Sexual Problems in Women
Cause
A woman's sexuality is a complex mix of mental, emotional, and physical signals. A problem in one area can grow to involve others. For example, a physical problem can lead to fear of pain, and the fear can lead to guilt about its effect on your partner. So the causes of sexual problems in women are often interrelated.
Psychological causes may be related to past or current physical or emotional problems. These mental and emotional causes include:
- Stress.
- Marital or relationship discord.
- Previous pelvic trauma.
- Involuntary and often painful contractions of the vagina (vaginismus), sometimes linked to memories of pelvic trauma or abuse.
- Depression.
- Fears that illnesses, such as cancer, or surgery, such as a mastectomy or hysterectomy, will make sexual activity unpleasant for the woman or her partner.
- Unhappiness with body image.
- Anxiety.
Physical causes can be normal hormonal changes, injuries, medical procedures, or other medical problems. Physical causes include:
- Hormonal changes such as those related to the menstrual cycle, use of birth control pills or hormone therapy, pregnancy, recovery from pregnancy, perimenopause, and postmenopause.
- Pain during intercourse. This may result from:
- Physical changes from surgery, radiation therapy, or other medical procedures.
- An injury.
- A physical abnormality.
- Vaginal dryness.
- Painful, involuntary contractions of the vaginal muscles (vaginismus). This is sometimes linked to the body's "memory" of pelvic trauma or abuse.
- Genital herpes.
- A vaginal infection (vaginitis).
- Medical conditions, including diabetes, arthritis, urinary incontinence, urinary tract infection, stroke, coronary artery disease, hypertension, atherosclerosis, multiple sclerosis, hypothyroidism, endometriosis, or a nervous system problem (neurological disorder).
Aging may cause a decrease in sexual desire and changes in the vagina. These changes include:
- Increased vaginal sensitivity, so that the vagina may be easily bruised or chafed.
- Narrowing, shortening, and/or stiffening of the vagina, causing pain during intercourse (dyspareunia).
- A reduction in lubrication and a lengthening of the time needed to lubricate the vagina.
- More time needed to feel sexually aroused.
- Orgasms that do not last as long they once did.
Medication use can sometimes decrease sexual desire and arousal. Such medications include:
- Blood pressure and diabetes medicines, such as diuretics, alpha-blockers, and calcium channel blockers.
- Antidepressants. These include tricyclics and selective serotonin reuptake inhibitors (SSRIs).
- Antihistamines, which are allergy medicines.
- Opioids and tranquilizers. Opioids are used to treat pain. Tranquilizers are used to calm the nervous system.
- Appetite suppressants. These are also known as diet pills.
- Chemotherapy for cancer.
Losing a partner is a common life event that can lead a woman to be less sexually active and satisfied. This is not a "sexual problem," but it can leave you with unmet needs for intimacy.
Cultural and societal factors may play a role in a woman's sexual health. Inadequate health services and/or a lack of sex education may result in a woman's lack of knowledge about sexual behavior. In addition, a woman may feel unable to meet the societal standards of attractiveness or sexuality, or she may believe herself to be incapable of meeting family and cultural expectations of a woman's role in life.1
Drinking alcohol to excess may increase the time it takes for a woman to reach orgasm. In addition, some women who feel sexually inadequate when sober may drink to mask those feelings temporarily. Alcohol can play a role in creating a cycle of drinking and sexual problems.
 Go to previous section |  Go to top of page |  Go to next section |
| Author: | Caroline Rea, RN, BS, MS | Last Updated: March 11, 2008 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology | |
 | ||
