Women who do not enjoy satisfying sexual experiences with their partners often report the following:
- Lack of sexual desire (low libido)
- Inability to attain an orgasm
- Pain or other distress during penile penetration
- An inability to fantasize about sexual situations
- Indifference to, or repulsion by, having sex
- Feelings of fear or anger towards their partners
Most often, any of these responses have psychological complications. Whether the symptoms are due to physical factors, such as menopause, or have their origins in more deep-seated psychological triggers, many women are likely to feel inadequate or dysfunctional. They blame themselves for not being sexually responsive, have trouble explaining to their partners about how they feel, and experience low self-esteem as a result.
Establishing the cause of sexual dysfunction is half the battle. The stage of sexual activity at which a woman is having problems may offer some clues. Other evidence may be found through physical and psychological testing. Your family doctor can refer you to specialists who can help pinpoint what's causing the problem.
In sexual desire disorder, a woman experiences a decreased interest in having sex. If the lack of interest is new and extends to all partners and situations, the doctor will likely consider causes such as medications, medical conditions such as depression, hormonal changes, or imbalances in certain neurotransmitters (the brain's chemical messengers). On the other hand, sexual desire disorder may be caused by interpersonal factors if it's confined to one partner or one situation.
Sexual arousal disorder refers to a woman's inability to become lubricated, aroused, or sexually excited, even after being sexually stimulated.
Orgasmic disorder means that a woman may enjoy sexual activity but has difficulty reaching orgasm or takes a very long time to reach orgasm. Physical causes are rare, except in cases of nerve damage in the spine. Psychological factors may range from never having learned how to have an orgasm, to unrealistic expectations from a partner, to feelings of guilt at experiencing pleasure. Orgasmic disorder is diagnosed only when a woman has no difficulty with arousal, only with climax
Female sexual dysfunction has many possible symptoms and causes, so treatment varies. Communicating your concerns and understanding your body and its normal response to sexual activity are important steps toward gaining sexual satisfaction.
Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.
Nonmedical treatment for female sexual dysfunction
Practice healthy lifestyle habits. Go easy on alcohol — drinking too much can blunt your sexual responsiveness. Stop smoking — smoking restricts blood flow to your sexual organs, decreasing sexual arousal. Be physically active — regular physical activity can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy your sexual experience.
Use a lubricant. A vaginal lubricant may be helpful during intercourse if you experience vaginal dryness or pain during sex.
Treating female sexual dysfunction linked to a hormonal cause might include:
Estrogen therapy. Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
Androgen therapy. Androgens include male hormones, such as testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower amounts of testosterone. Androgen therapy for sexual dysfunction is controversial, however. Some studies show a benefit for women who have low testosterone levels and develop sexual dysfunction; other studies show little or no benefit.
The risks of hormone therapy may vary, depending on whether estrogen is given alone or with a progestin, your age, the dose and type of hormone, and health issues such as your risks of heart and blood vessel disease and cancer. Talk with your doctor about benefits and risks. In some cases, hormonal therapy might require close monitoring by your doctor.