Vaginal Problems - Prevention

The following tips may help you prevent a vaginal infection.

• If you think your frequent vaginal infections may be related to using a diaphragm, spermicidal foam or jelly, or condoms, discuss other birth control options with your doctor.
• Wipe from front to back after using the toilet, to avoid spreading bacteria from the anus to the vagina.
• Wash the vaginal area once a day with plain water or a mild, nonperfumed soap. Do not use bubble bath. Rinse well and dry thoroughly.
• Change tampons at least 3 times a day during your period, or alternate tampons with pads. Remember to remove the last tampon used during your period.
• Wear cotton underwear and avoid clothes that fit tightly, such as tight-fitting jeans. Cotton underwear and loose-fitting clothing help prevent the vaginal area from staying warm and moist, which can promote the growth of yeast cells. Tight-fitting clothes may cause skin irritation leading to a rash.
• Remove wet bathing suits and exercise clothing promptly.
• Avoid douching.
• Avoid the use of feminine deodorant sprays and other perfumed products. They may cause genital skin irritation or an allergic reaction (contact dermatitis).
• Having multiple sex partners and not using condoms can increase your risk of sexually transmitted diseases (STDs), which may increase your risk of a vaginal infection.
• Urinate after sex, and rinse your vaginal area with cool water.
• Limit intense exercise, such as bike riding or horseback riding, that can irritate the vulva.
• If you have diabetes, keep your blood sugar in good control.

Take antibiotics when needed, but avoid unnecessary use of antibiotics. Taking antibiotics exposes you to the risks of allergic reactions and antibiotic side effects (such as nausea, vomiting, diarrhea, and yeast infections). Also, antibiotics may kill good bacteria.

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Vaginal Problems - Topic Overview

Most women experience minor vaginal problems from time to time. These problems can be related to menstrual cycles, sex, infection, birth control methods, aging, medicines, or changes after pregnancy.
A change in your normal vaginal discharge may be the first sign of a vaginal problem. Changes in urination, such as having to urinate more frequently or a burning feeling when you urinate, also may be a symptom of a vaginal problem.
Conditions that may cause a change in your normal vaginal discharge include:

• Infections of the vagina, such as a yeast infection, bacterial vaginosis, trichomoniasis, human papillomavirus (HPV), or herpes.
• Infection of the cervix (cervicitis).
• An object in the vagina, such as a forgotten tampon.
• Sexually transmitted diseases (STDs), such as chlamydia or gonorrhea.
• Various sex practices, such as oral-to-vaginal and anal-to-vaginal contact.
• Vaginal medicines or douching.

Vaginal infections

The presence or excess growth of yeast cells, bacteria, or viruses can cause a vaginal infection. A vaginal infection may occur when there is a change in the normal balance of organisms in your vagina.
The three most common types of vaginal infections are:

• Candida vulvovaginitis (yeast infections).
• Bacterial infections (bacterial vaginosis).
• Parasitic infections (trichomoniasis).

Common symptoms of vaginal infection include:

• Increase or change in the vaginal discharge, including gray, green, or yellow discharge.
• Vaginal redness, swelling, itching, or pain.
• Vaginal odor.
• Burning with urination.
• Pain or bleeding with sex.

If you are pregnant and have vaginal symptoms, talk with your doctor about your symptoms before considering any home treatment measures. Some home treatment measures may not be appropriate, depending on the cause of your vaginal infection. Conditions such as bacterial vaginosis can affect your pregnancy, so it is important to talk with your doctor and be treated appropriately.
Vaginal infections may increase the risk for pelvic infections, such as pelvic inflammatory disease (PID).

Vaginal or vulvar problems

Other vaginal or vulvar problems may occur from the use of birth control methods, the use of medicines, or aging, or as a result of changes after pregnancy. These problems include:

• Vaginal prolapse, which may cause urination and bowel changes.
• Retained tampon, birth control device, or foreign object. See how to remove an object from the vagina.
• Vulvar or vaginal injury, such as landing on a metal bar such as on a bike or playground equipment or from an object in the vagina.
• Vulvar pain (vulvodynia).
• Noninfectious vaginitis. Examples of this include:
  • An allergic reaction or irritation from chemicals, such as those found in vaginal sprays, douches, or spermicides.
  • Hormone changes related to menopause, such as atrophic vaginitis.
  • Use of antibiotics and other medicines, which may change the balance of organisms in your vagina.

