Is it normal to have problems with sex?

Yes. About 4 in 10 women have problems with sex at some point during their lives. If you are having a sexual problem, and it is worrying or upsetting you, you may want to find a solution. Some problems can be solved by you alone, with a partner, or with the help of a gynecologist or other health care professional.

 

What causes sexual problems in women?

Some common causes of sexual problems in women include the following:

• Hormonal changes at certain times in a woman’s life, such as during pregnancy, perimenopause, or menopause

• Cancer treatments and their side effects

• Some illnesses and medications

• Relationship problems with your partner

• Past negative experiences

• Depression, anxiety, or stress

 

What types of sexual problems affect women?

“Female sexual dysfunction” is a general term for a problem with sex. The problem can be a lack of interest in sex. It also can be a lack of response to sexual activity. Sexual problems fall into four groups, which often overlap:

1. Desire and arousal problems

2. Orgasmic problems

3. Sexual pain

4. Sexual problems caused by medication or substances

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What are orgasmic problems?

Difficulty reaching orgasm is common. For many women, sharing love and closeness without having an orgasm is satisfying. But other women may feel that not having an orgasm is a problem. They may want to find a solution. Women with orgasmic disorder may

• take longer to have an orgasm

• have fewer orgasms

• have less intense orgasms

• have never had an orgasm

• not recognize their physical experience as orgasm
   

For some women, orgasmic disorder may be caused by

• a new health problem or mental health condition

• a change in a relationship

• surgery or radiation in the pelvic area (this is rare)
   

What medications can cause sexual problems?

Some women have sexual problems soon after starting or stopping some medications. Drugs that may cause problems with sex include the following:

• Anticholinergics—including drugs to treat asthma, chronic obstructive pulmonary disease (COPD), diarrhea, dizziness, insomnia, nausea, overactive bladder, and vomiting

• Hormone medications—including birth control pills and hormone therapy

• Heart medications—including drugs to treat high blood pressure

• Mental health medications—including selective serotonin reuptake inhibitors (SSRIs)

Using alcohol, marijuana, and pain-relieving drugs such as opioids also can lead to problems with sex.

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What should I expect during treatment of a sexual problem?

Each type of female sexual dysfunction is treated differently. Recommendations may depend on your symptoms:

• Irritation of the vulva—You may need to avoid harsh soaps, douches, wipes, scented products, and pads worn in your underwear.

• Vaginal dryness—You may be prescribed local estrogen therapy.

• Difficulty with penetration—Dr. Gueye may suggest using dilators. Dilators are tube-shaped devices that help stretch the muscles in the vagina.

• Pain or other pelvic problems—You may be offered pelvic floor physical therapy.

• Sexual pain after menopause—Dr. Gueye may discuss medications to help with vaginal thinning and dryness. Some involve estrogen and others do not.

You also may be referred to a sex therapist, even if you also are receiving medical treatment. Couples therapy or counseling on your own may be helpful.

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