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Sexual Problems of Women
A woman’s sexuality is a complex interplay of physical and emotional
responses that affects the way she thinks and feels about herself.
When a woman has a sexual problem, it can affect many aspects of her
life, including her personal relationships and her own self-esteem.
Many women are hesitant to talk about their sexuality. Instead, they
needlessly suffer in silence when their problem could be treated with
medical or psychological therapy, or both.
Sex includes a wide variety of intimate activities, such as fondling,
self-stimulation, oral sex, vaginal penetration and intercourse. Every
woman differs in her sexual interest, response and expression. A
woman’s feelings about sexuality can change according to circumstances
and the stages of her life. Women also can experience a variety of
sexual problems, such as lack of desire, difficulty in becoming
aroused, or pain during sex. An occasional sexual problem that seems
to go away on its own is normal. However, when the problem is
persistent, or pain is involved, it’s time to contact a health care
professional.
Although sexual responses are highly individualized and do vary, when
a woman has sex, her body goes through a pattern of responses called
the sexual response cycle. The cycle consists of the following stages:
* Desire. This is the
feeling that you want to have sex.
* Arousal. Physical changes occur in your body to prepare it for sex.
The changes include moistening of the vagina and its opening, called
the vulva; relaxation of the muscles of the vagina; swelling of the
labia, (skin folds surrounding the vulva), and the clitoris (a small,
sensitive organ near the opening of the vagina that acts as a source
of sexual excitement); and lifting of the uterus.
* Orgasm. Known as the peak of the sexual response, the muscles of the
vagina and uterus contract and create a strong feeling of pleasure.
* Resolution. The body returns to its normal state.
Sexual dysfunctions are disturbances in one or more of the sexual
response cycle’s phases, or pain associated with arousal or
intercourse.
You may be at greater risk for sexual problems if you are:
* single, divorced, widowed, or separated. * experiencing emotional or
stress-related problems. * experiencing a decline in your economic
position. * feeling unhappy, or physically and emotionally
unsatisfied. * a victim of sexual abuse or forced sexual contact.
There are several types of sexual dysfunctions. They can be lifelong
problems that have always been present, acquired problems that develop
after a period of normal sexual function, or situational problems that
develop only under certain circumstances or with certain partners.
Causes of sexual dysfunctions can be psychological, physical, or both.
Lack of sexual desire is the most common sexual problem in women.
Often, sexual desire is affected by a woman’s relationship with her
sexual partner. The more a woman enjoys the relationship, the greater
the desire for sex. The stresses of daily living can affect desire,
and feeling uninterested in sex occasionally is no cause for concern.
But, when sexual fantasies or thoughts and desire for sexual activity
are persistently or recurrently reduced or absent, and cause distress
or interpersonal difficulties, the problem is known as hypoactive
sexual desire disorder, or inhibited sexual desire disorder.
Avoiding all or almost all genital sexual contact with a sexual
partner, to the point that it causes personal distress and
relationship difficulties is a problem known as sexual aversion
disorder. It affects women who have experienced some type of sexual
abuse, or who grew up in a rigid atmosphere in which sex was taboo.
Sexual arousal disorder is the persistent or recurrent inability to
reach or sustain the lubrication and swelling reaction in the arousal
phase of the sexual response. It is the second most common sexual
problem among women, and most frequently occurs in postmenopausal
women. Decreased estrogen levels that occur after menopause may make
the vagina dry and thin, shrink vaginal tissue, and reduce blood flow
to genital tissues. As a result, for menopausal and postmenopausal
women, the arousal phase of the sexual response may take longer, and
sensitivity of the vaginal area can decline. Arousal disorders often
lead to orgasm problems. Orgasms vary greatly in length and intensity,
and often feel different at different times for women.
Persistent absence or recurrent delay in orgasm after stimulation and
arousal is known as female orgasmic disorder. About 10 percent of
women have never had an orgasm, regardless of the stimulation or
situation.