A young girl with unusual vaginal symptoms should be evaluated by her doctor to determine the cause. Vaginitis in a young girl may be caused by:

• A ball of toilet paper in her vagina.
• Pinworms that have spread from the anus to the vagina.
• The spread of bacteria from an upper respiratory infection of the ears (otitis media) or throat (tonsillitis) to the vagina by her hands.

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What is Vaginal Prolapse?

It’s more common than you may think.

Vaginal prolapse (also called pelvic organ prolapse, or vaginal organ prolapse) is what happens when organs inside the pelvis fall, bulge or protrude into the vaginal wall. This condition is due to weakened muscles or ligaments that can occur from a number of causes, including childbirth, previous surgeries, and obesity. If you have signs and symptoms of vaginal prolapse, learning more about this condition (and discovering you have options!) can lead to a better way of life.

	Understanding Vaginal Prolapse Types of Vaginal Prolapse Vaginal Prolapse and loss of bladder control

Understanding vaginal prolapse

There are a number of muscles, ligaments, and other tissues that elevate and support the pelvic area. They provide support for pelvic organs including the uterus, urethra, bladder, and the rectum.
Vaginal prolapse happens when pelvic organs, including the bladder or rectum, bulge into the vaginal wall due to a weakening of important muscles and supporting ligaments. If left untreated, these organs may fall or protrude to a point that they prolapse (bulge or push into)—the vaginal area. In extreme cases, the vagina can even fall to the point where it extends outside the body.

Healthy pelvic area before prolapse The bladder, vagina, and rectum are normally well supported by pelvic muscles and ligaments

Vaginal Prolapse (VP) Vaginal prolapse occurs when weakened muscles or ligaments allow the pelvic organs to descend into the vaginal wall, causing discomfort and other symptoms.

Types of Vaginal Prolapse

Vaginal prolapse is a general term that refers to a prolapse in the pelvic area. However, there are several specific types of prolapse that contribute to the overall condition of vaginal prolapse. It’s helpful to know about each type, since many women may experience more than one.

Vaginal Vault For women who have had a hysterectomy the normal support from the uterus is no longer in place and prolapse can occur when the top portion of the vagina descends down into the lower vagina.	Vaginal vault prolapse The apex, or upper portion of the vagina, collapses and descends into the vaginal canal. This sometimes occurs after a hysterectomy, causing the vagina to turn inside out
	Bladder prolapse (cystocele, pronounced “sist-uh-seal”)–the bladder bulges or “herniates” into the vaginal wall
	Rectal prolapse (rectocele, pronounced “rekto-seal”)–the rectum bulges (herniates) into the vagina
Uterine Prolapse When the muscles and ligaments of a woman are weakened, and the woman still has a uterus, prolapse can occur when the uterus descends into the vagina.	Uterine prolapse (procidentia, pronounced “pro-sid-entsha”)–the uterus falls into the vagina
Enterocele Enterocele occurs when the intestine bulges into the vagina. Enterocele’s can occur from the front, back or top. This illustration shows an enterocele from the back.	Small bowel prolapse (enterocele, pronounced “enter-o-seal”)–the small bowel bulges (herniates) into the vagina

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Vaginal Discharge: Changes That May Be Signs of a Problem

Is vaginal discharge normal?

Yes. Glands inside your vagina and cervix make small amounts of fluid. This fluid flows out of the vagina each day, carrying out old cells that have lined the vagina. This is your body's way of keeping your vagina healthy and clean. The discharge is usually clear or milky and doesn't smell bad.

The color and thickness of the discharge change with your monthly cycle. The discharge is thicker when you ovulate (when one of your ovaries releases an egg), when you breastfeed or when you're sexually excited.

What changes may be a sign of a problem?

Changes that may signal a problem include an increase in the amount of discharge, a change in the color or smell of the discharge, and irritation, itchiness or burning in or around your vagina. This is called vaginitis. A discharge that's stained with blood when you're not having your period could also be a sign of a problem. If you have any of these signs, you should talk to your doctor.

