Dr. MJ Bazos MD,
Sexual Dysfunction in
What is sexual dysfunction?
When you have problems with sex, doctors call it
"sexual dysfunction." Men and women can have it. There are 4 kinds of sexual
problems in women.
- Desire disorders - When you are not
interested in having sex or have less desire for sex than you used to.
- Arousal disorders - When you don't feel a
sexual response in your body or you start to respond but can't keep it up.
- Orgasmic disorders - When you can't have
an orgasm or you have pain during orgasm.
- Sexual pain disorders - When you have pain
during or after sex.
What causes sexual
Many things can cause problems with your sex
life. Medicines, diseases (like diabetes or high blood pressure), alcohol use,
or vaginal infections can cause sexual problems. Depression, an unhappy
relationship or abuse (now or in the past) can also cause sexual problems.
You may have less sexual desire during
pregnancy, right after childbirth or when you are breast-feeding. After
menopause many women feel less sexual desire, have vaginal dryness or have pain
The stresses of everyday life can affect your
ability to have sex. Being tired from a busy job or caring for young children
may make you feel less desire to have sex. Or, you may be bored by a
long-standing sexual routine.
How do I know if I have a problem?
Up to 70% of couples have a problem with sex at
some time. Most women sometimes have sex that doesn't feel good. This doesn't
mean you have a sexual problem.
If you don't want to have sex or it never feels
good, you might have a sexual problem. The best person to decide if you have a
sexual problem is you! Discuss your concerns with your doctor. Remember that
anything you tell your doctor is private.
What can I do?
If desire is the problem, try changing
your usual routine. You may want to rent an erotic video or read a "sexy" book
with your partner.
Arousal disorders can often be helped if
you use a vaginal cream for dryness. Mineral oil also works. If you have gone
through menopause, talk to your doctor about taking estrogen or using an
If you have a problem having an orgasm,
masturbation can help you. Extra stimulation (before you have sex with your
partner) with a vibrator may be helpful. You might need rubbing or stimulation
for up to an hour before having sex. Many women don't have an orgasm during
intercourse. If you want an orgasm with intercourse, you or your partner may
want to gently stroke your clitoris.
If you're having pain during sex, try
different positions. When you are on top, you have more control over penetration
and movement. Empty your bladder before you have sex. Try using extra creams or
try taking a warm bath before sex. If you still have pain during sex, talk to
your doctor. If you have a tight vagina, you can try using something like a
tampon to help you get used to relaxing your vagina. Your doctor can tell you
more about this.
If you have gone through menopause or have had
your uterus and/or ovaries removed, taking the hormone estrogen may help with
sexual problems. If you're not already taking estrogen, ask your doctor if this
is an option for you.
You may have heard that taking sildenafil
(Viagra) or the male hormone testosterone can help women with sexual problems.
There have not been many studies on the effects of Viagra or testosterone on
women, so doctors don't know whether these things can help or not. Both Viagra
and testosterone can have serious side effects, so using them is probably not
worth the risk.
What else can I do?
Learn more about your body and how it works. Ask
your doctor about how medicines, illnesses, surgery, age, pregnancy or menopause
can affect sex.
Practice "sensate focus" exercises where one
partner gives a massage, while the other partner says what feels good and
requests changes (example: "lighter," "faster," etc.). Fantasizing may increase
your desire. Squeezing the muscles of your vagina tightly and then relaxing them
may increase your arousal. Try sexual activity other than intercourse, such as
massage, oral sex or masturbation.
What about my partner?
Talk with your partner about what you each like
and dislike, or what you might want to try. Ask for your partner's help.
Remember that your partner may not want to do some things you want to try. Or,
you may not want to try what your partner wants. You should respect each other's
comforts and discomforts. This helps you and your partner have a good sexual
relationship. If you can't talk to your partner, your doctor or a counselor may
be able to help you.
If you feel like a partner is abusing you, tell
How can my doctor help?
Your doctor can also give you ideas about
treating your sexual problems or can refer you to a sex therapist or counselor
if it is needed.