Sexual problems in women (II)

The doctor will carry out a thorough evaluation of symptoms and if necessary a physical examination. He may perform a pelvic examination to evaluate the health of the reproductive organs and a Pap smear to detect changes in the cells of the cervix. This will be to check for cancer or a pre-cancerous condition. He or she may order other tests to rule out any medical problems that may be contributing to the problem.

An evaluation of your attitude towards sex, as well as other possible contributing factors such as fear, anxiety, past sexual trauma, abuse, relationship problems, alcohol or drug abuse, will help the doctor understand the underlying cause of the problem and make appropriate recommendations for treatment.

The ideal approach to treating sexual problems in women involves a team effort between the doctors, and trained therapists. Most types of sexual problems can be corrected by treating the underlying physical or psychological problems. Other treatment strategies focus on the following:

  • Providing education. Education about human anatomy, sexual function, and the normal changes associated with ageing, as well as sexual behaviours and responses may help a woman overcome her anxieties about sexual function and performance.
  • Enhancing stimulation. This may include the use of erotic materials; videos or books, masturbation, and changes to sexual routines.
  • Providing distraction techniques. Erotic or non-erotic fantasies, exercises with intercourse, music, videos, or television can be used to increase relaxation and eliminate anxiety.
  • Encouraging non-coital behaviours. Non-coital behaviours; physically stimulating activity that does not include intercourse, such as sensual massage, can be used to promote comfort and increase communication between partners.
  • Minimising pain. Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. The use of vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

Effect of hysterectomy on sexual function.

Many women experience changes in sexual function after a hysterectomy. These changes may include a loss of desire as well as decreased vaginal lubrication and genital sensation. These problems may be associated with the hormonal changes that occur with the loss of the womb. Furthermore, nerves and blood vessels critical to sexual function can be damaged during the surgery.

How menopause affect a woman’s sexual function

  • The loss of oestrogen following menopause can lead to changes in a woman’s sexual functioning. Emotional changes that often accompany menopause can add to a woman’s loss of interest in sex and/or ability to become aroused. Hormone replacement therapy — HRT — may improve certain conditions, such as loss of vaginal lubrication and genital sensation, which can create problems with sexual function.
  • It should be noted that some postmenopausal women report an increase in sexual satisfaction. This may be due to decreased anxiety over getting pregnant. In addition, postmenopausal woman often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

Many women experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the women and her partner, and can have a negative impact on their relationship. If you consistently experience these problems, see your doctor for evaluation and treatment.