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Tips on preventing vaginitis

• After using the toilet, always wipe from front to back. This may help prevent getting bacteria from your rectal area into your vagina.
• Wear cotton underpants during the day. Cotton allows your genital area to "breathe." Don't wear underpants at night.
• Avoid wearing tight pants, pantyhose, swimming suits, biking shorts or leotards for long periods.
• Change your laundry detergent or fabric softener if you think it may be irritating your genital area.
• The latex in condoms and diaphragms and the sperm-killing gels that are used for birth control can be irritating for some women. If you think one of these things is a problem for you, talk to your doctor about other types of birth control.
• Avoid hot tubs.
• Bathe or shower daily and pat your genital area dry.
• Don't douche.
• Avoid feminine hygiene sprays, colored or perfumed toilet paper, deodorant pads or tampons, and bubble bath.

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What can cause these changes?

These changes can occur if the normal balance of healthy bacteria (germs) in your vagina is upset. Many things can disturb the balance of a healthy vagina, including douching, feminine hygiene sprays, certain soaps or bubble baths, antibiotics, diabetes, pregnancy or infections.

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How can douching be harmful?

The chemicals in douches may irritate your vagina and change the normal balance of germs in your vagina. Douching can also spread an infection into the uterus, increasing your risk of getting pelvic inflammatory disease (PID). PID is an infection of the fallopian tubes that can cause you to be unable to have children.

Douching isn't necessary to keep your body clean. Smells you may notice usually come from outside the vagina (vulva). Keeping this area clean with gentle soap and water can prevent smells.

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What is a yeast infection?

Small amounts of yeast fungus are often found in a healthy vagina. But if too much grows, it can cause a yeast infection. Possible signs of yeast infections are listed in the box below.

Yeast infections usually aren't caught from a sex partner. You may be more likely to get a yeast infection if you are using antibiotics, are pregnant, have diabetes, or stay hot and sweaty for long periods. Some women get frequent yeast infections for no obvious reason.

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Signs of yeast infections

• White, cottage cheese-like discharge
• Swelling and pain around the vulva
• Intense itching
• Painful sexual intercourse

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How are yeast infections treated?

Yeast infections are usually treated with a medicine you put into your vagina. Yeast infections can also be treated with oral medicine.

If you have yeast infections often, your doctor may suggest you use a medicine you can buy without a prescription. But if you have any questions about what's causing your vaginitis, you should call your doctor. Many other things besides a yeast infection can cause vaginitis.

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What is bacterial vaginosis?

Bacterial vaginosis is usually caused by Gardnerella vaginalis bacteria. Why some women get this infection isn't clear. It's probably not caught from a sex partner. Possible signs are listed below.

Bacterial vaginosis is treated with antibiotic medicine, usually a pill.

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Signs of bacterial vaginosis

• A white, gray or yellowish vaginal discharge
• A fishy odor that is strongest after sex or after washing with soap
• Itching or burning
• Slight redness and swelling of the vagina or vulva

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What is trichomoniasis?

Trichomoniasis is caused by an organism called Trichomonas vaginalis. You can be infected but have no signs for a long time. Possible signs of trichomoniasis are listed in the box below.

Trichomoniasis is usually caught by having sex without a condom with someone who is infected. It's usually treated with oral antibiotics.

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Signs of trichomoniasis

• A watery, yellowish or greenish bubbly discharge
• An unpleasant odor
• Pain and itching when urinating
• Most apparent after your period

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What about other infections?

Two sexually transmitted infections, chlamydia and gonorrhea, can also cause vaginal discharge. These are infections of the cervix caused by bacteria. Sometimes the only symptom may be an increase of vaginal discharge. Both of these infections can be treated with antibiotic shots or pills.

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Should my sex partner be treated?

Sometimes. Talk to your doctor if you're sexually active. You may also need to avoid having sex or use condoms until you've been treated.

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Masturbation and multiple orgasms

Posted by: webmaster2 on Tuesday, October 04, 2005 - 07:42 Print article   Email to a friend

by Anne Griza
Sexologist

Multiple orgasms are sex-linked climaxes in a row, non-interruptive, one immediately after another. There occurs several vaginal contractions thus a sex-linked climax just like in the outlined orgasm feeling. Disregarding of the sexual rapport whether masturbation or sex congress.

There isn't yet known if there is any biological or psychological component for this kind of sex-linked behavior in certain women, what is known is that it is seldom and only few can reach.

Only women can have this type of orgasm, for men have the so-called refractory period, which is the elapsed time between a sexual relation and another and therefore necessary for a new erection.

A woman who already has this experience bears no guarantees that it would take place again. Most women have only single orgasms, far from meaning that they would be better or worst sexual partners than those multiorgasmatic-ones, even if indulging in masturbation.

