Defining Female Sexual Dysfunction
The Sexual Revolution has come and gone, but women's sexuality is still shrouded in mystery and misconception. Not that long ago women were thought to be crazy or "bad" if they showed any interest in sex, and only a few generations have passed since hysterectomy was a routine solution to any number of physical and psychological conditions -- both real and perceived.
Medicine has come a long way in clarifying what constitutes function and dysfunction, but the medical community, and society as a whole, has a long way to go. A case in point is the debate in the psychiatric community over whether premenstrual syndrome exists, and if it does, whether it's classifiable as a "mental disease." Women want female sexual dysfunction to be taken seriously and to be investigated responsibly, just as male sexual dysfunction has been. And they want to know: Is Viagra, Levitra, or Cialis their magic bullet, too?
To find out, they need to understand exactly what female sexual dysfunction is. It usually is defined as an inability to experience sexual pleasure or as pain during intercourse. Dysfunction, however, doesn't mean abnormal. If a woman experiences either of those problems, she's far from alone.
In a study conducted by Irwin Goldstein, M.D., a former professor of urology at Boston University School of Medicine and a leading researcher in sexuality problems, 58 percent of 300 women interviewed reported some type of sexual dysfunction, such as discomfort during intercourse, dryness, increased time for arousal, diminished ability to achieve orgasm, or diminished clitoral sensation.
Sexual problems, even those that are physically based, are not necessarily something to worry about. Most women at some time feel unaroused at the thought of sex, and pressures of work or other stress can keep you from enjoying sex fully (which is unfortunate, because an orgasm is a great relaxant, as is intimacy).
A low libido could simply mean you're tired. Some symptoms, such as vaginal dryness, may be the normal consequences of aging, easily corrected with hormone replacement therapy or lubricants. The problem can be magnified if your partner takes Viagra, Levitra, or Cialis and gets firm, hard erections after years of a softer one.
The continuum of sexual response among women is so broad that inability to achieve orgasm is only considered dysfunction if a specific psychological inhibition or physical impairment is present. Famed sex therapists William Masters and Virginia Johnson, with co-author Dr. Robert Kolodny, say relatively few cases of orgasmic dysfunction have a medical cause.
Instead, they say it's more likely to be the result of a "negative mind set that the woman brings to a sexual situation," such as shame, embarrassment, resentment, or fear. Of course, we should remember that that's what was said about male sexual dysfunction, too.
The reasons for female sexual dysfunction are many and varied, ranging from depression to chronic illness to drug side effects. If you are concerned about any aspect of your sexual functioning, a visit to a gynecologist is in order.
In the next section, we'll examine some of the physical factors that lead to sexual dysfunction in women, including hormones, infection, and fatigue.