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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 worry. This is called female sexual dysfunction.
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 recapturing your sexual pleasure.
Symptoms
Sexual concerns occur in women of all ages but may become more prevalent during hormonally vulnerable times, such as postpartum or with the menopausal transition. Sexual concerns may also occur with major illness, such as Cancer.
Your desire to have sex is absent.
You can't maintain arousal during sexual activity
You don't become aroused even though your have a desire to have sex.
You don’t experience an orgasm.
You have pain during sexual contact. you experience personal distress because of it:
Several reasons may be part of the cause to sexual dissatisfaction or dysfunction you are experiencing. These factors tend to be interrelated. Women with sexual concerns gain help from a combined treatment approach that addresses medical as well as emotional issues.
Physical. Arthritis, urinary or bowel difficulties, pelvic surgery, fatigue, headaches, other pain problems and neurological disorders such as multiple sclerosis can cause sexual dysfunction. 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 sensatioal.
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 (dyspareunia), 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 the menopausal transition.
Psychological and social. Psychological factors such as untreated anxiety, depression or stress, and a history of sexual abuse can cause this condition. 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 or result from sexual dysfunction. Regardless of the cause of sexual dysfunction, you usually need to address emotional and relationship issues for treatment to be effective.
Your doctor may engage a discussion about your sexual concerns during the course of a routine medical visit, or you can initiate the discussion if you have concerns that you'd like to address with your doctor. You and your doctor will talk about your sexual history, whether you're currently sexually active and what your sexual concerns are.
Your doctor will likely review medications you're taking along with your medical history and perform a complete physical exam. During the pelvic exam, your doctor may check for signs of physical changes contributing to sexual concerns, such as thinning of your genital tissues, decreased skin elasticity, scarring, pain or pelvic organ prolapsed.
Your doctor may refer you to a specialized counselor or sex therapist to evaluate emotional and relationship factors as well as review your sexual identity, beliefs and attitudes.
Low sexual desire. You have poor libido, or lack of Sex Drive. This is the most common type of sexual disorder among women.
Sexual arousal disorder. Your desire for sex might be intact, but you're unable to become aroused or maintain arousal during sexual activity.
Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact.
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. Usually, successful treatment requires no medications.
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 an unthreatened 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.
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.
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.
Medical treatment
Hormonal treatment
Estrogen therapy. Estrogens are important in maintaining the health of vaginal and external genital tissues. Replacing Estrogen can improve sexual function in a number of ways, including increasing the tone and elasticity of vaginal tissues, increasing vaginal blood flow, enhancing lubrication, and having a positive effect on brain function and mood factors that impact sexual response. Localized Estrogen therapy in the form of a vaginal cream, gel or tablet can help with sexual changes due to menopause.
Progestin therapy. In some research studies, women taking progestins experienced a decrease in sexual desire and vaginal blood flow. However, in other studies, women experienced improvements in desire and arousal when they took a progestin in addition to Estrogen. More studies are under way to see if different progestin regimens, alone or in combination with Estrogen and other hormonal agents, may benefit sexual function. Progestins generally are prescribed to balance Estrogen's effect on the Uterus and not to treat sexual dysfunction.
Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone is important for sexual function in women as well as men, although testosterone occurs in much lower amounts in a woman. Androgen therapy for sexual dysfunction is controversial. Some studies show a benefit for women who have Low Testosterone levels and develop sexual dysfunction, for instance after surgical menopause due to removal of the ovaries. In these women, testosterone therapy reportedly improved libido, arousal and sexual thoughts. Other studies show little or no benefit of testosterone therapy for women.
Adjusting or changing medications that have sexual side effects.
Treating thyroid problems or other hormonal conditions.
