What are sexual problems?

A sexual problem means that sex is not satisfying or positive for you. In women, common sexual problems include feeling little or no interest in sex, having problems getting aroused, or having trouble with orgasm. For some women, pain during intercourse is a problem.

Most women have a sexual problem at one time or another. For some women, the problem is ongoing. But your symptoms are only a sexual problem if they bother you or cause problems in your relationship.

There is no "normal" level of sexual response, because it is different for every woman. You may also find that what is normal at one stage of your life changes at another stage or age. For example, it's common for an exhausted mother of a baby to have little interest in sex. And it's common for both women and men to have less intense sex drives as they age. This is linked in part to hormone changes in the body.

What are some causes of sexual problems in women?

Female sexuality is complex. At its core is a need for closeness and intimacy. Women also have physical needs. When there is a problem in either the emotional or physical part of your life, you can have sexual problems.

Some common causes include:

• Emotional causes, such as stress, relationship problems, depression or anxiety, a memory of sexual trauma, and unhappiness with your body.
• Physical causes, such as hormone problems, pain from an injury or other problem, and certain conditions such as diabetes or arthritis.
• Aging, which can cause changes in the vagina, such as dryness and stiffening.
• Certain medicines that can cause sexual problems. These include medicines for depression, blood pressure, and diabetes.

What are the symptoms?

Sexual problems can include:

• Having less desire for sex.
• Having trouble feeling aroused.
• Not being able to have an orgasm.
• Having pain during intercourse.

How are sexual problems in women diagnosed?

Women often recognize a sexual problem when they notice a change in desire or sexual satisfaction. When this happens, it helps to look at what is and isn't working in the body and in life. For example:

• Are you ill, or do you take a medicine that can lower your sexual desire or response?
• Are you stressed or often very tired?
• Do you have a caring, respectful connection with a partner?
• Do you and your partner have the time and privacy to relax together?
• Do you have painful memories about sex or intimacy?

Your doctor can help you decide what to do. He or she will ask questions, do a physical exam, and talk to you about possible causes.

Some women find it hard to talk to their doctor about sexual problems at first. Sometimes it helps to write out what you want to say beforehand. For example, you could say something like “For the past few months, I haven't enjoyed sex as much as I used to.” Or you could say "Ever since I started taking that medicine, I haven't felt like having sex.”

How are they treated?

Treatment for sexual problems depends on what is causing the problem. There may be one or more issues causing the problems. Many sexual problems can be worked out after you know the cause or causes.

Sex involves emotional, physical, and relationship issues. Successful treatment requires a high level of comfort between you and your doctor. Ideally, you and your partner will also be able to talk openly about sexual concerns. Treatment may include treating health problems, getting communication counseling, and learning about things you can practice at home. For example, you might take a warm bath to relax, have plenty of foreplay before sex, or try different positions during sex.

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