There's a myth that women who display multiple orgasms are hotter than those who don't.

In principle, such is just a myth, since the amount of orgasms doesn't necessarily mean quality sex, and there shouldn't be forgotten that this fact may not be a rule in a woman's sexual life.

As far as a man concerns, if his sex partner has multiple orgasms, it's likely being a super-man, capable of taking a woman to bliss. Therein lies the fantasy that having sex with him could be highly pandering. As it is known that, an orgasm bears on a string of feelings that go beyond the physical scope, there can also be considered myth.

Given that, such a fantasy exists that men and women ought to be extremely sexed up, a woman might try to fake multiple orgasms so that would her sex partner become even more sexually aroused or deeply admire her sexually. That is a mistake, for sex has to be blissful for both partners and even if she has no multiple orgasms, it doesn't mean that she didn't like the sex act or didn't feel sex-linked pleasure. Furthermore, some women seem able to induce sex-linked pleasure only with masturbation.

Besides, her partner may realize that she is faking it, since he can spot biological reactions of orgasm, such as vaginal contractions for instance. And in the long run she may bring about self-consciousness between them and unfulfilling mostly for herself.

Sex is an act that must be done in order to induce pleasure and self-indulgence as masturbation. A silly orgasm may be more gratifying for the couple than a batch of quirk orgasms, let alone that a woman's multiple orgasms may lead her man to sex-linked climax more rapidly and finish a sexual relation before its time.

Before thinking of myths or superwomen, it's paramount that each and every one thinks about what one really likes, and manages to give and take pleasure. That is what a sex act is all about, other than a way to win a partner's heart and mind.

To know how to please and to be pleased triggers a sentiment of profound pleasure, which might be just as equal if not even better than having multiple orgasms.

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Masturbation e Virtual Sex

Posted by: webmaster2 on Monday, September 11, 2006 - 01:04 Print article   Email to a friend

By Jonatas Dornelles
Anthropologist

Seemingly pointless to remind about advances brought across by the internet for us earthlings. There can be data sought on virtually anything in a split second. Yet acquaintances made possible by getting to know whom we would never come across. At the chat-rooms, or soul-searching sites, there can be found flings of casual sex as much as long lasting loving affairs. So what traits would denote virtual sex?

By the internet sex might ensue, actually, under these two guises, either through computer generated imagery or vis-à-vis. Virtual sex speaks for itself. In that the pc and sexual partners while having a go at masturbation. So what’s with masturbation on your own but in front of the monitor?

As far as some patrons of this sexual novelty are concerned, the bottom line meant rather exciting in front of the pc. In fact, those who masturbate in front of the computer seem unlikely to feel left behind. There’d be someone to play along by textual messaging, in that, the imagery and sounds shared lively by means of web cam and gadgetry alike.

Deriving pleasure meant the same for those into virtual sex if not rather intense than what could conventionally be approached by sex. The explanation for all that is downright simple. It’s because masturbation can more efficiently turn on spots prone to sexual arousal. It goes without saying that, by and large, people should know how to get themselves aroused.

Yet physical solitude is another deterrent in virtual sex indulgence. As far as most people concern, there’d be underlying hang-ups in having sex with those barely known partners.  The simple fact of being naked in front of someone else could perhaps cause certain fidgeting. Before a machine, one might feel more at ease and looking forward to pleasure. The explanation is hassle-free as sworn by those all-rounders in sexual trends. Sometimes someone could be feeling neglect at home. Logging on so socializing with other birds of feather, could be extremely pleasant. On top of being so easy, now that only a key stroked takes to terminate rendezvous.
Virtual sex encompasses traits regarded key by the current western society. Thus individuality, since epitomizing it, is revered up, so much for imaginative pathways the lack of physical contact heralded on to arousal threshold.

And yet safe sex guaranteed, given the fact that virtual sex enabled homebound safety, let alone the virtual absence of risk for contagious venereal diseases or AIDS.

Moreover, virtual sex would envelope the best out of dual modality as in on and off.  It’s when, for instance, folks get together on the web and catch up with personal background, both sexually and masturbatory.

To put it short, further down the line they might as well be physically getting down to fantasy all of which previously mingled via computer.

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Next Steps

Prevention

The most important thing you can do to prevent or recover from sexual problems is communicate openly and honestly with your partner.
Adopt a healthy lifestyle to promote overall well-being. This will increase your confidence and self-esteem, which will in turn increase your interest in sex and your responsiveness.

