Why some women struggle to enjoy sex

Sex is a true gift meant not only for creating new life but also for the pure pleasure it can bring.  In its purest, most natural form, sex is great for both men and women.  But more often than not, it’s women who suffer the most of simply being able to have a good time while enjoying the experience.

Why one woman may dread sex can be entirely different from another woman who also views sex with disdain. This common and complicated issue can involve factors ranging from a physical bone of contention to a psychological matter or both.  When women get to the point of having little to no interest in sex, it’s time to address the issues at hand before it ruins their relationship with their partner. 

What is going on when a woman has these feelings of no interest in sexual relations?  Most likely it is Female Sexual Dysfunction (FSD).  Women with FSD usually have persistent, recurrent problems with sexual response, desire, orgasm, or pain resulting in extreme distress while putting a strain on a woman’s relationship with her partner. 

FSD can fall into five types of problems and are the main reasons why some women want nothing to do with sex:

1.  Low libido – Doctors often refer to a lack of desire in sex as hypoactive sexual desire disorder (HSDD). There can be numerous reasons for low libido in women that can include certain prescription medications such as antidepressants and anti-seizure medications, alcoholism, using street drugs, smoking, any surgery that may have affected her body image or sexual function, fatigue, stress, hormonal changes due to menopause, pregnancy, breastfeeding, poor body image and low self-esteem. 

2.  Painful sex – This can include pain during sex due to menopausal vulvo-vaginal atrophy resulting from a lack of hormones as well as a burning pain syndrome of the genitals.

3.  Difficulty being aroused – Sexual arousal disorder can originate in the genital area (comparable to erectile dysfunction in men) or an issue at the brain level which is more common in women.

4.  Aversion to sex – This is often related to a history of sexual abuse.

5. Inability to achieve orgasm – Up to 10-20 percent of women never achieve an orgasm and many others have difficulty. 

Treating female sexual dysfunction

Even though most women with FSD will want to have some form of treatment, not all women necessarily will.  If the problem is not bothering a woman, there may not be a need for any treatment.

Due to the fact FSD has many possible symptoms and causes, the treatment plans will vary.  Any woman experiencing any of the five problems needs to thoroughly discuss her specific symptoms and her body’s normal sexual response with her doctor or counselor.  To successfully treat FSD, most women will benefit from a combined treatment approach addressing medical, relationship, and emotional issues.

Some of the methods used to treat FSD can include the following:

·      Seeking counseling with a therapist who specializes in sexual and relationship problems.

·      Using a vaginal lubricant for vaginal dryness causing pain during intercourse.

·      Addressing any underlying medical condition or hormonal change.  This might include a prescription medication of flibanserin or Addyi for premenopausal women with low sexual desire. 

·      Estrogen therapy can improve sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.

·      Although controversial, androgen therapy is another avenue since androgens include testosterone and testosterone plays a role in healthy sexual function in women. 

David B. Samadi, MD, Urologic Oncology Expert and Robotic Surgeon located at 485 Madison Avenue on the 21st floor, New York, NY – 212-365-5000.  Follow Dr. Samadi at www.samadimd.com,  www.prostatecancer911.com, and www.roboticoncology.com.