Too often when I hear about female sexual problems the focus is on low sexual arousal or inability to achieve orgasm.  There are however, other sexual problems that women encounter that don’t get the same focus.  I would like to use this forum to discuss a very difficult topic: female sexual disorders and dysfunction. Sexual problems may be affected by many factors, including both physical and emotional triggers.

Sometimes women encounter difficulties with sexual performance and pleasure.Through my clinical practice, I am aware that individuals want to resolve this as quickly as possible. Unfortunately, sexual problems must be dealt with in bits and pieces. The first step in this process is to get to know your “sexual self”. This includes preferences, problems, fantasies, conflicts, interpersonal aspects, and physiological responsiveness.

Take a moment to think about the lessons received about your body and sexuality. Did anyone lay the much needed foundation to enter into your adult sexual life with confidence? Do you understand your body and how it works? This also includes the mind — body connection. They are intimately connected and thus must be understood when addressing sexual concerns.  Oft times, there are old messages that have been passed down by family or society regarding sexuality that may operate on an unconscious level.  These messages have a power influence on sexual responsiveness. Additionally, sexual abuse and/or assault may have lingering consequences for sexual satisfaction. Talking to a professional may be helpful in resolving these issues.

Women especially need to let go of the culturally supported idea that sex is for men. Reject the idea that to be a lustful woman who wants more than intimacy or reproduction makes you a whore or perverse in some way. Give yourself permission to indulge in sex solely for the purpose of pleasure.

When dealing with a sexual dysfunction, it is okay to be self-centered. Stay focused on your specific sexual and emotional needs. This is one of the rare times in adulthood where being selfish is not only permitted, but also encouraged. There will come a time when your partner should be educated and included in this process, but not yet. Take your time and learn about your body and mind. Take note of any negative thoughts that may be intruding upon your sexual experience.

Sexploration

Sex is a natural bodily function, like eating and sleeping. Enlist all of your senses to gather information about how your body responds to various types of stimulation. Use a personal pleasure massage (Sexploration) as a foundation for understanding the obstacles to sexual gratification. Many people experience conflict (e.g. guilt or shame)  associated with masturbation or self pleasuring. It is an invaluable tool when it comes to addressing sexual problems.  If you must, consider it like homework and just do it! Don’t just focus on the genitals however, explore every aspect of your body. Remember the brain is the biggest erogenous zone. Your personal thoughts, feelings, and fantasies maybe the key to unlocking pleasure.

Once you have successfully completed the here-and-now experience that allows you to gather information without distraction, feel free to use sex toys and other accessories, such as video or auditory stimulation, to facilitate arousal. Fantasy is another tool that may support sexual responsiveness. Let your mind go and be free of worry about performance, fears of rejection, desires to please others and feelings of inadequacy. Top yourself off with the sights, sounds, smells, touching and tastes of personal pleasure. Ultimately this work will lead to climax.

Once you have learned enough about your body and personal needs for pleasure, educate your partner. You can use words along with a hands on demonstration.  Give him a guided tour of your body and show your partner what turns you on and what you dislike.  Keep in mind what tickles a woman’s fancy tonight, may turn her stomach tomorrow. Women can be persnickety that way.  So don’t get worried if things change a bit.

Sexploration work is a means to improvement of overall sexual health. If you experience problems, work on strengthening your sexual awareness and responsiveness. Note that sexual problems often requires the assistance of a multi-disciplinary team of professionals such as urologists, endocrinologists, psychotherapists, and sex therapists. It is important to rule out any medical causes of sexual dysfunction. Therefore, a medical professional should be consulted. Don’t be afraid to ask for help. Following are some techniques you can try on your own to address sexual problems.

Techniques to Address Female Sexual Problems

Low sexual desire. Limited interest is one of the most persistent sexual problems faced by women. A person’s sexual response builds on the previous stage. Arousal is the first stage of the sexual response cycle, is affected by desire. Lack of interest often results in problems with arousal, and this subsequently leads to problems with reaching orgasm. Therefore, it is essential that a woman takes time to understand her physiological and emotional response to various methods of stimulation. Problems with desire, arousal, and difficulty achieving orgasm can be related to many factors, including age, hormonal shifts, medications, overall health, relationship problems, mood, fatigue, or alcohol and drug use. It is important for a woman to rule out any medical causes of low sexual desire. Therefore, early consultation with medical professional is recommended.

Vaginismus. If you are dealing with vaginismus, personal pleasure work or Sexploration should be done before the use of dilators or digits (fingers) into the vagina. Here, the objective is to remain relaxed as you and, subsequently, your partner progressively dilate the vagina. It is also important to emphasize the need for humble expectations. Working through vaginismus requires patience and understanding. In this instance, sexual intercourse in prohibited until you successfully progress through the stages of dilation without pain or emotional distress. There may, however, be some discomfort. This specific condition requires the support of a multidisciplinary team of professionals. Physical therapy for pelvic muscle work and/or medication to reduce pain may also be warranted.

Dyspareunia. Painful intercourse can have many causes, both psychological and physiological. It is often secondary to other conditions including vaginismus, menopause, endometriosis, allergic reactions, inflammation, and vaginal infections. Dyspareunia may also result from psychological distress associated with sexual abuse or trauma. There may be some simple solutions such as insuring proper arousal with more foreplay or the use of a personal lubricant (Replens or Astroglide), identification and removal of allergens, or learning to relax. Medicinal treatments may consist of addressing the underlying condition with physical therapy, medication and/or surgery. While other treatments will focus on resolving emotional conflicts.

A physician may recommend medical treatments for women with low circulating hormones. Osphena is a non-estrogen medical alternative that, “works like estrogen in the lining of the uterus.” In pill form, it has systemic effects and thus “can work differently in other parts of the body” (www.osphena.com). This product facilitates arousal and diminishes pain in post-menopausal women. An estrogen alternative, Estring is ring shaped device that is placed in the vagina for up to 90 days. VagFem is an estradiol vaginal tablet, that is inserted into the vagina with an applicator and dissolves.

The aforementioned prescriptions for postmenopausal women work to restore the vaginal environment and reduce symptoms of itching, pain, decreased lubrication, burning, and urinary dysfunction. There are side effects and risks associated with the use of any form of medical treatment. They can be as mild as nausea or headache, and as severe as stroke or cancer. In order to make an informed decision regarding your personal care, consult your healthcare professional for a complete description of the risks.

A non-medical treatment — sex, sex, and more sex — can serve as the panacea for problems with desire and arousal. Remember the law of inertia: a body in motion stays in motion. Keep your body moving.

It is important to inundate yourself with sexual material. Using the assortment of implements at your disposal, stimulate your mind and body. Watch movies, read books, have conversations, self-pleasure (regularly). Don’t let anything get in the way of your recipe for ecstasy. She’s got to have it!