• Eat a healthy diet
• Don't use tobacco
• Get active physically for at least 30 minutes every day
• Get plenty of rest
• Keep stress under control
• Drink alcohol in moderation, if at all
• Have regular health screening, such as Pap test and mammogram

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Other Therapy

Psychotherapy
If the problem is one of lack of knowledge, your health care provider or a sex therapist can teach you (and your partner) about the sexual response cycle and the elements of sexual stimulation. Armed with this new knowledge, many couples can go forward on their own.
Psychotherapy can help a woman identify problems in her life that may be expressed as sexual problems.

• For some women these problems are fairly clear, including past sexual or other abuse, rape, or traumatic sexual encounters.
• For others, the problems may be less clear-cut, involving unresolved emotional issues or dissatisfaction with other areas of life.
• In either case, the therapist usually focuses on resetting the woman's attitudes toward sex.
• The goal is to get rid of old attitudes that got in the way of enjoyable sex, establishing new attitudes that increase sexual responsiveness.

If the problem relates to your relationship, couples counseling is recommended. (You don't have to be married to go to a "marriage counselor.")

• The couples therapist is trained and experienced at helping couples recognize, understand, and solve their problems.
• First, the counselor explores the relationship to find the trouble spots.
• The counselor will recommend exercises and activities that will improve the couple's communication and trust.
• If that can be accomplished, often the sexual problem can be solved more easily.

Sex therapy A sex therapist may take couples therapy one step further by focusing on the couple's physical relationship. After identifying the couple's attitudes about sex and the sexual problem, the sex therapist recommends specific exercises to re-focus the couple's attention and expectations. Specific objectives may include any of the following:

• Learning to relax and eliminate distractions
• Learning to communicate in a positive way what you would like
• Learning nonsexual touching techniques
• Increasing or enhancing sexual stimulation
• Minimizing pain during intercourse

Sex therapists often use what are called "sensate focus" exercises to treat sexual problems. The exercises start with nonsexual touching and encourage both partners to express how they like to be touched. The goal is to help both partners understand how to recognize and communicate their preferences. Sex therapists can recommend exercises to help with vaginismus.

• One successful technique is the use of Kegel exercises. Many women are familiar with these from their childbirth education classes. Kegel exercises involve voluntary contraction and relaxation of the muscles around the opening of the vagina. Women do this instinctively when they need to urinate at an inconvenient time.
• Some women have been helped by using dilators to relax the vaginal spasms. A small dilator is placed in the vagina for 10 minutes, then removed. Larger dilators are used over time to train the vaginal muscles. Kegel exercises may improve the chance of success with this technique.

Group therapy or a support group may be very helpful for a woman. There she can discuss her problems with others who share them. Women often gain insight and practical solutions from these groups, as well as a greater confidence from knowing she is not alone. Couples groups also can be very helpful if both partners are willing. A sex therapist usually recommend such a group if he or she thinks it would be helpful.

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Medical Treatment

If the sexual problem is caused by a medical or physical problem, your health care provider or consulting specialist will suggest an appropriate treatment plan. This will vary, of course, depending on the nature of the problem. The plan may include medication, lifestyle changes, or surgery. Your health care provider may recommend counseling even if the problem is physical.
Effective therapies are readily available for some physical problems.

• Vaginal lubricants - These products are highly recommended for women with vaginal dryness. They can be bought in a drugstore without a prescription. They are available as creams, gels, or suppositories. Water-based products are the best choices. Oil-based products such as petroleum jelly, mineral oil, or baby oil can interact with latex condoms and cause them to break.
• Topical estrogen - These products can help make sex more comfortable for menopausal women with vaginal dryness or sensitivity. Estrogen is applied as a cream or vaginal insert. These products are available by prescription and are very effective for some women.
• Clitoral therapy device - The Eros clitoral therapy device has been approved by the U.S. Food and Drug Administration (FDA) to treat women with disorders of sexual arousal. The device consists of a small suction cup, which is placed over the clitoris before sex, and a small, battery-operated vacuum pump. The gentle suction provided by the vacuum pump draws blood into the clitoris, increasing pressure on the clitoral nerve. This device increases lubrication, sensation, and even the number of orgasms in many women who have used it. The device is available by prescription.
• Drugs - Sildenafil (Viagra) is the well-known "erection drug" for men. It is used to treat erectile dysfunction, a common sexual problem among men. No similar drug is yet available for women. The effects of Viagra in women have been studied, but results are not conclusive. In some studies, the drugs helped with arousal problems, but in another important study, they did not. The drug has the same side effects in women as in men, including headache, flushing, nasal congestion and irritation, abnormal vision, and stomach upset. It can worsen retinitis pigmentosa, a hereditary degenerative disease affecting the eye. Most importantly, it can cause dangerously low blood pressure and has been linked to unexplained heart attacks in men. Viagra cannot be taken by people who take a nitrate drug for a heart condition, because the combination can be deadly.

