In therapy, Kaffko helps couples redefine sex as an encounter that results in arousal, rather than in penetration or orgasm. ‘This forces them to be more creative and intimate, and also less anxious, since there are no orgasm Olympics to compete in.’
Kaffko also treats women whose sexual response suffers from what she calls 'negative self-talk' about sex. These women may have come from a family that looked on sex with suspicion, or may have a history of sexual abuse.
Through cognitive-behavioural therapy, Kaffko helps them challenge their internalized assumptions about sex. ‘It doesn’t happen overnight, but progress is certainly possible.’
Depression, which affects at least twice as many women as men, also wreaks havoc on sexual response.
‘Part of what gets depressed is the sex drive,’ said Holzapfel. Ironically, many antidepressants that boost serotonin further lull desire and genital sensitivity in about two-thirds of long-term users.
Some people find that waiting until after they’ve had sex before taking their daily dose of medication, or interrupting their drug regimen when they expect to have sex, is enough to normalize their sexual response. But such 'drug holidays' can be dangerous unless closely supervised by a doctor.
Hormonal changes
Many women also experience a decline in sexual interest in the years leading up to and following menopause. This should come as no surprise, said Holzapfel, since menopause wipes out about half of a woman’s testosterone (the hormone that drives desire in both men and women) and 80 % of her estrogen.
The vaginal dryness that accompanies diminishing estrogen can easily cause women to lose interest in sex.
‘Vaginas aren’t stupid,’ said Holzapfel. ‘If they’re in pain, they’ll make sure that desire shuts down so they won’t have to go through the experience again.’ Hormone replacement therapy, genital lubricants or simple peanut oil can sometimes remedy the problem.
Some doctors may offer women with vaginal dryness the medication Viagra, which in men enhances blood flow to the pelvic region. In women, physicians hope that the little blue pills will restore plumpness and sensitivity to the vaginal tissues.
‘Though it’s not officially approved for use in women, doctors do prescribe it,’ said Holzapfel. However, studies of Viagra in women have produced disappointing results so far.
Doctors who suspect that a woman has low testosterone can order a blood test and, if the levels are indeed low, initiate testosterone replacement therapy (TRT).
