Dr Brigid Monda
Women are socialised to believe sex isn’t something they should enjoy so many problems in this department remain untreated. Yet ‘Female Sexual Dysfunction’ (FSD), like a diminishing sex drive or loss of libido can disrupt a woman’s sex life and is a common medical condition.
How often a woman has sex varies from one to another and a woman’s sexual responsiveness usually peaks in her late 30s and early 40s.
Disorders of Desire
Lack of sexual desire is the most common sexual problem in women and has many causes: boredom with the same sexual routines, a bad relationship or experience like rape, stresses of demanding work and family; nothing kills the libido faster than fatigue.
Arousal disorders
May be due to inadequate stimulation, especially in older women, some require more stimulation to be aroused. Anxiety too may inhibit arousal.
Estrogen and the male sex hormone Testosterone produced in small quantities in women by the ovary also drops significantly after menopause causing a decline in genital sensation and libido.
Orgasmic disorders
These can stem from negative feelings about sex because of childhood sexual abuse or rape, anger, depression, use of drugs or alcohol.
Focusing too much on technique and the orgasm and not mutual pleasure diminishes sexual excitement because it creates anxiety and distractions.
Vaginismus, the painful spasm of the vaginal muscles makes penetration painful and can be caused by a woman’s fear of losing control, fear of pregnancy, past sexual abuse, painful vaginal scars from circumcision or childbirth, irritation from douches, spermicides or latex condoms and pelvic infections.
Dyspareunia or ‘ pain during intercourse’ may also occur.
Pregnancy
Intercourse does not harm the baby but a decrease in sexual desire often prolonged by breast feeding may occur. A combination of fatigue, fluctuating hormone levels and a still healing episiotomy may prevent couples from having sex after birth.
Menopause
Declining levels of testosterone, estrogen and progesterone may cause a gradual loss of desire, difficulty getting aroused and painful intercourse because the vagina is dry due to a lack of lubrication and thin friable tissues due to the lack of estrogen making sexual activity uncomfortable. Hot flushes can make women feel unattractive and experience mood swings.
Terminal illness
Loss of the uterus or breast due to cancer removes physical symbols of femininity that may result in feelings of decreased sexuality. The treatment itself can be painful, sap the woman’s energy as well as cause premature menopause. Diabetes can cause a reduction in lubrication and blood flow to the genitals. Some medications can also affect her libido.
