Sexual Dysfunction, Female
From Encyclopedia of Sex and Sexuality
Sexual problems are not always easy to define. How do you know if you have a sexual problem? If you want to have sex but cannot find a safe and conveniently available partner, it is cetainly a problem but not one usually considered a sexual problem. If you have lost most or all sexual desire for your mate, it is more likely to be an emotional or relationship problem than a sexual problem. Perhaps the clearest definition of a sexual problem is: dissatisfaction with any persistent aspect of your sexual performance, sensation, or satisfaction at any stage during the sex act (assuming you really care for your partner). Such problems are called “sexual dysfunctions,” a term meaning that something is interfering with one’s desired sexual performance or feelings. What are the most common sexual problems of women who come to sex therapists for help? The most common of these sexual dysfunctions are: orgasm difficulties; painful intercourse; and lack of sexual interest.
Other problems, such as boredom with sexual routine and worries about the content of sexual fantasies are not sexual dysfunction problems at all. These require a little more sexual literacy rather than sexual treatment.
There are other kinds of sex problems that are more complicated and are really psychological problems requiring the services of a psychotherapist before any significant sexual behavior changes may take place. For example, there are women (and men) who do not permit themselves to have any pleasure—sexual or otherwise. For other problems one may have to go to a physician. If there is pain or discomfort during intercourse, this may indicate a medical problem. The causes of this problem could be in the penis or in the vagina (or for some, in the head), or in the way the partners are having intercourse. In all cases, these problems are real and must be dealt with if one is to enjoy his or her sex life. They must be diagnosed and treated quickly.
If you think you have a sexual problem or dysfunction, it is probably wise to see a sex therapist or physician about it. Today most sexual dysfunctions are relatively easy to treat and correct.
 See also
- Eating Disorders and Sexual Dysfunction
- Marital Therapy
- Masters and Johnson
- Masturbation in Sex Therapy
- Premenstrual Syndrome (PMS)
- Sex and Headache
- Sex Therapy
- Sexual Response Cycle
 Orgasmic Difficulties in women
Much of the contemporary writing on sex might be entitled In Search of the Female Orgasm. Perhaps the most common concern about women’s sexual performance is related to orgasm or lack of them. We know that once a woman is sexually aroused, the flow of blood to the labia, clitoris, and other parts of the genitals creates a tension that is best relieved through orgasm. Frequent sexual excitement without orgasmic relief results, for some women, in aches and pains in different parts of the body and in nervous tension.
While it is true that women can conceive without experiencing orgasm, and they may feel much sexual pleasure, excitement, and satisfaction without orgasm, in missing orgasm they clearly miss nature’s bonus to the body. Many sex therapists support the view of scientists who point out that the process of evolution (or God) has created magnificent human male and female bodies, whose every part, system, and response exists for a reason. The female, as well as the male, is given the ability to have this marvelous sensual experience we call an orgasm.
Some professionals and lay persons unfairly label women who fail to experience orgasm as suffering from an affliction. Whether it is due to a medical problem, or whether the woman has not learned how to create conditions for orgasm or has not been given stimulation sufficient to allow the orgasm reflex to occur, she might be labeled “frigid” (see Anorgasmia). Some husbands and partners put counterproductive pressure on women, even out of loving consideration, to try to have orgasms every time they make love. The reality and complexities of female physiology and factors such as stress work against the likelihood of orgasm under such conditions.
Some women are not certain whether they are having orgasms or just “good sensations.” Orgasmic responses are subjective—they may be consistently mild for some women, while other women may feel overpowering orgasms. If a woman’s partner gives her or if she gives herself sufficient stimulation, she will be quite aware of the sensation of reaching orgasm—usually a sense that she is still sexually aroused. She may still want to continue, but she will usually know that she has had an orgasm. Women who are concerned about experiencing only mild sensations should speak to a sex therapist.
A woman who knows that she consistently does not have any orgasms may be considered to be, at present, nonorgasmic. But this is not a permanent condition and is certainly not a sickness. It simply means that the right conditions or stimulation have not occurred to create the optimal sexual response we call orgasm.
When a woman is with a partner whom she very much likes, in an environment she enjoys (not in the back seat of a car or any other place where she may worry or feel uncomfortable), feeling no legal, religious, or other restraints, and is experiencing sufficient sexual stimulation—if all these conditions are right and she still cannot reach her peak, then she represents a classic case of a nonorgasmic woman.
Orgasmic difficulties may be broadly classified in two types. One is when the “problem” is due to the inability of a partner to bring a woman to orgasm, and the other when, no matter how sexually skilled her partner, the woman cannot reach orgasm. The conditions under which orgasms may or may not occur are very varied. A woman may be orgasmic with self-stimulation but not with her partner, she may be orgasmic with one partner but not another, or she may not achieve orgasm either by herself or with a partner. Each situation requires somewhat different approaches by the sex therapist.
Another type of orgasmic problem is sometimes experienced: some women may have a “flat moment” preceding the orgasmic response when it seems as if nothing is going to happen. Many women say they do not experience this at all. But others, when it occurs, sometimes think: “Nothing is going to happen, and I might as well forget about it,” creating a self-fulfilling prophecy. However, if a woman who experiences a “flat moment” keeps up stimulation, she may very well have an orgasm.
If a woman is able to reach orgasm through self-stimulation, or if a woman reached orgasm with a previous partner but not with her present mate, it does not mean that she is subconsciously rejecting her present lover. It may indicate an inability to communicate to the man what kinds of physical pressures and movements she needs to reach an orgasm. The problem does not necessarily point to sexual diffidence on the part of the man—he cannot guess what is on her mind.
In order to have a clearer understanding of what is producing an orgasmic problem, a woman must consider the relationship she has with her husband or partner. All the sex therapy and advice in the world will not help women who basically dislike the person they are having sex with or who find their partner unattractive. If they really dislike their partner, they should see a marriage counselor, pastoral counselor, or other professional to explore their interpersonal problems and find means of dealing with the unsatisfactory relationship.
One type of orgasmic difficulty, caused mainly by the mass media and folk myths, is the idea that only young women are sexually attractive and that when a woman gets older she loses her attractiveness to men and her interest in sex. These are merely cultural stereotypes; not even hysterectomy, menopause, or the empty nest syndrome results in significant decreases in sexual desire (or in attractiveness to men). You have to will yourself to lose interest by believing in these myths. A “hot flash” that often accompanies menopause is sometimes used as an excuse by women who do not want to have sex with their husbands for other reasons. It is as if they are saying to themselves: “See, my body is now telling me that my sexual life is over.” Hot flashes do signal hormonal changes during menopause, but they definitely do not mean the end of sexuality. On the contrary, many women find that, freed of worry about pregnancy and with children gone from the house, menopause is a time to celebrate a rediscovered privacy and intimacy that may have been buried for decades. Husband and wife can now have a renewed opportunity to behave as two newlyweds, if they so desire. Sexiness is mainly in the head, and often a change in attitude is needed before there can be a desired change in orgasmic response. For some women sex can be better than ever when they get older. Although the orgasmic response may be a little weaker, it can still be very enjoyable and satisfying for women into their seventies and eighties (see also Aging and Sex).