Women and Sexual Dysfunction

Women's health experts shed light on female sexual problems.

Sexual Dysfunction in Women

Several population-based surveys show that approximately 43 percent of American women have some form of sexual dysfunction, from low desire to painful intercourse. With so much sex in the movies and on televisions, you would think that American women would be seeking help for sexual dysfunction. But the reality is that you often don’t see women until their husbands practically push them through the door. In some cases, they haven’t had sex for a year or more.

Female sexual dysfunction is not purely physiological, treating it is complex. Despite the complexity, there is no physical reason for a woman to settle for a lackluster sex life at any age.

Women bring different needs and issues into the bedroom. Unfortunately, many are conflicted because they see themselves through the lens of the media or through their partner’s eyes, without ever developing their own sexual persona. When I ask my patients what it is that they want from their sexual relationships, they often struggle to express their desires.

Women should get in touch with their female sexual power to discover what they want and need out of their sexual relationships. These needs should be respected at any age, whether the woman is 18 or 80. If you are unsatisfied with your sex life, discuss your concerns with your doctor. He or she can then address problems that may be compromising your experiences. In general, the doctor will explore three areas:

A woman's overall health

A woman who is anemic or exhausted for other reasons may not have the energy for sex. Clearly, sex requires energy! Pain from a medical issue, such as joint pain from arthritis, may be getting in the way of enjoyment. These problems can be effectively treated in most women. For some, the answer may be as simple as a new mattress or new position.

Psychological issues in women

Depression, anxiety, and relationship issues need to be addressed. Paradoxically, some of the medications used to treat depression also blunt desire. The right prescription can make all the difference. For example, the antidepressant bupropion (Wellbutrin) has actually been shown to increase libido.

A poor experience with sex that is painful – physically, emotionally or both –will certainly affect desire. The porn industry has done a real disservice to women in terms of creating unrealistic expectations. Younger women who have no frame of reference experiment with sexual behavior because they think it is expected. But I’ve even treated older patients who have developed oral cancer from HPV because they have engaged in dangerous sexual behavior. It sounds basic, but don't do anything that you don’t want to do! Fortunately, counseling can be effective in overcoming a bad experience.

Hormone levels in women

Our hormones play a key role in nearly every aspect of sexual health. Plunging estrogen levels associated with menopause can lead to a plunge in arousal. Testosterone, so vital to male libido, has also been linked to libido in women.

We used to put every woman on the same hormone replacement regimen as soon as she reached menopause. It was a cookie-cutter approach with no scientific basis. Now, we offer custom hormones based on individual need. It makes an incredible difference in terms of arousal and libido!

Vaginal dryness, seen as an epidemic in post-menopausal women, can be treated effectively with estrogen cream, a vaginal estrogen ring or vaginal estrogen suppositories. Several botanicals, as well as newer silicone-based lubricants can increase sexual satisfaction for those wishing to avoid hormones. Women are living so much longer. Why not be healthy physically and sexually throughout your lifespan?