Ask
me about the most significant moments in sexual medicine history, and
I'll name two: the creation of the birth control pill in the 1960s, and
the introduction of Viagra in 1998.
When
Viagra hit the market, it changed the face of sexuality for men, young
and old, forever. It took sexual dysfunction from behind closed doors
and brought it out into the open.
It
also, however, highlighted the fact that research on women's sexual
functioning and treatment was significantly lagging -- even though studies report that 43% of women have experienced, or are experiencing, some form of sexual dysfunction.
In 2004, the American Foundation of Urological Disorders identified
distinct diagnostic categories for the most common women's sexual
function complaints: hypoactive sexual desire disorder, sexual arousal
disorder, orgasm disorder and pain disorders such as dyspareunia and
vaginismus.
Here's what you should know about each:
Hypoactive sexual desire disorder
Hypoactive
sexual desire disorder is defined as the absence of sexual thoughts or
feelings. This is one of the most prevalent issues seen in female
patients. For women, it can be stressful and negatively impact their
relationships.
Causes include sexual
trauma history, the quality of a woman's current relationship (I'm just
not that into you ... ), hormonal imbalance and depression or anxiety.
When
patients come to see me for this issue, I usually ask whether they
fantasize about actors, models or even the pool boy. If they answer yes,
then more than likely it is a relationship issue, not a psychological
and/or biological issue. For women, it is hard to turn off the fight
you had with your spouse earlier in the day or the fact that he
constantly irritates you with something you don't like.
Most
times the fix is communication and spending quality time together. A
sex date is usually my prescription. Try it, you might like it!
Sexual arousal disorder
Sexual
arousal disorder is defined as the inability to achieve or maintain
adequate lubrication after sufficient stimulation. It oftentimes
overlaps with sexual desire disorder. It can also be dependent on the
stage of life a woman is in.
Menopause,
for example, which is categorized by a significant loss of estrogen,
can have a huge impact on a women's sexual activity. The loss of
estrogen can lead to the loss of vaginal lubrication and cause vaginal
atrophy, which can be painful.
For
women who are not in menopause, sexual arousal can also be caused by a
lack of blood flow to the labia, poor partner ability, hormones and
other factors. Viagra has been prescribed for women to help increase
arousal to the vulva, but it is not FDA-approved for use in women.
Arousal
and desire at times go hand-in-hand. Men tend to forget that women need
longer foreplay; it takes about 15 minutes or more to become fully
aroused.
Foreplay for women is not
only physical, but also mental -- it starts way before you get to the
bedroom. So start the foreplay before you hit the bed. E-mails, text
messages and even taking out the garbage go a long way.
Orgasm disorder
Orgasm
disorder is defined as the inability to achieve orgasm. Being able to
be aroused, either physically and/or mentally, is necessary in order to
achieve orgasm.
For many women,
orgasms are elusive because they are unable to stay in the moment. They
are thinking about a host of other things which distract them from
feeling and being present.
In
addition, a lot of women do not know their bodies and/or have difficulty
talking about what makes them feel good. How can you advocate for
improvement if you don't understand what you are trying to improve?
Sometimes
improving orgasm can be as easy as changing your sexual position.
Switching a woman from the missionary position to being on top can help
give her increased clitoral stimulation as well as control of the depth
of penetration and rate of thrusting.
Pain disorders
Pain disorders in women are common place. At some point in a woman's life, many will experience painful sex.
Dyspereunia
is defined as persistent or recurrent genital pain that occurs before,
during or after intercourse. Vaginismus is the involuntary spasm of the
muscles of the vaginal walls. There is a range of causes for these pain
disorders that include insufficient lubrication, trauma, surgeries,
irritation and emotional factors.
Earlier
this year, Osphena was brought to market and has changed the lives of
some women with pain disorders caused by menopausal symptoms.
Vaginismus, on the other hand, is treated by using varying and
increasing sizes of vaginal dilators, usually in conjunction with
therapy.
When a patient comes about
this issue I always want to know whether they use latex, as there may be
an allergy, or if water-based lubricant is being used. Water-based
lubricants tend to dry faster, needing repeated application. The drying
out can lead to small vaginal tears due to friction. Silicone-based
lubricants tend to be more slippery and need less reapplication, which
often means less tearing.
Hormone issues
Biologically,
women and men are quite different in their hormonal makeup, yet we
share some of the same hormones in differing amounts. Testosterone and
estrogen are our main hormones and have been found to play a significant
role in our sexual response.
Testosterone,
when it is at a low level in men, can lead to decreased desire and
erections that are less firm. Women also need testosterone for desire.
Research has shown that birth control pills tend to bind to the free
testosterone in women's blood, leaving little to fuel desire.
There
has been much conversation about testosterone being prescribed to women
in order to improve sexual functioning. Despite the controversy, by
2006, over 1.3 million testosterone prescriptions were written for
women. Women clearly are ready to change the status quo and reclaim
their right to good sex.
Just start by asking, "Where's my orgasm?"
Via CNN
0 comments:
Post a Comment