What is sexual dysfunction?
Sexual dysfunction can mean lack of desire, lack of sexual arousal, difficulty getting orgasm, pains during sexual intercourse, tight vagina and possible consequences of other underlying disease.
Too little sexual desire, lack of libido, is the most common sexual problem among women. But these problems are connected. For example, small desire leads to low sexual arousal and pleasure, and therefore orgasm is also rarely achieved.
How common is sexual dysfunction?
Lack of sexual desire is reported from 10-51 % of women in studies from different countries. Among women in established couples relationships, sexual desire is far from always what leads to sex. In an American study, 40% reported that they never or rarely felt desire for sex, but they nevertheless experienced sexual arousal.
Sexual thoughts are rare among many women without them being dissatisfied with their sexual life for that matter, and the existence of sexual fantasies or sexual thoughts largely reflects the ability to achieve sexual satisfaction in women.
Fewer seem to have problems with experiencing sexual arousal. In an American study, it was sued for 5 %, while in a British study it was 17%, and 8% in a Swedish survey.
How does Sexual Desire and Arousal occur?
The foundation of sexual desire and arousal in women is not as well understood, but seem to be caused by a combination of several factors, such as chemical neurotransmitters in the brain, sex hormones and external conditions.
Swelling of the female genital organs-clitoris, labia, vagina – occurs normally in women within seconds after erotic stimulation. It is caused by nerve stimuli that lead to increased local accumulation of blood-compare with erection in men. At the same time, the muscle tension of the vaginal wall is reduced in such a way that the vagina can be expanded and increased excretion of fluid from the vaginal wall ensures that the vagina is well moistened and prevents abrasions.
The influence of the female sex hormone estrogen on sexual function is complex. Although lowogs levels and shriveled vaginal wall in older women provide a smaller blood collection in the lower abdomen when the woman is not stimulated, women over 50 years of age react as much to sexual stimuli as younger women with clearly higherogs levels. After stimulation, the clitoris, labia and vagina undergo the same changes as in younger women as a result of increased blood supply.
Small amounts of the male sex hormone testosterone seem to affect the sexual reaction. But the significance of this is still unclear.
Factors Affecting Sexual Life
A variety of factors are associated with reduced subjective arousal. It can be distractions (thoughts move around other things than sex), negative expectations after past bad sexual experiences, sexual unrest, fatigue and depression. A partner who has problems with his sexual satisfaction, stress, problems with getting pregnant and a prolonged couple relationship (“everything goes on routine”) are all factors associated with a decrease in sexual desire.Suites after sexual and other assaults can cause sexual problems both shortly after and many years later. Correspondingly, the ability to arousal is strengthened when you have a stable past and present mental health, good control over your own emotions and a good self-image, Good past sexual experiences and positive emotions for the partner.
Drugs such as new antidepressants (SSRIs) and oral contraceptives negatively affect the sexuality of some. The same seems to apply to individual blood pressure drugs (beta-blockers).
Many diseases have a negative impact on sexuality. It can apply to multiple sclerosis, renal failure, diabetes, diseases of the nervous system and cancer disease.
Clarification of the problem
Your explanation and description of the problem are important. Most often it is good if both partners meet with the doctor or therapist. For the doctor, there are some circumstances that are important to clarify, and you should therefore prepare to answer the following questions:
- Are you all in the mood for sex?
- Can you get sexually excited?
- Do you achieve orgasm?
- Is the emotional relationship between you and your partner good?
- How is your mental and emotional health?
- What is the quality of your previous sexual experiences?
- Have you been sexually abused?
- Do you have special problems associated with sexual activity?
- Do you feel that you are using enough time for the erotic foreplay?
- Do you have sexual fantasies?
Blood tests and other examinations do not matter in the investigation of this problem. The explanation is very rarely abnormal hormonal disorders.
How is Sexual Dysfunction Treated?
The choice of treatment depends on what your problem is. This is an area that is a bit explored, and it is not sure how good the various treatments are. However, we can conclude that drugs have no, or very limited, effect in most people. International experts recommend that we concentrate on the mental and general health, with a particular focus on the interpersonal problems between you and your partner, and any psychological problems that you are dealing with.
As mentioned, medicines seem to have a bad effect. Supplementation of small amounts of male sex hormone has been tried in some studies, but benefit is at best limited. However, women who had to remove the ovaries early May often benefit from testosterone. The overuse of male sex hormone can lead to a certain degree of masculinization – especially among older women. Sildenafil is also tested on women. Although, in theory, there would be an opportunity for influence, larger studies of close to 800 women with a lack of desire and arousal show that the preparation was without sufficient effect on sexual desire, experience, moisture in the vagina and satisfaction.
Psychological treatment seems to be able to give the best results. So-called cognitive-behavioral therapy is directed towards to identify and influence the factors that contribute to sexual dysfunction, as inappropriate thoughts, unreasonable expectations, behaviors that reduce the partner’s interest and trust (disrespectful behavior, or dishonesty), inadequate erotic stimulation and inadequate physical stimulation elsewhere on the body. Cognitive behavioral therapy aims to increase the couple’s emotional closeness and communication, as well as to increase the erotic stimulation. The number of treatment meetings may vary, but three to six occasions are recommended and usually both parties should participate.
Another psychological method (focused sex therapy) consists in training up the various constituents of the sexual act. It begins with non-sexual physical contact that gradually increases to sexual touch. Partners are invited to take turns to take on each other and tell each other if the caresses are pleasant.
Both of these methods help to take focus from a performance goal (for example, that to reach orgasm). Good research on this is in short supply, but in a study combining these two methods, 74% of women indicated that sexual and marital satisfaction had improved.