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A host of sexual problems besides female sexual arousal disorder (FSAD) can affect women at any stage of life. As with FSAD, the cause can be primarily physical, psychological, or both. To be considered a disorder, the problem must cause personal distress or problems in a woman's relationship with her partner. Keep in mind that sexual activity is not correlated with overall sexual satisfaction or intimacy in all woman. A physician will need to determine the cause before deciding on an appropriate treatment. The most common disorders include:
Hypoactive sexual desire disorder
Women with this disorder experience a persistent lack of sexual desire or appetite, absence of sexual fantasies and complete lack of interest in and avoidance of sexual contact with a partner. A Journal of the American Medical Association study says sexual dysfunction was common in 43 percent of women. It may be caused by boredom or unhappiness in a long-standing relationship or may result from traumatic events in childhood or adolescence. Depression also may play a role. Possible physical causes include drug side effects and a hormone deficiency.
Painful intercourse
Dyspareunia and vaginismus are the two most common sexual pain disorders in women. Women with dyspareunia experience pain during sexual intercourse. This disorder can have a range of causes:
- Poor vaginal lubrication because of inadequate foreplay
- The natural changes that occur after menopause
- Postmenopausal thinning of the vaginal wall
- Inflammation or infection of the area
- Irritation from an allergic reaction or to a contraceptive device
Pelvic pain may also be a symptom of a condition affecting the cervix and/or uterus, such as the growth of tumors. A physician will need to determine the underlying cause before prescribing treatment. For women who have passed menopause, and therefore have lower blood levels of the female hormone estrogen in their bodies, estrogen replacement therapy or topical creams may be helpful. Liberal use of a water-soluble lubricant just before intercourse may also alleviate pain for some women.
A relatively rare condition, vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance, interfering with sexual intercourse. Its cause is almost always psychological: It usually occurs in women who fear that penetration will be painful and may stem from a previous traumatic or painful experience.
The problem is treated with educational counseling and, sometimes, progressive vaginal dilation, which helps to relax the muscle spasm. This therapy involves the use of vaginal inserts, each progressively larger than the last, which help condition the vaginal opening. As one becomes comfortable, the next larger size is inserted in the vagina. This process continues until the vagina has been dilated sufficiently for intercourse to take place painlessly.
Female orgasmic disorder
Women with this disorder are aroused by sexual stimulation but then are unable to cross the threshold from arousal to climax, or orgasm. It is not just the failure to have an orgasm during intercourse. This can be quite common for women. But most are able to achieve orgasm when their partner manually or orally stimulates the clitoris. Women who don't have orgasms are considered to have the disorder. Antidepressants and some medications may contribute to the problem.
Other causes have to do with the sexual relationship itself:
- Inadequate foreplay
- Ignorance of genital function and anatomy
- Premature ejaculation
Some women may fear losing control, abandoning themselves to a partner or finding pleasure in a sexual experience. Counseling usually is prescribed.
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This article was reviewed and updated June 2007.
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