Sex is something that most all of us engage in for a significant period of our lives. This article is not intended to encourage nor discourage sex itself, but to open up what can be a very sensitive subject for many women. Up to 40% of women may feel that they have problems with sex, some distressingly so. These problems may be temporary or lifelong.
I must say, up front, that the most important thing is that sex is an act that should take place between consenting adults. No one should ever force you to have sex. NO ONE. If this is the case, please talk with your provider.
Sex is complex
Our sexual experience changes from the days when we first start sexual relations, through pregnancy, family and work changes and menopause. There are physical, emotional, mental, hormonal, cultural and relationship aspects that all play a role in the experience. All of these facets play a role in how our body responds to sex and how we enjoy sex...or not.
A little definition
Sex is not defined by just penile penetration in a woman's vagina. There are many ways in which humans are intimate and sexual. For each of us, this changes as we age, as our bodies change, and as our relationships change. When health providers think about the sexual response, we sometimes break it down to libido (interest in sex), arousal (enjoyment) and orgasm. The most common problem that women report is a difficulty with libido. It is important to talk about these details in order to narrow down those complex issues that can contribute to sexual dysfunction.
Talk about it!
An important part of identifying sexual problems and improving relations is communicating with your partner. If you feel that there is a problem, it is likely that he or she does, as well. It takes two to tango, and if there's a problem, you'll likely both need to put in a little effort to work things out.
Spice things up. Remember when you had so much interest in sex? When a relationship was new and different? What about trying something new and different now? There are numerous products on the market- lubricants, stimulants, toys- that exist for this very purpose. This doesn't necessarily mean trying something new sexually, but perhaps even spicing up a little romance with a date, flowers or unexpected getaway.
Sex can certainly be affected by medical problems, surgery and medications. Depression, anxiety, and other mental health disorders certainly impact how we experience sex. Sleep plays a huge role. I have many women who ask me why they have decreased libido when transitioning to menopause. Though hormones do play some role, many will notice that night sweats disturb sleep. If you're not getting good sleep, why would you be in the mood to enjoy sex? Humans were built to reproduce sexually. Our bodies, however, when not in the best condition for reproducing, may be "turned off" towards sex. If the body is sick or tired, it is not going to be very responsive or interested in sex.
If you've noticed a change in your sexual experience, is it possibly related to a change in your life? Sexual relationships often change with a new partner, young children, family stressors, work changes, and children leaving the house. Our sexual experience and expectations when we are young in new relationships is far different from those after years in a marriage or after menopause. Are there work, financial, or other stressors? Anything we do (including sex) may be difficult to enjoy when we can't relax. It's important to take in to account how these factors may be affecting sexual enjoyment and address them.
It's a pain
Sex should not be painful. If it is, it is important to evaluate why this is and hopefully correct the issue. Infections are a potential source of pain that should be treated as soon as possible. Vaginal dryness, particularly while breastfeeding or after menopause, can make sex uncomfortable. Some women have conditions such as endometriosis, fibroids, musculoskeletal pain, or other pelvic structural problems. Most physical problems are treatable, possibly curable, but should be evaluated by your provider.
The bottom line...
Unfortunately, there is no "magic pill" that can solve all sexual problems for all women. However, there are many options available that may be able to help...depending on the problem. As mentioned, the issues may be complex. Though it may be uncomfortable, you should be able to talk with your women's health provider about any problems you may be experiencing with sex. That's just one of the things we're here for. Contact an office to make an appointment >
Dr. Brandi Vasquez is a board-certified OB/GYN physician and surgeon in the Oregon City and Canby offices of Women’s Healthcare Associates. She obtained her undergraduate degree from the University of Washington and then attended OHSU where she earned her MD and PhD. She returned to Oregon to practice after completing her residency at Duke University and a Global Health fellowship in Moshi, Tanzania. In addition to advocating for increased awareness about heart disease, her clinical interests include minimally invasive gynecologic surgery (including robotic surgery), sexual health, international work and education.
Sources: Images - Conceive Online, Healthline