Female Sexual Dysfunction

Sexual dysfunction refers to a problem with one or more stages in the sexual response cycle. Researchers say about 45 percent of women 50 and older report having some degree of sexual dysfunction.

The most common type of female sexual dysfunction is low desire or lack of desire (occurring in 43 percent of the women in the New England Journal of Medicine study). Stress, hormonal changes, fatigue, relationship issues or abuse can affect a woman’s desire to have sex.

Another common problem is the inability to have a satisfactory orgasm (reported by 34 percent of women 57 and older). Some women find they are no longer able to reach orgasm, while others may report having much weaker orgasms. Emotional issues (like fear, depression or anger) and use of alcohol or certain medications can affect the ability to have an orgasm. A woman may need more stimulation to reach an orgasm as she gets older. In some cases, a woman may be reluctant to express sexual needs with her sex partner.

Pain during intercourse is an other common problem. The pain may occur during penetration, during deep thrusting or after sex. In most cases, the symptoms are the result of insufficient lubrication of the vagina (occurring in 39 percent of older women). Hormonal changes, illness or pelvic infection, lack of arousal, medications, endometriosis, cysts or tumors can affect vaginal lubrication and/or cause pain during intercourse.

Helping Women
Bat Sheva Marcus, L.M.S.W., Ph.D. is a Medical Sexologist and Clinical Director at The Medical Center for Female Sexuality in Purchase, NY. She says female sexual dysfunction hasn’t received nearly the amount of attention from health care providers and pharmaceutical companies as male sexual dysfunction. Some experts even question whether female sexual problems are a legitimate medical issue. However, the symptoms are real in many women. And for some, sexual dysfunction can greatly affect self-esteem, cause significant emotional distress and lead to strained relationships.

Marcus says tracking the root of the problem can be tricky. Many female sexual problems are associated with changing levels of hormones, and thus, are more common during life transition phases, such as after the birth of a child, during perimenopause and after menopause. But other factors can also be involved, like physical health, relationship issues, former sexual experiences and use of alcohol, drugs or certain medications.

During an initial interview with clients, Marcus obtains a history of sexual experiences and assesses relationships with partners and children. That helps narrow down possible factors that may be contributing to the problem. Blood tests may be done to measure hormone levels. The client may also be evaluated by a nurse practitioner and urologist.

Treatment is still a relatively new field and it can take time and persistence to find the right therapy or combination of therapies. Some medications, like testosterone gel, may be used off-label. Estrogen replacement may also be needed as well as counseling or couples therapy. In addition, women may need to learn how to effectively communicate their sexual needs with a partner and/or develop different methods to raise sexual arousal.

News 2 Viewer Inquiry
Dr. Bat Sheva Marcus has a website at http://www.centerforfemalesexuality.com

For general information:
American College of Obstetricians and Gynecologists, http://www.acog.org