![]()
Overview
The term sexual dysfunction describes a person's inability to fully, healthily,
and pleasurably experience some or all of the various physical states or stages
the body normally goes through during sexual activity. These stages can
be broadly thought of as the desire phase, the arousal phase, and the orgasm
phase. It has been estimated that about 19% to 50% of women are affected
by sexual dysfunction to some degree.
In women, sexual dysfunction takes many forms and has numerous causes, but
a particular kind of dysfunction at one stage of sexual activity is often connected
to dysfunction at another. This makes it important to address all of sexuality's
aspects - whether physical, psychological, physiological (mechanical), or
interpersonal - in order to resolve problems. Female sexual dysfunction is actually
quite common. As many as one in seven women believes she's never had an orgasm.
In men, sexual dysfunction is called erectile dysfunction.
Causes
Female sexual dysfunction can have a physiological basis in the body (something
is physically wrong), a psychological basis in the mind, or be the result of
both underlying mental and physical problems. It can also be a matter of
problems with technique: some women never fully experience sexual arousal and
orgasm because they or their partners lack sexual knowledge. They may not understand
how female sex organs respond or are stimulated, or don't use appropriate arousal
techniques. In these cases, a lack of understanding of the function of the clitoris,
the female sex organ producing orgasm, may be at the root of the problem.
At the same time, sexual dysfunction has a strong interpersonal component.
A person's notion of their own sexuality is largely determined by culture, society,
and personal experience. It may be intimately connected to their own or society's
ideas about the appropriate or inappropriate expression of sexual behaviour.
These feelings may cause anxiety because of a personal or cultural association
of sexual experience and pleasure with immorality and bad behaviour. Anxiety
is then expressed physically by the body in a way that prevents normal sexual
function. Anxiety can do this, for example, by stopping or slowing the state
of sexual excitement allowing the lubrication or moistening of the female genitalia -
an important step towards fulfilling forms of sexual activity.
Personal character, disposition, and life experience play a large part in
sexual dysfunction. Fear of intimacy can be a factor in arousal problems.
Experiences of abuse, either in childhood or in past or current relationships,
can establish a cycle of associating sex with psychological or physical pain.
Attempting sexual activity in these circumstances causes more psychological
or physical pain. For example, if anxiety prevents lubrication, sexual intercourse
can be painful.
Conflict, tension, and incompatibility with a sexual partner can cause sexual
dysfunction. Depression may be a cause, and stress a contributing factor.
Medications, including oral contraceptives, antihypertensives, antidepressants,
and tranquilizers are very common causes of sexual dysfunction. Also, the use
of oral contraceptives can decrease a woman's interest in sex. If you're taking
any of these medications, talk to your doctor about its possible contribution
to sexual problems.
Physical causes include disorders of the genitalia and the urinary system
such as endometriosis, cystitis, vaginal dryness, or vaginitis. Other conditions
such as hypothyroidism, diabetes mellitus, multiple sclerosis, or muscular dystrophy
can have an impact on sexual desire and ability. Surgical removal of the uterus
or of a breast may contribute psychologically to sexual dysfunction if a woman
feels her self-image has been damaged.
Certain prescription and over-the-counter medications as well as the use of illegal drugs
or abuse of alcohol may contribute to sexual dysfunction. Cigarette smoking may
have a negative effect on sexual arousal in women.
Although women can remain sexually active and experience orgasms throughout
their lives, sexual activity often decreases after age 60. While part of this
may be due to a lack of partners, changes such as dryness of the vagina caused
by lack of estrogen after menopause may make intercourse painful and reduce
desire. After menopause, about 15% of women feel a strong decrease in sexual
desire.
Symptoms
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
- experience pain or other distress on 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, cannot
explain to their partners about how they feel, and experience low self-esteem
as a result.
Treatment
Physical disorders should be treated. For decreased desire associated
with aging and dryness of the vagina, a combination of the hormones testosterone
and estrogen can be effective. When psychological factors are foremost, counselling
from a psychiatrist, psychologist, or sex therapist may help to remove or reduce
the causes. Psychotherapy may be more useful if there has been some trauma in
a woman's background, or problems that stem from stress or relationships. Therapy
that includes a sexual partner is more helpful in increasing the chance of learning
to experience orgasm. There's a 95% success rate in therapy helping women get
over orgasmic dysfunction.
To both treat and prevent sexual dysfunction, women should understand how their
sex organs work and how they can respond. Knowing the best ways to stimulate
the clitoris and to enhance vaginal sensations throughout life is very helpful
and can be learned through information and education that can be found in books
and booklets that discuss normal anatomy, sexual function, and normal changes
of aging. Activities like "Kegel exercises" involve repeated clenching
of the vaginal muscles and improving muscle tone, as well as a sense of control
and the quality of orgasm. This is one technique of many that women of every
age can use in order to enhance sexual pleasure.
Other tips:
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 gains little or no pleasure from
sexual activity. The lack of pleasure almost always results in loss of
desire (which can sometimes happen first). The cause is likely depression or
drugs (prescription or otherwise) if the lack of interest is new and extends
to all partners and situations. On the other hand, this problem may point to
interpersonal factors if it's confined to one partner or one situation. If an
aversion to sexual pleasure has lasted through life, it may come from deep-seated
dilemmas about sexual gratification caused by family dysfunction or childhood
trauma.
Sexual arousal disorder refers to a woman's inability to become lubricated,
even after being sexually stimulated. The disorder may be lifelong but is more
commonly restricted to a particular partner.
Orgasmic disorder means that a woman may enjoy sexual activity but can't
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 climax.
© MediResource Inc. Terms and conditions of use: The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.