Hormone replacement therapy (HRT) - HRT has been used to relieve symptoms of menopause for years.

• It comes in 2 forms, estrogen only (ERT) and combination estrogen-progestin, a synthetic form of the hormone progesterone (HRT). ERT generally is used for women who have had a hysterectomy, while HRT is used for women who still have their uterus, because the progestin protects the uterus from the effects of too much estrogen, especially uterine cancer.
• For many years, HRT was believed to have many beneficial effects for menopausal women, continuing the protective effect that estrogen provides naturally before menopause. These benefits were thought to include protecting against heart disease, high cholesterol, colon cancer, Alzheimer disease, and osteoporosis. New research findings published in 2002 called these beliefs into question. Long-term use of HRT or ERT was linked to significantly higher risks of breast cancer, heart attack, stroke, blood clots (from one kind of HRT), and ovarian cancer (from ERT). The research did show that HRT protects against osteoporosis and colon cancer, but the risks are considered to outweigh the benefits.
• HRT can be very effective in some women in relieving vaginal dryness and discomfort during intercourse, as well as "vasoactive" symptoms such as "hot flashes" and sleep problems.
• Most experts believe that short-term use of HRT for treatment of menopausal symptoms is safe.
• The safety of long-term use of HRT is very questionable. Most experts recommend that women who have taken HRT for 5 years or longer stop taking it.
• Each woman's need for HRT and risks in taking HRT are unique to her. These should be discussed in detail with your health care provider.
• Use of HRT in menopausal women is now considered on a case-by-case basis.

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Self-Care at Home

Treatment is not needed for all sexual problems. Some problems can be solved by you and your partner alone with a little openness and creativity.

• Some problems go away by themselves over time--patience and understanding are all that is required.
• Sometimes talking the problem out with your partner is enough. Women who learn to tell their partners about their sexual needs have a better chance of having a satisfying sex life.
• Try to make the solution is fun--think up ways to inject a little romance and excitement into your sexual routine.

Some strategies women use to overcome sexual problems:

• Set aside time to be alone or alone with your partner, without children and other distractions
• Use erotic videos or books to increase stimulation
• Masturbate to learn about what increases your arousal
• Fantasize about what arouses you sexually; if appropriate, tell your partner about these fantasies
• Use sensual massage and other forms of touch
• Try new sexual positions or scenarios
• Use relaxation techniques such as a warm bath before having sex
• Use a vaginal lubricant to relieve arousal problems due to vaginal dryness

Several excellent books are available in mainstream bookstores or from mail-order sources to help couples deal with sexual and communication problems. Many people prefer this "do-it-yourself" method to talking about these problems with an outsider.

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Exams and Tests

Evaluation for a sexual problem will start with an extensive medical interview. Be sure to tell your health care provider about any medical or mental illnesses and surgeries you have or have had in the past and any medications you take, including over-the-counter medications, herbs, and supplements.
A complete physical examination also will be done. Depending on the type of problem you are having, your health care provider may choose to include a pelvic examination or may refer you to a gynecologic specialist for that part of the examination. For certain other types of problems, consultation with other specialists may be needed.
In most cases lab tests are not needed, although your health care provider may request tests to rule out certain conditions. You may have blood drawn to check hormone levels.
X-rays and other radiology tests are needed only in unusual circumstances.

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When to Seek Medical Care

Not all sexual problems require medical attention. Many people have temporary sexual problems, usually due to medical problems, to anxiety, or to stress in another area of life. If you are distressed by the problem or you are afraid your relationship is threatened, don't be afraid or embarrassed to seek outside help. If your health care provider is unable to help you beyond ruling out physical problems, a mental health counselor should be able to help or point you in the right direction.
Any sexual problem that persists for more than a few weeks is worth a visit to your health care provider. He or she can rule out medical or medication causes of the problem and can offer advice on solving other types of problems. He or she can help you sort out exactly what the problem is if you aren't sure. He or she can refer you to other specialists if necessary: a psychotherapist, a marriage counselor, or a sex therapist.
Certain problems require attention right away.