Most women are biologically able to experience orgasm. Never having an
orgasm, or not having one in certain situations, are problems that
often can be corrected by learning how the female body responds, how
to ensure adequate stimulation, and/or how to overcome inhibitions or
anxieties.
Some blood pressure,
antidepressants and antipsychotic medications can decrease desire and
interfere with orgasm. If you are taking such drugs and experiencing
such sexual function side effects, talk with your health care
professional about changing your prescription.
Pain during or after
intercourse, called dyspareunia, occurs in nearly two out of three
women at some time during their lives, according to the American
College of Obstetricians and Gynecologists. Like other sexual
disorders, it can have physical or emotional causes, or both. The most
common cause of pain during sex is inadequate vaginal lubrication that
can occur from a lack of arousal, medications, or hormonal changes.
Painful sex also can be a sign of illnesses, infections, cysts, or
tumors needing medical treatment or surgery, which is another reason
why you should discuss the problem with your health care professional.
A type of sexual pain disorder is vaginismus, which is the involuntary
spasm of the muscles at the opening of the vagina, making anything
entering the vagina painful. Vaginismus can have medical causes,
including:
* scars in the vagina from an injury, childbirth or surgery
* irritations from douches, spermicides or latex in condoms
* pelvic infections
Vaginismus also can have psychological causes. It can be a response to
a fear, such as fear of losing control or fear of pregnancy. It can
also stem from pain or trauma, such as rape or sexual abuse.
According to the American College of Obstetricians and Gynecologists,
a woman’s sexual response tends to peak in her mid-30s to early 40s.
That’s not to say, however, that a woman can’t have a full physical
and emotional response to sex throughout her life. In fact, the 1999
JAMA study found the prevalence of many sexual problems among women
tends to decrease as they age. Most people will have a passing sexual
problem at some point in their lives, and that is normal.
If your relationship or sexual problem is new, try having an open,
honest talk with your partner to relieve concerns and clear up
disagreements or conflicts. Women who learn to tell their partners
about their sexual needs and concerns have a better chance at a more
satisfying sex life. If the sexual problem persists, do discuss your
concerns with your health care professional. Most sexual problems can
be treated.
PREVENTION
A healthy lifestyle can go a long way toward preventing chronic
illnesses and diseases that can contribute to sexual dysfunctions.
Eating a balanced diet, getting plenty of exercise, stopping smoking,
limiting alcohol consumption, and controlling stress will make you
feel well, help you build a healthy self-image, boost your energy, and
help you maintain confidence in your sexuality. Visit your health care
professional regularly to head off medical problems that may affect
your sexual responses.
Other things you can do to enhance your sexual desire and pleasure
include:
* Communicate with your partner. Emotional intimacy is the essential
beginning for sexual intimacy for many women. Talk frankly and
honestly about your feelings with your partner to help build your
relationship. Silence can result in repressed feelings, anger and
alienation that can harm your well-being and even your long-term
mental and physical health.
* Express your desires. Tell your partner what you want sexually, what
“turns you on” and guide your partner in what pleases you.
* Be less predictable, and more spontaneous in your sexual
experiences. Partners who have been together for years can get into
patterns where sex is always the same. Try new ways to be intimate,
prolong your sexual experience, and be more creative with touching,
positions, and timing and location of sexual activities.
* Examine your priorities. Don’t let work or family responsibilities
take time away from your relationship with your partner. Spending time
together is part of building intimacy, and helps both partners feel
connected to each other and cared for by each other.
* Stay sexually active after menopause. Regular sexual activity, with
a partner or through self-stimulation, helps improve vaginal
lubrication and elasticity as estrogen levels decline.
Sexuality is highly personal and varies from woman to woman. A woman’s
sexual responses can vary from one time to another, and no one pattern
is more “normal” than another. Nearly everyone has a problem with sex
at some time in their lives, and often the problem can be worked out
with patience and talking with your partner. When the problem is
life-disrupting, causes trouble in your relationships or involves
physical pain, it’s time to talk with your health care professional.
In many cases, your sexual problem can be treated, with medical
treatments, psychological therapy, or both.
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