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FEMALE SEXUAL DYSFUNCTIONYou've enjoyed a healthy, satisfying sex life during most of your adulthood. But lately, intimate moments with your partner are less satisfying than they once were. You might feel as though your sexual desire has waned. Or perhaps things that once brought you pleasure now seem painful. You're concerned about your sexual health. You're not alone. Many women experience sexual difficulties at some point in their lives. By some estimates as many as four in 10 women experience at least one sexual concern. In medical circles, this is what is known as female sexual dysfunction. Female sexual dysfunction implies persistent or recurrent problems encountered in one or more of the stages of sexual response. What you're experiencing isn't considered female sexual dysfunction unless you're distressed about it or it negatively affects your relationship with your partner. Although sexual problems associated with female sexual dysfunction are multifaceted, they're treatable. Communicating your concerns and understanding your anatomy and your body's normal physiological response to sexual intimacy are important steps toward regaining sexual satisfaction.
Signs and symptoms Sexual concerns occur in women of all ages but may become more prevalent during hormonally vulnerable times, such as after childbirth or with the changes thatb take place associated with menopause. Sexual concerns may also occur with major illness, such as cancer, or emotional problems, such as depression. Your problems might be classified as female sexual dysfunction if you experience one or more of the following and you experience personal distress because of it: * Your desire to have sex is low or absent. * You can't maintain arousal during sexual activity or you don't become aroused despite a desire to have sex. * You cannot achieve an orgasm. * You have pain during sexual contact.
Several factors may contribute to sexual dissatisfaction or dysfunction. These factors tend to be interrelated. Women with sexual concerns benefit from a combined treatment approach that addresses medical as well as emotional issues. * Physical. Physical conditions that may cause or contribute to sexual problems include arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems and neurological disorders such as multiple sclerosis. Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs, can decrease sex drive and your ability to achieve orgasm. * Hormonal. Lower estrogen levels during the menopausal transition may lead to changes in your genital tissues and your sexual responsiveness. The folds of skin that cover your genital region (labia) shrink and become thinner, exposing more of the clitoris. This increased exposure sometimes reduces the sensitivity of the clitoris, or may cause an unpleasant tingling or prickling sensation. In addition, with the thinning and decreased elasticity of its lining, the vagina becomes narrower, particularly if you're not sexually active. Also, the natural swelling and lubrication of the vagina occur more slowly during arousal. These factors can lead to uncomfortable or painful intercourse, and achieving orgasm may take longer. Changes associated with the declining estrogen levels of menopause may impact sexual function. However, most women continue to have satisfying sexual intimacy during and after menopause. * Psychological and social. Psychological factors that cause or contribute to sexual problems include emotional difficulties such as untreated anxiety, depression or stress, and a history of sexual abuse. During pregnancy, after childbirth or while breast-feeding, you may experience a decrease in sexual desire. You may find it difficult to fill multiple needs and roles, such as job demands, homemaking, being a mother and sometimes also caring for aging parents. Your partner's age and health, your feelings toward your partner, and your view of your own body or that of your partner are additional factors that may combine to cause sexual problems. Cultural and religious issues also may be contributing factors. Psychological factors may contribute to sexual dysfunction as mentioned. Regardless of the cause of sexual dysfunction, you usually need to address emotional and relationship issues first.
If you're bothered by your sexual concerns, make an appointment with your health care provider for guidance.
Treatment Treatment may involve treating the underlying medical or hormonal condition contributing to sexual dysfunction, as well as addressing emotional and relationship issues that result or contribute to the dysfunction. In some cases, female sexual dysfunction can be treated by taking specially prescribed medications. But quite often, successful treatment requires no medications. Nonmedical treatment for female sexual dysfunctionImprove your sexual health by making healthy lifestyle choices and enhancing communication with your partner. * Communicate with your partner. Open and honest communication with your partner can enhance your emotional and sexual intimacy. Some couples never talk about sex, while others are less inhibited. 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. There are good books to help you with this. Ask your doctor for recommendations. It can be difficult to resolve differences in sexual desire with your partner over a lifetime. Communicating your feelings can help. * Make healthy lifestyle changes. Avoid drinking excessive amounts of alcohol, stop smoking, exercise regularly and make time for leisure and relaxation. All are as important for your sexual health as for your overall health. Too much alcohol blunts your sexual responsiveness. Cigarette smoking restricts blood flow. Decreased blood flow to your sexual organs can lead to decreased sexual arousal or orgasm. Regular aerobic exercise can increase your stamina, improve your body image and elevate your mood. Learning to relax amid the stresses of your daily life can enhance your ability to focus on the sexual experience and attain better arousal and orgasm. * Strengthen pelvic muscles. Pelvic floor exercises can help with some arousal and orgasm problems. Doing Kegel exercises strengthens the muscles involved in pleasurable sexual sensations. To perform these exercises, tighten your pelvic muscles as if you're stopping your stream of urine. Hold for a count of five, relax and repeat. Do these exercises several times a day. Your doctor also may recommend exercising with vaginal weights. By using a series of five weights, each increasingly heavier, that you hold in place in your vagina, you can strengthen pelvic floor muscles. You gradually work up to heavier weights as your muscle tone improves. * Seek counseling. Talking with a sex therapist or counselor skilled in addressing sexual concerns can benefit you whether your condition is due to emotional factors or not, since even sexual problems that are hormonal in origin can affect your emotional health and intimacy with your partner. Evaluation with a sex therapist typically includes a review of your sexual identity, beliefs and attitudes; relationship factors including intimacy and attachment; communication and coping styles; and your overall emotional health. Therapy often includes education about sexual response and techniques, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises.
At each stage of your life, you experience changes in sexual desire, arousal and satisfaction. Accepting these changes and exploring new aspects of your sexuality during times of transition contribute to positive sexual experiences. Understanding your body and what makes for a healthy sexual response can help, too. The more you and your partner know about the physical aspects of your body and how it works, the better able you'll be to find ways to ease sexual difficulties. Ask your doctor about how things like aging, illnesses, pregnancy, menopause and medicines might affect your sex life. Know that sexual response often has as much to do with your feelings for your partner as it does with physical sexual stimuli. You may feel sexual because you want to get closer to or communicate your affection with your partner. For women, emotional intimacy tends to be an essential prelude to sexual intimacy. Show affection and communicate openly with your partner about your feelings — it can help you reconnect and discover each other again.
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