Female Sexual Concerns

Sexuality in any given woman is a complex process that includes neurological and psychological factors, the blood and endocrine systems, family, societal and religious beliefs, and the age, health status and personal experience of the woman. In addition, sexual activity normally incorporates interpersonal relationships.  A problem in any of these areas can evidence itself as a sexual problem.

There is great variation in individual female sexual functioning and there is no one standard or set of criteria that a woman must meet for her sexual functioning to be considered normal.  If you experience a sexual issue that troubles you, then it is a problem for which you should seek help.

Among the most common sexual problems in women are hypoactive sexual desire disorder (commonly referred to as low sex drive), difficulty with orgasm (technically labeled female orgasmic disorder), pain during intercourse (called dyspareunia), and sexual performance anxiety.

Hypoactive Sexual Desire Disorder may exist if you do not have a desire for sex and are not interested in the sexual advances of your significant other. This definition is vague since the presence of any health problems, medications, sleep problems and fatigue, depression or anxiety, aging factors, and life circumstances all can, and do, affect normal sexual desire and interest.  Additionally, this definition recognizes that there are naturally occurring differences in sexual interest among women.

Difficulty with orgasm, or female orgasmic disorder, is a persistent delay or absence of orgasm. This definition is also vague because it recognizes that life and health issues affect orgasmic functioning and it recognizes the naturally occurring variations in a woman's ability to achieve orgasm.  

Pain during intercourse (dyspareunia) is a commonly reported female sexual problem.  It may be related to poor vaginal lubrication or to vaginismus, which are the involuntary contraction of the muscles of the outer one third of the vagina.  Vaginismus occurs when the vagina is unable to relax and permit penetration.  Typically the reason(s) behind vaginismus is some physical or psychological trauma associated with sex or penetration.

Sexual performance anxiety is when fear or anxiety about engaging in sexual activity becomes a block to your sexual feelings and thoughts.  Performance anxiety can center on many concerns but in women is usually related to achieving orgasm, having sufficient vaginal lubrication, and having passion, tenderness, intimacy and sensitivity toward her partner. Performance anxiety can result in you having avoidance of sexual encounters, having lowered self-esteem, and experiencing sexual dysfunction.

Before you decide to seek any psychological intervention, it is important to rule out biological, chemical or health factors that may be related to a sexual problem.  Accordingly, a complete examination by a physician(s) is needed.  Then, treatment will vary depending the nature of your problem, your life circumstances, your personality and your emotional make-up.

The types of treatment for all of the female sexual problems listed above can involve traditional psychotherapy, relaxation techniques, reality therapy, cognitive and behavioral therapy, and stimulation and pain control techniques. Sex education can also be an element of therapy as can the use of external stimuli (e.g. plastic dilators in the case of painful intercourse) used with the consultation and direction of a certified sex therapist or sexual dysfunction clinic.

In consultation with your physician, treatment may also involve hormone treatment and medication.  

For more information about female sexual concerns, please click on the linked websites listed below.

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