Female Sexual Problems And Concerns

Female sexuality, like male sexuality, is a complex process involving psychological, neurological, vascular and endocrine systems. Sexuality includes family, societal and religious beliefs, and is altered with aging, health status and personal experience. In addition, sexual activity incorporates interpersonal relationships, each partner bringing unique attitudes, needs and responses into the coupling. A problem in any of these areas may lead to sexual problem..

The term Sexual Dysfunction is a general term used to describe a number of sexual problems which inhibit normal sexual relations.  Among the most common sexual problems in women are hypoactive sexual desire disorder (commonly referred to as low sex drive), difficulty with orgasm (technically labeled female orgasmic disorder), pain during intercourse (called dyspareunia), and sexual performance anxiety.

There are wide variations in both male and female sexual functioning, and there is no standard that women must meet for their sexual functioning to be considered normal.  If you experience a sexual problem that troubles you, then it is a problem that needs to be addressed and you should be encouraged to see how it can be corrected.

Please note that the terminology "female sexual dysfunction" has replaced the word "frigidity" when referring to the inability of a woman to function adequately in terms of sexual desire, sexual arousal, and/or orgasm.  Frigidity in the past referred to a sexual dysfunction among females in the same way that the term impotence referred to the same broad phenomenon among males. The term frigidity continues to be used occasionally in everyday language, commonly as an insult or derogatory term for women who are perceived to be unaffectionate or are seen as sexually non-responsive.  Many therapist regard frigidity to be a sexist term that places the blame on the woman herself rather than on her socio-cultural milieu, emotional experiences, or health status, all of which can contribute to sexual non-responsiveness.

The three most common sexual problems in women are hypoactive sexual desire disorder (HSDD), more commonly referred to as low sex drive, followed by difficulty with orgasm (Female Orgasmic Disorder), and then pain during intercourse (Dyspareunia).

Hypoactive Sexual Desire Disorder (HSDD) may exist when the person does not have a desire for sex and is not interested in the sexual advances of her partner. While aging and life circumstances affect sexual desire, they do not necessarily lead to a permanent deletion of sexual desire and interest.  The DSM 1V-TR of the American Psychiatric Association (APA) defines low sexual drive, Hypoactive Sexual Desire Disorder (HSDD), as a deficiency or absence of sexual fantasies and desire for sexual activity. The definition is vague because the APA acknowledges that there can be significant differences in sexual interest levels among women.

Low sex drive can be caused by a range of factors, which vary from one individual to the next. Fatigue, the daily responsibilities and multiple roles women often assume, and many possible psychological causes can impact on a woman's sexual desire. It is also known that certain health conditions and medications can affect sexual desire. Depression and anxiety disorders can interfere with sexual desire, but so can some of the drugs used to treat these conditions. Birth control pills, mood stabilizers, tranquilizers and other medications have all been shown to decrease sexual interest and desire. 

Difficulty with orgasm, or female orgasmic disorder, is a persistent delay or absence of orgasm. This definition is also from the APA and it again attempts to allow for individual variation by not giving a specific number or percentage to define a "normal" amount of orgasms. One reliable survey states that 29% of women say they always have orgasms during sexual intercourse.  Problems related to orgasm are usually responsive to therapy which relies on maximizing stimulation and minimizing inhibition.  Stimulation may include masturbation with prolonged stimulation and muscular control of sexual tension (alternating contraction and relaxation of the pelvic muscles during high sexual arousal).

Pain during intercourse, dyspareunia, is one of the three most common sexual related problems reported by women.  Vaginal tightness, or difficulty or inability to allow penetration for intercourse is the primary symptom of Vaginismus. Vaginismus, the involuntary contraction of the muscles of the outer one third of the vagina, is often related to sexual phobias or past abuse or trauma.  Vaginismus may be complete or situational, so that a pelvic examination might be possible while intercourse is not. Normally, the vaginal sphincter keeps the vagina closed until sexual stimulation helps it to expand and relax. This relaxation allows normal and non-painful sexual intercourse to take place. Therefore, vaginismus occurs when the vagina is unable to relax and permit the penetration of the penis during intercourse. With some women, vaginismus prevents all attempts at successful intercourse. 

The cause of vaginismus is often a result of an aversive stimulus associated with penetration. Some of the more common aversive stimuli are traumatic sexual assaults, painful intercourse, and traumatic pelvic exam.  Vaginismus may also be the result of the woman having strong inhibitions about sex stemming from strict religious orthodoxy or cultural norms.  In some cases, vaginismus may occur after a history of successful and enjoyable intercourse due to a vaginal infection, the physical after-effects of childbirth, tiredness or some other cause.

Gender Identity Disorder refers to women who evidence of a strong and persistent gross-gender identification. They have a frequently stated desire to be, or insistence she is the other sex. The person may try to pass as the other sex and/or want to live or be treated as the opposite sex.

Performance anxiety is a sexual problem in which anxiety about engaging in sexual activity becomes an block to sexual feelings and thoughts.  Performance anxiety can result in avoidance of sexual encounters, lowered self-esteem, relationship problems and actual sexual dysfunction. Fears of sexual performance are not limited to men or to worries about physical responsiveness but can include concerns about vaginal lubrication and both male and female climaxing. Fears can also reflect anxiety about one's sexual response on a broader level, such as how much passion, tenderness, intimacy and sensitivity a person feels toward his or her partner.

Identification of the underlying cause can be important in the treatment of sexual disorders. Before you decide to seek any psychological intervention, it is important to rule out biological, chemical or health factors that may be related to a sexual problem.  Accordingly, a complete examination by a physician should certainly take place before any therapeutic treatment is begun.  Treatment will then vary depending on the unique aspects of the person, the nature of their problem, and their life circumstances.   

Treatment may involve psychotherapy, hormone treatment, medications, behavior techniques, and the use of external stimulation. The treatment for all of the above problems can involve traditional psychotherapy, relaxation techniques, reality therapy, cognitive behavioral therapy, pain control techniques, hypnosis, hormone treatment, and medication.  Sex education can also be a very important part of the therapy as can the use of external stimulation (e.g. plastic dilators in the case of painful intercourse) used with the direction of a sex therapist.

For more information about sex and sexual related issues or problems, please click on the linked websites listed below.

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