Couple/Sexuality

Female Sexual Dysfunction

Since the development of Viagra, male sexual dysfunction has received increasing acknowledgement and attention. On the other hand, female sexual dysfunction is much less discussed, and often more complex to treat.

However, there is little doubt that these problems exist.

In the late 90's a landmark, large-scale survey of sexual dysfunction in women was reported in the Journal of the American Medical Association. This survey of more than 1,700 American women reported that:

  • 33 % of respondents complained of low libido
  • 20 % experienced problems with arousal
  • 25 % failed to achieve orgasm regularly
  • 15 to 20 % reported discomfort during intercourse

‘This last figure varied according to the age of the women, with younger women being more susceptible,’ said Dr. Stephen Holzapfel, director of the Sexual Medicine Counselling Unit at Women's College Hospital and associate professor in the departments of family and community medicine, obstetrics and gynecology at the University of Toronto.

'A surprising number of these women push themselves to have intercourse through persistent pain.’

Holzapfel cautions against taking the survey’s results as a final statement about female sexuality, noting that definitions of sexual health vary with place and time.

‘In Victorian times, for instance, women who lusted for sex and experienced orgasm were seen as sick and deviant. Today, these women are seen as healthy and their sexually quieter sisters are labelled dysfunctional, when they just might be at the low end of the normal spectrum.’

Still, many sexually active women feel there’s something missing in their sex lives. They may respond, to some degree, to their partner’s advances, but only rarely make the first move. They sense that sex could be a more compelling experience, but don’t quite know how to make it happen.

A declining sexual response can reflect emotional issues in the woman’s life and her relationships. Particularly for women approaching menopause, it may also be associated with hormonal changes

Emotional issues

‘Arousal is simpler for men and more complex for women,’ said Holzapfel. In the beginning of a relationship the discrepancy is masked by novelty and excitement. But he says that when the relationship settles, ‘men continue to get aroused by simple visual clues like seeing their partner undress, while arousal for women becomes more context-dependent.’

In other words, women in long-term relationships need a context of intimacy to jump-start their sexual desire, whereas men typically use sex as a conduit to intimacy. Which is why, when one of his female patients complains of a lacklustre libido, Holzapfel always begins by assessing the ‘state of the union’ between the woman and her partner.

After the birth of a child or with the passage of time, many couples stop displaying the loving behaviours that stoke a woman’s sexual response, he says. His prescription for these couples is to express appreciation to your partner, even if it feels awkward at first. Also, schedule ‘wicked weekends’ sans kids at least four times a year.

‘Such measures may sound trite, but in my practice I’ve found that they really do work,’ said Holzapfel.

Karen Kaffko, a psychologist and sex therapist in private practice in Toronto, challenges couples to revise their 'mental picture' of sex.

‘Many couples give up the necking and petting that got them all revved up when they were dating, and come to equate sex with intercourse, which of course is very boring,’ she said.

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