• If intercourse suddenly becomes painful when it wasn't before, for example, you may have an infection or other medical condition that requires prompt attention.
  
  
• If you have reason to believe you have a sexually transmitted disease, you and your partner both need to be treated right away, as do any other sexual partners either of you may have.
  
  
• Any unusual reaction to sexual activity, such as headache, brief chest pain, or pain elsewhere in the body, also warrants a visit to your health care provider.

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Female Sexual Problems Causes

The causes of sexual problems are as varied and complex as the human race. Some problems stem from a simple, reversible physical problem. Others can stem from more serious medical conditions, difficult life situations, or emotional problems. Still others have a combination of causes. Any of the following can contribute to sexual problems:

• Relationship problems - Discord in other aspects of the relationship, such as distribution of labor, childrearing, or money, can cause sexual problems. Issues of control or even abuse in the relationship are especially harmful to sexual harmony. Such problems can prevent a woman from communicating her sexual wants and needs to her partner.
  
  
• Emotional problems - Depression, anxiety (about sex or other things), stress, resentment, and guilt can all affect a woman's sexual function.
  
  
• Insufficient stimulation - A woman's (or her partner's) lack of knowledge about sexual stimulation and response may prevent a woman from achieving a satisfactory experience. Poor communication between partners can also be a culprit here.
  
  
• Gynecologic problems - A number of pelvic disorders can cause pain in intercourse and thus decrease satisfaction.
  
  
  • Vaginal dryness - The most common reason for this in younger women is insufficient stimulation. In older women, the decrease in estrogen that occurs in menopause is the cause of vaginal dryness. Poor lubrication can also be linked to hormone imbalances and other illnesses and to certain medications. It can inhibit arousal or make intercourse uncomfortable.
    
    
  • Vaginismus - This is a painful spasm of the muscles surrounding the vaginal opening that causes the vaginal opening to "tighten." It can prevent penetration or make penetration extremely painful. Vaginismus can be caused by injuries or scars from surgery, abuse, or childbirth, by infection, or by irritation from douches, spermicides, or condoms. It can also be caused by fear.
    
    
  • Sexually transmitted diseases - Gonorrhea, herpes, genital warts, chlamydia, and syphilis are infectious diseases spread by sexual contact. They can cause changes in the genitals that make sex uncomfortable or even painful.
    
    
  • Vaginitis - Inflammation and irritation of vaginal tissues due to infection or other causes can make intercourse uncomfortable or painful.
    
    
  • Endometriosis, pelvic mass, ovarian cyst, surgical scars - Any of these can cause an obstruction that prevents intercourse or makes it difficult or painful.
    
    
  • Pelvic inflammatory disease - This is an infection of the vagina that moves up into the cervix, uterus, and ovaries. It can be very painful on its own and make intercourse extremely painful.
    
    
  • Nerve damage after surgery - Unavoidable cutting of small nerves during pelvic surgery (such as hysterectomy) may decrease sensation and response.
  
  
• Physical conditions - Many physical or medical conditions can decrease a woman's satisfaction with her sex life.
  
  
  • Tiredness (fatigue)
    
    
  • Chronic diseases such as diabetes, heart disease, liver disease, kidney disease
    
    
  • Cancer
    
    
  • Neurologic disorders
    
    
  • Vascular (blood flow) disorders
    
    
  • Hormonal imbalances
    
    
  • Menopause
    
    
  • Pregnancy
    
    
  • Alcohol or drug abuse
  
  
• Medications - Certain medications can reduce desire or arousal. One well-known group of drugs that have this effect are the selective serotonin-reuptake inhibitor (SSRI) group of antidepressants, which includes drugs such as Prozac and Zoloft. Others include certain chemotherapy drugs, drugs for high blood pressure, and antipsychotic medications.
  
  
• Other medical treatments - Treatments such as radiation therapy for certain types of cancer can reduce vaginal lubrication. They can also make skin and the membranes lining the genitals tender and sensitive.
  
  
• History of abuse - A woman who has suffered sexual or other abuse may have trouble trusting her partner enough to relax and become aroused. She may have feelings of fear, guilt, or resentment that get in the way of a satisfactory experience, even if she cares deeply about her current partner.
  
