Dealing with female sexual dysfunction
Sexual dysfunction affects a staggering one in three young and middle aged women at some stage, and half of all older women. So why do we still feel so much shame about things sometimes not working quite how they should down there? http://www.nhs.uk/Livewell/Goodsex/Pages/Femalesexualdysfunction.aspx
Yes, female sexual dysfunction is awkward, embarrassing and uncomfortable – but in most cases it can be treated relatively easily if you know where to look and can bear to ask for expert help. If you're struggling, here's a handy guide.
What is female sexual dysfunction?
For women, sexual dysfunction can involve a loss of libido, problems reaching orgasm, and pain or discomfort during sex – or any combination of these.
What causes it?
There are various possible causes of female sexual dysfunction – either physical, psychological, or stemming from relationship problems.
Psychologically, sexual dysfunction may be caused by mental health problems such as depression, anxiety or stress, which can make it feel difficult to 'let go' during sex. Another possible cause is fear or anxiety directly associated with the act of sex itself – possibly as a result of a previous traumatic experience, or a lack of education and knowledge about sex.
If there are problems in your relationship with your partner, this can also affect your sexual function. Whether you're struggling to overcome an infidelity or some other obstacle, or even just having doubts about the relationship, this may be an underlying cause for your love life hitting the rocks in the bedroom.
Physically, problems having sex can be related to certain diseases – such as diabetes – or particular medications, including hormonal contraceptives and anti-depressants. Changes in hormone levels – whether through the menopause or hormonal problems like an underactive thyroid – can also contribute to symptoms like vaginal dryness and lowered libido.
When it comes to pain during sex, a condition called vaginismus is a common cause. Often linked to psychological triggers, vaginismus is a spasming of the muscles in and around the vagina, which makes it tricky for anything to be inserted – and so can also cause difficulties with medical examinations.
Sexual dysfunction can also affect women who've experienced Female Genital Mutilation (FGM) or vaginal trauma such as childbirth or rape. In these cases, the problem may have both physical and psychological roots.
Finally, of course, sexual dysfunction can also be caused by what healthcare professionals call a lack of "effective stimulation". If you get on just fine with masturbation but struggle to perform with your partner(s), it might be time to have a quiet word about upping their foreplay game.
How is female sexual dysfunction treated?
For obvious reasons, the treatment depends a lot on the root cause of the problem – which is why it's so important to speak to your local GP, practice nurse or sexual health clinic.
For some women, the solution may be as simple as investing in a good quality lubricant cream or gel (and erotic toys, if you fancy), working on creating the right atmosphere, and spending more time on foreplay.
If your GP believes your problems are largely physical, they may suggest – depending on your personal circumstances – options to treat the other, underlying condition. For hormonal issues, this may be some form of hormone replacement treatment, or changing to a non-hormonal method of contraception.
When it comes to tackling psychological causes of sexual dysfunction, it can be less clear-cut. Common mental health problems like depression and anxiety can be treated using anti-depressants, but it's worth noting that these only treat the symptoms, not the root causes, and can themselves contribute to sexual dysfunction.