AAMFT Consumer Update
Female Sexual Problems

In Western society we are bombarded with messages about sexuality from the popular media, and yet it can be embarrassing to talk about our personal sexuality, especially any sexual concerns we may have. Sexual problems can have a ripple effect on many other areas of our lives including intimate relationships with a partner, the family, and work, and our general well being. At the same time all of our life interactions and activities can affect our sexuality The media tends to present sex as easy, good, and spontaneous, and it implies that we should always be in the mood for it. If only sex were that simple.

If you and your partner are experiencing problems with sex, you are not alone. Recent studies reveal that nearly 40 percent of women of all ages report having sexual problems. It just isn't the kind of thing people want to admit. But you deserve to have a pleasurable sex life and there are professionals who can help.

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 just to intercourse, and can also refer to a variety of intimate sexual activities such as fondling, self-stimulation (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 more promptly if you are experiencing physical pain.

What causes female sexual problems?

Sexual problems can be influenced by a wide variety of factors. There are two main components-biological and psychological-and usually they interact. Biological problems usually involve such things as hormonal imbalances, infections (like yeast infections), or diseases (like diabetes or multiple sclerosis) that have potential side effects like pain during sex or excessive dryness. There are certain times in a woman's life when she is more prone to sexual problems because of hormonal changes. For example, some women experience a range of sexual responses right after childbirth and during menopause. Also, some commonly prescribed medications, like certain antidepressants, can lead to sexual side effects.

There is also the psychological aspect. This can include such things as the many conflicting cultural messages one learns about sexuality Gender messages are especially influential, impacting how a woman views her sexual self, including body image, roles, power, and her view of her partner.

From birth throughout her life every woman is developing a unique "sexual story" influenced by culture, gender, family of origin, and personal experiences. The "story" takes on the beliefs and meanings that she attributes to her sexuality Couples must negotiate their personal "sexual stories" as they develop their own style of sexual communication and activity This should be an ongoing process, since everyday life problems may get in the way of intimacy and sexuality. Job worries, pressures of juggling work and family, substance abuse, depression, and financial worries can all influence how you feel sexually In our fast paced world, having a lot on your mind, as most people do, can get in the way even when you want to focus on being intimate.

Over time psychological troubles can create biological problems and vice versa. It all starts to blur together so you can't even really pinpoint where the issues started. You just know you want help.

How do you know when to seek help?

It really depends on the woman and her partner. Sometimes a problem seems to go away pretty quickly on its own. But, if this is something that is really worrying or frustrating you or your partner and does not seem to go away no matter what you try, or if you are experiencing considerable pain or discomfort, it may be time to consider professional help.

How do you get help?

Help is available through both individual or couples therapy.  Many people will use a combination of the two. When a couple begins therapy, the therapist may refer one or both partners to a physician to rule out any medical conditions that could be contributing to the problem. The therapist or physician should fully inform you of the reasons for the medical procedure. A physician can also help with issues surrounding medication, like experimenting with the dosage of your medication to reduce sexual side effects. There are some hormonal treatments for women that are helpful during and after menopause. For now, there are no drugs available to help improve women's sexual functioning like there are for men, though some may be available in the next few years.

Therapy can help women, either alone or with a partner, who are experiencing sexual problems. Most therapists are used to talking to couples about their sexual lives and will not be embarrassed if you bring it up. The therapist is there to help the woman and her partner gain understanding of some of the relationship dynamics and background issues that may be influencing the problem. The therapist can also provide you with information about human sexuality and sexual functioning, and answer your questions.

References and Resources

For Each Other: Sharing Sexual Intimacy. By Lonnie Barbach. New American Library (Reissue edition, 1984). A complete program for women and their partners as they deal with the complex physical and emotional aspects of a relationship that affect sexual satisfaction. This sensitive book answers questions, discusses male and female body functioning, and provides tools couples can use to improve the sexual relationship.

Ordinary Women, Extraordinary Sex: Every Woman's Guide to Pleasure and Beyond by Sandra Scantling and Sue Browder (Contributor). Plume (1994). This book guides women in ways to expand pleasure in all areas of their lives, and tap into their sexual energy to enrich sexual fulfillment. Barriers and capacities of pleasure are explored, with an emphasis on enhancing the connection between the mind and body.

Passionate Marriage: Love, Sex, and Intimacy in Emotionally Committed Relationships. By David Schnarch. W. W. Norton (1997). Using vignettes of couples' bedroom behavior and therapy sessions, this book explores how sexual problems can trigger personal growth, enhancing intimacy, eroticism, and desire. The author uses specific suggestions to guide adult couples in reaffirming and inspiring their relationships and emotional fulfillment.

Women's Sexuality Across the Life Span: Challenging Myths, Creating Meanings. By Judith Daniluk. Guilford Press (1998). This book explores how women experience and express their sexuality throughout their lives, discussing how the body and meanings change over time. With a focus on how women can become more comfortable with their sexuality, minds, and bodies, topics include menopause, sexual violence, sexual myths, and sexual problems.

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Item #1047

Keywords: low sex drive, arousal disorder, low sexual desire, dyspareunia.

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