  
• Attitudes toward sex - Many people, either because of the way they were brought up or because of earlier bad experiences, don't view sex as a normal and enjoyable part of a couple's relationship. They may associate sex or sexual feelings with shame, guilt, fear, or anger. On the other hand are people who have unrealistic expectations about sex. Portrayals of sex in television and movies as always easy and fantastic mislead some people into believing that is how it is in real life. These people are disappointed or even distressed when sex is sometimes not earth-shattering or when a problem occurs.
  
  
• Sexual problems of the partner - If a woman's partner has sexual problems, such as impotence or lack of desire, this can inhibit her own satisfaction.

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Female Sexual Problems Overview

Long considered a taboo subject, women's sexuality is now openly discussed and portrayed on television, in magazines, and on the internet. Most importantly, women themselves are becoming increasingly aware of their sexuality and their sexual health. Women of all ages are learning more about their sexuality.
What is "sexuality"? For a woman, as for a man, sexuality encompasses a very broad range of physical activities and psychological experiences. These activities fulfill an important physical and emotional need for closeness and intimacy. Sexuality doesn't include just your sexual practices. Your feelings about yourself, how you relate to others, and about sex and previous sexual experiences are part of your sexual makeup. Your feelings about your partner and your relationship definitely affect your sexual satisfaction.
Women's interest in sex and responses to sexual stimulation vary widely. Although most women's sexual responsiveness peaks in the late 30s and early 40s, a woman can have satisfying sexual experiences throughout her life. The quality of her experiences is affected by individual differences, by life situation, by age and hormonal levels, and by overall health and well-being.
A sexual problem is anything that interferes with a woman's satisfaction with a sexual activity. When this happens, it is often referred to by health professionals as female sexual dysfunction (FSD).
According to a groundbreaking article in the Journal of the American Medical Association (JAMA) in 1999, sexual problems are common in women and men, but especially in women. In a survey of men and women aged 18-59 years, about 43% of women and 31% of men reported some sexual problem.
Sexual response cycle
To understand why sexual problems occur, it is important to understand the sexual response cycle. This cycle is the same in both men and women, although at different rates and, obviously, with different physical changes. The cycle has 4 steps.

• Desire (excitement phase) - Desire is a sexual "charge" that increases interest in and responsiveness to sexual activity. You feel "in the mood." Your heartbeat and breathing quicken, and your skin becomes reddened (flushes).

• Arousal (plateau phase) - Sexual stimulation--touch, vision, hearing, taste, smell, or imagination--brings about further physical changes. Fluids are secreted within the vagina, moistening the vagina, labia, and vulva. These fluids provide lubrication for intercourse. The vagina expands, and the clitoris enlarges. The nipples become hardened or erect.

• Orgasm (climax) - At the peak of arousal, the muscles surrounding the vagina contract rhythmically, causing a pleasurable sensation. This is often referred to as the sexual climax.

• Resolution - The vagina, clitoris, and surrounding areas return to their unaroused states. You feel content, relaxed, possibly sleepy.

Every woman progresses through the cycle at her own rate, which is normal for her. A sexual problem may occur if any of these stages does not occur.
Sexual problems
The types of sexual problems in women correspond to the stages of the sexual response cycle. Inability to achieve any of the stages can interfere with sexual satisfaction and thus create a problem. Any of these can be very distressing for a woman, because everyone deserves a satisfying sex life. They can be distressing for her partner, too, and can lead to problems in the relationship.

• The sexual problems reported by women in the JAMA study comprised 3 types:
  
  
  • Lack of sexual desire (22%) - Lack of interest in sex, or desire for sex, is a common problem in both men and women, but especially in women. Lack of desire stops the sexual response cycle before it starts. Lack of desire is temporary in some people and an ongoing problem in others.
    
    
  • Difficulties becoming sexually aroused or achieving orgasm (14%) - Inability to become sexually aroused is sometimes related to lack of desire. In other cases, the woman feels sexual desire but cannot become aroused. Orgasm may be delayed or not occur at all (anorgasmia). This can be very distressing for a woman who feels desire and becomes aroused. It can create a vicious cycle in which the woman loses interest in sex because she does not have an orgasm.
    
    
  • Pain during intercourse (7%) - Pain during intercourse (dyspareunia) is not uncommon. Like other sexual problems, it can cause a woman to lose interest in sex.

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