Sexual Problems

 

Female

DEFINITION:

Any difficulty to perform intercourse or reach climax is called Sexual problem.

What is Sexual Problem?

Sexuality encompasses a very broad range of physical activities and psychological experiences for men and women. These activities fullfill an important physical and emotional need for closeness and intimacy.

Common Sexual Problems in Women:

  • Desire disorder- No or less interest in sex (Loss of Libido)
  • Arousal disorder- No feeling of sexual response in body (Cold Attitude)
  • Orgasmic disorder- No orgasm or pain during orgasm (No Climax)
  • Sexual pain disorder- Pain during or after sex (Dyspareunia)
Causes:

Sexual problem in woman could be result of physical or physiological.

Physical Causes:

  • Diabetes
  • Heart Disease
  • Neurological disease
  • Hormonal imbalances
  • Menopause
  • Chronic disease (e.g. Kidney, Liver)
  • Alcoholism
  • Drug abuse
  • Side effect of certain medicine (Eg. Antidepressant)
  • Vaginal dryness
  • Vaginismus/ Vaginitis
  • Endometriosis
  • PID – Pelvic Inflammatory disease
  • Pregnancy

Psychological Causes:

  • Stress
  • Anxiety
  • Concern about sexual performance
  • Marital or relationship problems
  • Depression
  • Feeling of guilt
  • Effects of post sexual trauma

Symptoms :

  • Inability to relax vaginal muscles enough to allow intercourse
  • Inadequate vaginal lubrication
  • Inability to attain orgasm
  • Burning pain on the vulva or in the vagina

DIAGNOSIS:

Diagnosis is made upon following tests.

Physical examination:

  • Attitude towards sex
  • Fear/ anxiety/ guilt
  • Relationship problems
  • Past sexual trauma
Causes for sexual problems in women

1.Desire disorder or loss of libido:

Libido (sexual drive) creates the urge to have sex. Women experience fluctuations in her sexual life more often than men, because women reproductive system is more complicated. Women experience high and low libido. The course for fewer libidos will be menstrual cycle, pregnancy, lactation, and menopause. Main cause for desire disorder will be poor diet, lack of physical activity, some underlying disease, depression, stress due to excess work, relationship problems, responsibilities etc. All these causes need immediate attention of doctor. treatment includes, change the time of sexual activity or try different sexual position.

2. Arousal disorder:

It can be because of decreased Estrogen level or can be more often psychological. Treatment includes Estrogen supplement or Estrogen cream, Psychotherapy etc.

Treatment:

Doctor, sex therapist, Counsellors will suggest the treatment. Most of the time treatment is based upon Psychological factors. Sometimes, it is to cure physical factors.
h5>TREATMENT:

Physical factors

:

  • Minimizing pain:
  • Sexual position            – Position that allow woman to control the depth of penetration, will help to relieve pain.
  • Vaginal Lubricants       – It will help to reduce pain caused by friction.
  • Warm bath                 – In some cases bath before coitus will give the relaxation.
  • Topical Estrogen          – Estrogen is applied as a cream or vaginal insert. It will decrease the dryness of vagina.
  • Hormone Therapy        – As hormones play an important role in regulating sexual function. If level of estrogen decrease, women may experience poor vaginal lubrication and decreased genital sensation. Research suggests that if level of testosterone is low than also there will be lack of arousal, and orgasm. Hormone replacement might help to overcome such sexual problem, but long use of hormones also has a risk of breast cancer, stroke, blood clots and ovarian cancer.
  • Clitoral therapy device – A small suction cup, placed over the clitoris before sex. With battery operated vacuum pump gentle suction draws blood into the clitoris which increases pressure on the clitoral nerve. This device increases lubrication, sensation and orgasm.

  • Drugs   – Viagra effect (Sildenafil) in men for erectile dysfunction is well known, but effect in women is still in research phase, as it includes certain side effects. Eg. Headache, flushing, nasal congestion, low blood pressure, abnormal vision etc.
  • Surgery        – For certain cases to remove cysts, tumors or growth, surgery is required.

3. Orgasmic disorder or Anorgasmia:

In this condition, a woman finds difficulty in achieving an orgasm or has no orgasm at all. Main cause for orgasmic disorder will be

  • Hormonal changes (due to puberty, menstruation, pregnancy lactation or menopause)
  • Incompetence of male partner
  • Stressful living conditions

This problem is a psychological and it can be overcome with few changes in life style or with help of Sex Therapist or Counsellors. A few tip to overcome this problem will be a long fore play before coitus, to get proper stimulation use oral sex, cunnilingus, and clitoral stimulation. Right education, stress free environment, frank communication with partner, music, video etc., will be also a great help.

4. Sexual pain disorder or Dyspareunia:

Dyspareunia (pain during coitus) is also more common in women than a man and main cause for this conditions are:

  • Infection in the lower urinary tract, or reproductive tract (vagina, cervix, fallopian tubes, uterus etc.)
  • Decreased estrogen level and because of that woman might experience dryness in vagina.
  • Radiation therapy – Women under this therapy will also have pain during intercourse.

Treatment is symptomatic, which includes use of lubricants or women can take the penis in her hand and guide it to the vagina.

Psychological factors:

  • Sex Education:  Sex education includes human anatomy, sexual function behaviors and performance. This will help to reduce the anxiety about sex.
  • Stimulation materials or (Enhancing stimulation) : Erotic materials, videos, books, will help in Enhancement of stimulation. Masturbation changes in sexual routines will also be helpful.
  • Destruction techniques: Music, videos can increase relation and reduce anxiety. Erotic / non erotic fantasies, new sexual positions also are helpful.
  • Communication: Free/frank communication with partner will solve the problem. Stimulating activity before coitus will be a great help and it includes sensual massage, kissing etc.

Psychotherapy:

 

  • No knowledge about sex
  • Past sexual abuse or traumatic sexual encounter
  • Rape
  • Unresolved emotional issue
  • Dissatisfaction
  • Less desire for sex

Prevention:

Healthy life style:

  • Healthy diet
  • Regular exercise
  • Stress reliving exercise
  • Regular health screening (eg. Pap test, Mammogram)

Out look towards problems:

Few sexual problems either resolve naturally and few with the help of doctors. Like fear, anxiety, stress, relationship problem can be solved with proper communication or with the help of Therapist.