Inadequate sexual function in women is a complex problem that can have many different causes. It is estimated that up to 40% of women have suffered from sexual problems in the last year. This might be caused by physical illness, but is often linked to psychological factors.
The female equivalent of impotence is known as Female Sexual Arousal Disorder (FSAD). When men and women become sexually aroused, their genitals become engorged with blood. In women this normally results in:
.Enlargement of the clitoris and surrounding tissues (comparable to a male erection)
.Secretion of vaginal lubrication
.Relaxation and widening of the vaginal opening to permit intercourse.
FSAD patients have the desire to have sex but their genital area fails to respond in the normal way, making sex painful or impossible.
Causes and risk factors
FSAD can result from an underlying medical condition, such as high blood pressure or diabetes. It can also be caused by irritations, infections and growths in the vaginal area, or reactions to contraceptive devices. Medications used to treat high blood pressure, peptic ulcers, depression or anxiety and cancer may also cause problems.
Another factor is the physical, hormonal and emotional changes that occur during or after pregnancy or while breast feeding, or, very importantly, during and after the menopause. FSAD is also often linked to psychological causes. These can include:
.Inadequate or ineffective foreplay
.Depression
.Poor self-esteem
.Sexual abuse or incest
.Feelings of shame or guilt about sex
.Fear of pregnancy
.Stress and fatigue
Symptoms
The symptoms of sexual dysfunction can include lack of sexual desire, an inability to enjoy sex, insufficient vaginal lubrication, or, even if sexually aroused, a failure to achieve an orgasm. Women who suffer from Female Orgasmic Disorder (FOD) are unable to achieve orgasm despite being sufficiently aroused to have sex.
Women differ from men in that orgasm is a learned, not automatic, response. About five to ten percent of women never have an orgasm through any type of sexual activity - a condition called anorgasmia. Anorgasmia is most often the result of sexual inexperience, performance anxiety, or past experiences, such as sexual trauma or a strict upbringing, that have led to an inhibition of sexual response.
Some women are able to enjoy sexual activity in spite of reaching orgasm only some or even none of the time. FOD is a problem only if it has a negative effect on the satisfaction of a woman or her partner.
Treatment and prevention
On-going research has suggested the anti-impotence drug for men, ‘Viagra’, may help to treat sexual disorders in women by increasing blood flow to the sexual organs and thereby increasing physical stimulation in the area. However, the scientific community is still waiting for firm evidence to be published that the drug that the drug can work on women. A small study published recently found no positive impact on postmenopausal women.
Testosterone has been looked at as a treatment also but again, results have not been as positive as hoped. For the moment, doctors concentrate, where possible, on eliminating medications that might have a negative effect on sexual performance. They also review contraceptive methods to ascertain whether this is a factor.
Women who suffer from vaginal dryness may also be recommended to use lubricants during intercourse. Some doctors recommend that women use Kegel exercises, which help to develop the muscles around the outer portion of the vagina that are involved in pleasurable sensations. Psychological counselling can also play an important part in treating women with sexual problems, as can coaching in sexual foreplay and stimulation techniques.
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