Learn to love sex again

SEXUAL DYSFUNCTION: MANY REASONS YOU MAY NOT BE IN THE MOOD

Women most often benefit from a combination of treatments.

Loss of libido, or sex drive, can happen in both men and women. Some women may describe persistent, recurrent problems with sexual response, desire, orgasm or pain that cause them relationship problems.

This can occur at any stage of life. It can occur only in certain sexual situations or all.

Sexual response involves physiology, emotions, experiences, beliefs, lifestyle and relationships. Disruption of any component can affect sexual desire, arousal or satisfaction and treatment often involves more than one approach.

If you have ongoing sexual difficulties, make an appointment with your doctor, even if you feel slightly embarrassed because a satisfying sex life is important to a woman’s wellbeing at every age.

You might have a treatable, underlying condition, or you might benefit from lifestyle changes, therapy or a combination of treatments.

Symptoms

Low sexual desire, the most common, involves a lack of interest and willingness to be sexual.

Sexual arousal disorder. You have difficulty with arousal, are unable to become aroused or maintain arousal during sex.

Orgasmic disorder. You have persistent or recurrent difficulty in achieving orgasm.

Sexual pain disorder.

Causes

Sexual problems often develop when you have an imbalance of hormones, such as after having a baby or during menopause.

Factors, often interrelated, that contribute include:

Medical conditions, including cancer, kidney failure, multiple sclerosis, heart disease and bladder problems

Certain medications, including some antidepressants, blood pressure medications, antihistamines and chemotherapy drugs.

Lower oestrogen levels after menopause, which may lead to changes in your genital tissues, which can lead to painful intercourse (dyspareunia).

Sexual desire also decreases when hormonal levels decrease.

Your body’s hormone levels also shift after giving birth and during breastfeeding, which can lead to vaginal dryness and affect your desire to have sex.

Untreated anxiety or depression, long-term stress and a history of sexual abuse.

Long-standing conflicts with your partner about sex or other aspects of your relationship. Cultural and religious issues and problems with body image.

Diagnosis

Your doctor will:

Discuss your sexual and medical history. The more forthcoming you can be, the better your chances of finding an effective approach to treating them.

Perform a pelvic exam looking for thinning of your genital tissues, decreased skin elasticity, scarring or pain.

Your doctor may also refer you to a psychologist specialising in sexual and relationship problems.

Treatment

Treatment varies.

It’s important for you to communicate your concerns and understand your body and its normal sexual response.

Your goals for your sex life are important in determining treatment and evaluating progress.

Women with sexual concerns most often benefit from a combined treatment approach that addresses medical as well as relationship and emotional issues.

Nonmedical treatment

Talk and listen. Open communication with your partner makes a world of difference in your sexual satisfaction.

Practice healthy lifestyle habits. Go easy on alcohol. Drinking too much can blunt your sexual responsiveness.

Be physically active. Regular exercise can increase your stamina and elevate your mood, enhancing romantic feelings. Learn ways to decrease stress so you can focus on and enjoy sex.

Seek counselling. Therapy often includes education about how to optimise your sexual response, ways to enhance intimacy and recommendations for reading materials or couples exercises. Use a lubricant.

Try a toy. Use a vibrator to provide clitoral stimulation or clitoral vacuum suction devices.

Medical treatment

Your doctor might recommend you:

Adjust or change medication. Treat a thyroid problem or other hormonal condition.

Optimise treatment for depression or anxiety.

Try strategies for relieving pain.

Treatment linked to a hormonal cause might include:

Oestrogen therapy in the form of a vaginal ring, cream or tablet, which improves vaginal tone and elasticity, increasing blood flow and enhancing lubrication.

Androgen therapy, which is controversial.

The risks of hormone therapy may vary and might require close monitoring by your doctor.

Others: One drug, sildenafil (Viagra), may prove beneficial for some due to taking selective serotonin reuptake inhibitors, a class of drugs used to treat depression.

Lifestyle

Find ways to be comfortable with your sexuality, improve your self-esteem and accept your body.