problems - a number of pelvic disorders can cause pain during sexual intercourse, which decreases sexual satisfaction. These include:
- Vaginal Dryness - this is commonly a result of insufficient stimulation in younger women and a byproduct of menopause on older women. Vaginal dryness may also be linked to hormone imbalances, illnesses, and certain medications.
- Sexually Transmitted Infections - herpes, genital warts, chlamydia and syphilis are STD's that can cause changes in the genitals that may make sex painful and uncomfortable.
- Vaginismus - a painful spasm of the muscles around the vagina that causes the vaginal opening to tighten uncomfortably. This may make penetration very painful. Vaginismus can be caused by infections, injuries, scars, abuse, childbirth or fear.
- PID (Pelvic Inflammatory Disease) - infection of the vagina that travels up the cervix, uterus and ovaries, which can be painful and make intercourse especially painful.
- Endometriosis, pelvic mass, ovarian cysts or surgical scars may cause an obstruction that makes intercourse painful or prevents intercourse entirely.
Psychological - Untreated anxiety or depression can cause or contribute to female sexual dysfunction, as can long-term stress. The worries of pregnancy and demands of being a new mother can cause the same feelings.
Emotional distress can cause sexual dysfunction and, likewise, can create sexual dysfunction.
When To See Your Doctor:
Not all sexual issues require a doctor's care. Many issues are merely temporary and will pass. However, if a sexual problem lasts longer than a couple of weeks, is distressing you, your partner, or your relationship, don't be ashamed to make an appointment to see a doctor and get everything checked out. If the sexual problem is not physical, your doctor can refer you to a mental health professional to further address your problem.
Possible Treatments for Female Sexual Dysfunction:
Treatment for sexual problems will vary with the type of sexual problem experienced. Here are some of the common treatments for female sexual problems.
- Treatment of any underlying medical problems.
- Treatment of underlying mental illnesses such as depression or anxiety.
- Vaginal lubricants are highly recommended for women who have vaginal dryness and can be picked up at any pharmacy. Water (not oil) based products are the best choices.
- Topical estrogen can make sex more comfortable for post-menopausal women who have dryness or sensitivity. The estrogen can be applied through a cream or vaginal insert and are available with a prescription.
- Changing one medication for another. As some medications may cause sexual problems, sometimes the easiest answer is to switch medications to see if the symptoms diminish.
- Clitoral Therapy Device - the Eros clitoral therapy device has been approved by the FDA to treat women with sexual problems. The device is a small suction cup applied to the clitoris before sex and a small vacuum pump. This devise draws blood into the clitoris, which increases lubrication, sensation and even orgasms. It is available via prescription.
- If the benefits outweigh the risks, Hormone Replacement Therapy may be prescribed to post-menopausal women.
- Surgery may be warranted for certain tumors, growths, and cysts.
- Kegel exercises may help many women to increase tone in the vagina as well as prevent spasms in the vagina.
- Use of a small dilator may help relax the vaginal spasms. This small dilator may be inserted into the vagina for 10 minutes, then removed.
Non-Medical Treatment For Female Sexual Dysfunction:
- Open and honest communication with your partner can make a world of difference in your sexual satisfaction. Even if you're not used to communicating about your likes and dislikes, learning to do so and providing feedback in a nonthreatening manner can set the stage for greater sexual intimacy.
- Get healthy. Drinking can dull sexual responsiveness. Stop smoking. Start exercising. Regular aerobic exercise can increase your stamina, improve your body image and elevate your mood, helping you feel more romantic, more often. Finally, don't forget to make time for leisure and relaxation. Learning to relax can enhance your ability to focus on the sexual experience and attain better arousal and orgasm.
- Talk with a therapist familiar with sexual and relationship problems. With a therapist's help, you may gain a better understanding of your sexual identity, beliefs and attitudes; relationship factors including intimacy and attachment; communication and coping styles; and your overall emotional health.
- Group therapy may help some women. In a small support group, women can freely discuss their sexual problems with others who understand. This may create greater insight and practical solutions to her sexual problems.
Additional Female Sexual Dysfunction Resources:
American Association for Marriage and Family Therapy -a professional association for the field of marriage and family therapy. We represent the professional interests of more than 50,000 marriage and family therapists throughout the United States, Canada and abroad.
American Association of Sexuality Educators, Counselors and Therapists - a not-for-profit, interdisciplinary professional organization. In addition to sexuality educators, sexuality counselors and sex therapists, AASECT members include physicians, nurses, social workers, psychologists, allied health professionals, clergy members, lawyers, sociologists, marriage and family counselors and therapists, family planning specialists and researchers, as well as students in relevant professional disciplines.