Identifying and treating sexual problems for women

An enjoyable sex life is a healthy and natural part of adulthood. However, most women have gone through periods of either losing desire or of finding intercourse uncomfortable.

There are many reasons for sexual problems—stress or lack of energy from leading busy schedules are the most common causes. If sexual concerns are creating distress for you and your partner one option is to seek help from your doctor. Try not to feel embarrassed. Many successful therapies are available.

Common sexual problems

It is important to determine whether your sexual problems are of recent origin or whether they have always been present to some degree. This may help to identify potential causes that will, in turn, lead to the right solutions. Some common complaints are:

• lack of desire or timing of desire
• inability to achieve orgasm
• discomfort or pain during intercourse

Lack of desire

This is one of the most common sexual complaints in women and usually can be caused by a number of factors, including the following:

• Physical and emotional fatigue and loss of energy. This is usually a temporary problem that eases when stress is reduced. Try making dates with your partner for a night, a weekend, or even just an afternoon away from home. Distance from family responsibilities can arouse sexual desire.
• Boredom. When you have been with your partner for a long time, sex may start to feel as though it lacks the excitement you require for arousal. A little creative thinking can be a great cure.
• Unresolved conflict with your partner. If you hold onto anger or resentment, you may find it difficult to become sexually aroused. Talk to your doctor about a referral for therapy or marriage counseling.
• Medication or health conditions. Some of these can produce a side effect of reduced sexual desire. Discuss this with your doctor.
• Never had desire. This can result from psychological problems involving guilt or anxiety, sometimes stemming from abuse. Talk to your doctor if this is a concern for you.

Inability to achieve orgasm

A small percentage of women reach orgasm during intercourse. Most women require additional stimulation. The following tips can help get you on the right track:

• Know your needs yourself. If you don’t know what you like, how can anyone else?
• Discuss it with your partner. It can be a difficult topic but don’t be afraid to ask your partner for what you need.
• Consider exploring. Try some different positions and sexual aids. This can also add some new fun and mystery to your sexual encounters.
• Medical conditions or medications. Some can affect genital arousal. Discuss this with your doctor if you suspect this may be true in your case.
• Menopause. Menopause may affect genital sensitivity. Hormone replacement therapy or alternative medicines can be helpful. Talk to your doctor.

Discomfort or pain

Always talk to your doctor if sexual activity is causing discomfort or pain. Yeast or bladder infections can be at the root of discomfort as can a small pelvis. Menopause may result in decreased lubrication and vaginal dryness. Your doctor may recommend a lubricating gel or medication.

Sex is an important part of a full and rich life at all stages of adulthood. If something is preventing you from enjoying a fulfilling sex life, seek out further information or medical advice. You owe it to yourself.

This information is provided to supplement the care provided by your healthcare provider and is not to be used as a substitute for professional medical advice. Always seek the advice of your healthcare provider if you have questions about a medical condition or plan of treatment.

April Stewart
Nurse Practitioner trained in primary care