Sexual Dysfunction in Women Introduction

Sexual Dysfunction

in Women

Introduction

Sexual problems can occur in women of any age and can occur for a variety of reasons. Sexual problems can include decreased libido or lack of interest in sex, difficulties with arousal or achieving orgasm, or pain and discomfort with intercourse. Women are most likely to be happy with their sex life if they are physically and psychologically healthy and involved in a healthy relationship with their partner. Although hormones, some medications, and certain medical conditions can contribute to sexual problems, more commonly relationship difficulties and overall psychological well-being are the primary causes.

Causes

The cause of a sexual problem can be very simple and reversible, or could be complex and multifactorial. Pain with intercourse can be a result of hormone changes leading to vaginal dryness or thinning of the vaginal tissue. Dyspareunia, or painful intercourse, can also be caused by vaginal or cervical infections, or a disorder where the vaginal muscles are in constant spasm. Pain with intercourse should be brought to the attention of your gynecologist for physical exam and additional testing if needed.

Certain medical conditions can lead to sex problems. These include diabetes, heart problems, depression and other mood disorders. Because some medical conditions could be contributing factors to your sexual dysfunction it is important to see your primary care doctor for annual exams and blood work. Some medications have decreased libido as a side effect. These medications include some of those used to treat high blood pressure, mood disorders, depression, and oral contraceptives. It is also important to mention your decreased libido or sexual complaint to your primary care doctor so that they can evaluate whether or not you are taking a medication that may be causing the problem or suffering from a medical condition, such as depression, that could also be contributing.

Most women satisfied with their sex life are of overall good health physically and psychologically. This is important because substance abuse has been shown to have a direct correlation with sexual dysfunction. If you are a smoker, or abuse drugs or alcohol you are more likely to complain of a decrease sex drive. Obesity has also been correlated with a decrease in sex drive. Regular exercise and a balanced diet to reach a healthy weight can help to increase your libido, as well as your overall health.

Women in healthy relationships are more likely to experience a satisfying sex life. High stress levels, lack of time, and lack of sleep can all contribute to a stressed relationship. Schedule a “date night” for the two of you to be alone without the stress of children, family, bills, and jobs. If you are in a troubled relationship that does not encompass communication, respect, and love, you should seek couples counseling to help improve the relationship. An abusive partner can also cause relationship problems and sexual dysfunction. If you are in an abusive relationship notify the proper authorities. Also, a past history of domestic or sexual abuse may be contributing to the current sexual problems you are experiencing. With the proper counseling, you may be able to overcome these challenges from your past. A referral to a sex therapist or psychiatrist would also be appropriate in this situation.

What can I do on my own to improve my sex problem?

1. 
   Try over the counter vaginal lubricants to help make sex more comfortable. If still experiencing pain with sex, see your gynecologist for a physical exam.
   
2. 
   Talk to your partner about how to have more fun together and try new sexual techniques to increase interest in sex.
   
3. 
   Have a complete physical exam by your primary care doctor, including blood work, to rule out any medical conditions that may be contributing.
   
4. 
   If your partner is experiencing sexual dysfunction, have them see their doctor.
   
5. 
   Considering seeing a sex therapist, with or without your partner, to help with relationship problems or psychological problems that may be contributing to the decrease in libido.
   
6. 
   If you are abusing any substances (i.e. drugs, alcohol, cigarettes) enact a plan and seek assistance to help yourself quit.
   
7. 
   If you are overweight or obese, choose a weight loss plan for yourself.
   

Testing and Treatment

Hormone level testing is not recommended for the complaint of decreased libido because studies have not found a definitive correlation. Blood work by your primary care physician for diabetes, heart disease, etc. should be conducted on a regular basis to rule out that a medical condition is contributing to your sexual complaint. Physical exam, vaginal and cervical cultures, as well as STD testing conducted by your gynecologist are all important for the complaint of vaginal dryness or pain with intercourse

There are no FDA approved medications for women with a decreased libido. Certain medications, including testosterone, are sometimes thought to help increase a women’s libido. These medications can have some undesirable side effects of their own.

The majority of the time a psychological component is the main cause of sexual dysfunction, seeking help from a certified sex therapist may be of benefit for you. Many women find an improvement in their sexual complaint after several sessions of counseling with a certified sex therapist.