Definition Has your sex life lost some of its spark because your body feels unresponsive or you're just not interested? You might take comfort in knowing that as many as four in 10 women have the same problem at some point in their lives.
If you have persistent or recurrent problems with sexual response — and if these problems are making you distressed or straining your relationship with your partner — what you're experiencing is known medically as female sexual dysfunction.
Female sexual dysfunction has many possible symptoms and causes. Fortunately, they're almost all treatable. Communicating your concerns and understanding your anatomy and your body's normal response to sexual activity are important steps toward gaining sexual satisfaction.
Symptoms
You can develop female sexual dysfunction at any age, but sexual problems are most common when your hormones are in flux — for example, when you've just had a baby or when you're making the transition into menopause. Sexual concerns may also occur with major illness, such as cancer.
Your problems might be classified as female sexual dysfunction if you experience one or more of the following and you're distressed about it:
- Lack of sexual desire -your desire to have sex is low or absent.
- Inability to become aroused -You can't maintain arousal during sexual activity, or you don't become aroused despite a desire to have sex.
- Lack of orgasm, or sexual climax -You cannot experience an orgasm.
- Painful intercourse-You have pain during sexual contact.
Causes
Several factors may contribute to sexual dissatisfaction or dysfunction. These factors tend to be interrelated.
- 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 your sex drive and your body's ability to achieve orgasm.
- Hormonal. Lower oestrogen 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) 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, the vaginal lining becomes thinner and less elastic, particularly if you're not sexually active. At the same time, the vagina requires more stimulation to relax and lubricate before intercourse. These factors can lead to painful intercourse (dyspareunia), and achieving orgasm may take longer.
Your body's hormone levels also shift after giving birth and during breast-feeding, which can lead to vaginal dryness and can affect your desire to have sex.
- Psychological and social. Untreated anxiety or depression can cause or contribute to sexual dysfunction, as can long-term stress. The worries of pregnancy and demands of being a new mother may have similar effects. Longstanding conflicts with your partner — about sex or any other aspect of your relationship — can diminish your sexual responsiveness as well. Cultural and religious issues and problems with your own body image also may contribute.
Emotional distress can be both a cause and a result of sexual dysfunction. Regardless of where the cycle began, you usually need to address relationship issues for treatment to be effective.
When to seek medical advice
If sexual problems are undermining your relationship or disrupting your peace of mind, make an appointment with your doctor for evaluation.
Female sexual dysfunction is generally divided into the following four categories, which are not mutually exclusive:
- Low sexual desire. You have diminished libido, or lack of sex drive.
- Sexual arousal disorder. Your desire for sex might be intact, but you have difficulty or are unable to become aroused or maintain arousal during sexual activity.
- Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
- Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.
Sexual response is a complex interaction of many components, including physiology, emotions, experiences, beliefs, lifestyle and relationships. If any one of these components is disrupted, sexual drive, arousal or satisfaction may be affected.
Non medical treatment for female sexual dysfunction
you can improve your sexual health by enhancing communication with your partner and making healthy lifestyle choices.
- Talk and listen. Some couples never talk about sex, but 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 non threatening manner can set the stage for greater sexual intimacy.
- Practice healthy lifestyle habits. Avoid excessive alcohol. Drinking too much will blunt your sexual responsiveness. Also, stop smoking and start exercising. Cigarette smoking restricts blood flow throughout your body and less blood reaching your sexual organs means decreased sexual arousal and orgasmic response. 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 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 — a series of five weights, each increasingly heavier, that you hold in place in your vagina — to strengthen pelvic floor muscles. You gradually work up to heavier weights as your muscle tone improves.
- Seek counselling. Talk with a counsellor or therapist specializing in sexual and relationship problems. Therapy often includes education about normal sexual response, ways to enhance intimacy with your partner, and recommendations for reading materials or couples exercises. 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.
Sex therapy
Sex therapy is a short-term form of counselling, generally involving 5 to 20 sessions with a sex therapist. A typical session may be one hour every week or every other week.
During the session, the counsellor will give the patient "assignments" to do at home, such as:
- Reading books about sexuality
- Touching exercises that are designed to take away the pressure to perform during sex
- Practicing better sexual communication skills
Sex therapy may be useful for treating erectile dysfunction if a man is able to have a normal erection during sleep, the results of his physical examination and blood tests are normal and he is generally in good health. Sex therapy may also be helpful when erectile dysfunction is caused by stress, such as: work worries, financial worries, relationship conflicts, and poor sexual communication. In these cases, sex therapy may be the best treatment option.
Does sex therapy work?
Sex therapy is most effective when a man’s sexual partner is willing to be part of the treatment. Studies have shown that for men with stress-related ED, having the partner involved in the therapy resolves the problem 50%-70% of the time. When the man must go through counselling alone, the results are somewhat lower.
For Treatment, Counselling and Sex Therapy
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