Female sexual dysfunction

By Oladapo Ashiru (denrele@uic.edu)

 Oladapo Ashiru

The media tends to present sex as easy, good and spontaneous, implying that we should always be in the mood for it. If only sex were that simple!

The issues of intimacy are of great interest and concern to both men and women. Many knowledgeable doctors now recognise the interrelationship between sex, sexuality and level of health, vitality and function of their patients' lives. Many doctors now realise that sexual satisfaction is an indicator of overall health and are now including the area of sexuality in patients' medical histories.

Knowledgeable doctors now evaluate patients with a view to not only help them with their presenting complaints, but to also look for opportunities to enhance and improve their sex life at the same time. Many patients, both male and female, are, however, uncomfortable with giving the details of this very personal area of their lives. They may often just answer 'Fine,' 'OK' and 'No problem' when confronted with the sexual part of the medical questionnaire, even when all is not well with their sex life.

The overall attitude of secrecy, shame and uncertainty about the role of sexuality in overall health can be well summarized by a recent letter received by a physician"

"I am 52 years of age and so is my husband. It is about our sex life. It just seems like it's gone. Is that normal for our age or can we be low on certain vitamins? Is there something we can get to boost our sex drive? We always had a good sex life and now it is totally gone."

Participating in sexual activities is a good indicator of overall vitality. Loss of interest in sex is a very negative sign for a person's good health and longevity. Blockages in sexual energy will often manifest as deterioration in general health or mental state.

As reflected in the e-mail, there is a general myth that sexual energy wanes and disappears with age. The e-mailer and her husband are only 52 years old, yet she wonders whether a sex life that is "just gone" might be normal for that age.

Well, it's not normal for that age, or any other age for that matter. Continuing to have good health involves continuing to have a sex drive. Many things can sabotage a normal and enjoyable sex life. If you and your partner are experiencing problems with sex, you are not alone. Recent studies reveal that nearly 40 to 90 per cent of women of all ages report having sexual problems.

Many women experience sexual difficulties at some point in their lives. During menopause, as many as half of all women, or even more, may experience sexual dysfunction. Sexual function is no exception. At age 60, for example, one's sexual needs, patterns and performance may not be the same as they were when one was half that age.

What are female sexual problems?

There are a variety of sexual problems that women experience, either alone or with a partner. The term "sex" is not limited to just intercourse, and can also refer to a variety of intimate sexual activities such as fondling, self stimulation or masturbation and oral sex.

Sexual problems are generally defined as any problem that occurs in the course of sexual activity, including not being in the mood, trouble becoming aroused, which usually involves being too dry; difficulty having orgasms, pain during sex or pain related to sexual activity.

Most women experience these from time to time. It is when they are persistent that they become problematic for the woman and her partner. You should seek help promptly if you are experiencing physical pain.

Defining the problems

Sexual dysfunction is defined simply as a persistent or recurrent problem during one or more of the stages of having sex. It is not considered a sexual disorder unless you are distressed about it or if it negatively affects your relationship with your partner. Female Sexual Dysfunction occurs in women of all ages.

Doctors and sex therapists generally divide sexual dysfunction in women into four categories. These are:

Low sexual desire

In this case, you have poor libido, or lack sex drive. This is the most common type of sexual disorder among women and it accounts for 87.2 per cent of cases of FSD. It is the persistent or recurrent lack of sexual thoughts and/or receptivity to sexual activity, which causes personal distress. Low sexual desire may result from endocrine failure and may be associated with psychological or emotional disorders. Sexual aversion disorder is a subcategory of low sexual desire.

Sexual arousal disorder

In this situation, your desire for sex might be intact, but you're unable to become aroused or maintain arousal during sexual activity. It is persistent or recurrent inability to reach or maintain sexual excitement, which causes personal distress. This disorder includes poor vaginal lubrication, decreased genital sensation and poor vaginal muscle relaxation. Arousal disorders are most commonly physiological and can often result from medications, pelvic disorders, as well as neural and peripheral vascular diseases and accounts for 74.7 per cent of FSD.

FSD with orgasmic disorder, which accounts for 83.3 per cent of cases of FSD, comes with persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation. This causes personal distress and trauma to nerves. Pelvic surgery and spinal cord injury can be associated with orgasmic failure.

There is sexual pain disorder in which the vagina is painful after being sexually stimulated or touched. Subcategories include painful intercourse and vagina spasm. This may be caused by injuries during operations and physical or psychological trauma involving the pelvis. This accounts for 71.7 per cent of FSD.