Woman's Health > Reproductive Health Sexual Dysfunction in Women: What Can I Do If Sex Isn't Working for Me? Posted by R. James M.D. on Sep 16, 2004, 03:23

What is sexual dysfunction?

When you have problems with sex, doctors call it "sexual dysfunction."
Men and women can have it. There are 4 kinds of sexual problems in
women.

• Desire disorders - When you are not interested in having
  sex or have less desire for sex than you used to.


• Arousal disorders - When you don't feel a sexual
  response in your body or you start to respond but can't keep it up.


• Orgasmic disorders - When you can't have an orgasm or
  you have pain during orgasm.


• Sexual pain disorders - When you have pain during or
  after sex.

What causes sexual dysfunction?

Many things can cause problems with your sex life.
Medicines, diseases (like diabetes or high blood pressure), alcohol use,
or vaginal infections can cause sexual problems. Depression, an unhappy
relationship or abuse (now or in the past) can also cause sexual problems.

You may have less sexual desire during pregnancy, right after
childbirth or when you are breast-feeding. After menopause many women feel
less sexual desire, have vaginal dryness or have pain during sex.

The stresses of everyday life can affect your ability to have sex.
Being tired from a busy job or caring for young children may make you feel
less desire to have sex. Or, you may be bored by a long-standing sexual
routine.

How do I know if I have a problem?

Up to 70% of couples have a problem with sex at some time. Most women
sometimes have sex that doesn't feel good. This doesn't mean you have a
sexual problem.

If you don't want to have sex or it never feels good, you might have a
sexual problem. The best person to decide if you have a sexual problem is
you! Discuss your concerns with your doctor. Remember that anything you
tell your doctor is private.

What can I do?

If desire is the problem, try changing your usual routine. You
may want to rent an erotic video or read a "sexy" book with your
partner.

Arousal disorders can often be helped if you use a vaginal cream
for dryness. Mineral oil also works. If you have gone through menopause,
talk to your doctor about taking estrogen or using an estrogen cream.

If you have a problem having an orgasm, masturbation can help
you. Extra stimulation (before you have sex with your partner) with a
vibrator may be helpful. You might need rubbing or stimulation for up to
an hour before having sex. Many women don't have an orgasm during
intercourse. If you want an orgasm with intercourse, you or your partner
may want to gently stroke your clitoris.

If you're having pain during sex, try different positions. When
you are on top, you have more control over penetration and movement. Empty
your bladder before you have sex. Try using extra creams or try taking a
warm bath before sex. If you still have pain during sex, talk to your
doctor. If you have a tight vagina, you can try using something like a
tampon to help you get used to relaxing your vagina. Your doctor can tell
you more about this.

Can medicine help?

If you have gone through menopause or have had your uterus and/or
ovaries removed, taking the hormone estrogen may help with sexual
problems. If you're not already taking estrogen, ask your doctor if this
is an option for you.

You may have heard that taking sildenafil (Viagra) or the male hormone
testosterone can help women with sexual problems. There have not been many
studies on the effects of Viagra or testosterone on women, so doctors
don't know whether these things can help or not. Both Viagra and
testosterone can have serious side effects, so using them is probably not
worth the risk.

What else can I do?

Learn more about your body and how it works. Ask your doctor about how
medicines, illnesses, surgery, age, pregnancy or menopause can affect
sex.

Practice "sensate focus" exercises where one partner gives a massage,
while the other partner says what feels good and requests changes
(example: "lighter," "faster," etc.). Fantasizing may increase your
desire. Squeezing the muscles of your vagina tightly and then relaxing
them may increase your arousal. Try sexual activity other than
intercourse, such as massage, oral sex or masturbation.

What about my partner?

Talk with your partner about what you each like and dislike, or what
you might want to try. Ask for your partner's help. Remember that your
partner may not want to do some things you want to try. Or, you may not
want to try what your partner wants. You should respect each other's
comforts and discomforts. This helps you and your partner have a good
sexual relationship. If you can't talk to your partner, your doctor or a
counselor may be able to help you.

If you feel like a partner is abusing you, tell your doctor.

How can my doctor help?

Your doctor can also give you ideas about treating your sexual problems
or can refer you to a sex therapist or counselor if it is needed.