A healthy living blog from Marshfield Clinic

Ladies: Regain that lovin’ feelin’

middle-aged couple smiling in bed

When you’re unsatisfied with your sexual health, seek help. There could be more going on than you think.

Not interested in sexual intimacy, ladies? There may be more behind that bedroom boredom than a simple lack of interest.

It may be tied to female sexual dysfunction (FSD). If you haven’t heard of FSD you’re not alone. It affects more than 40 percent of women of all ages, race, ethnicity and socioeconomic status, but remains one of the most underdiagnosed medical problems in the United States.

Female sexual dysfunction (FSD) includes several disorders that disrupt phases comprising the sexual response cycle: excitement, plateau, orgasm and resolution. FSD symptoms are persistent or recurrent and can cause personal distress. They include:

  • Having pain during sex.
  • Not becoming aroused or “excited” during sex.
  • Not having an orgasm during sex.
  • Lacking desire for sex.

FSD: The causes

You can experience FSD any time in your life. Causes are unique to individuals and include:

  • Medications – medications to treat mood disorders or heart disease are among the most common to cause problems, although there are others.
  • Illicit drug use.
  • Pelvic surgery/trauma.
  • Vascular or blood flow problems like high cholesterol, high blood pressure or diabetes.
  • Hormonal problems like menopause, thyroid disease or postpartum.
  • Neurologic problems like spinal cord injuries or multiple sclerosis.
  • Psychological problems like depression, stress, history of abuse, self-esteem or relationship issues.

Cancer treatments & FSD

Certain cancer treatments have been associated with FSD. Radiation therapy to the pelvic area can cause radiation vaginitis, a thinning of the vaginal tissue or narrowing of the vagina. Pelvic surgery also can result in painful or uncomfortable intercourse.

Chemotherapy can cause hormonal changes, but more research is needed to clarify how much hormones affect sexual response or libido. What’s known is that chemotherapy side effects including fatigue, muscle weakness, nausea and physical changes can affect your sexual desire.

Mind over matter

For women, sexual health is more than physiology.

Women are responsive creatures who tie sexual activity into emotions, a core difference between men and women. For women, their brain is the biggest erogenous zone. Self-esteem, loss of a loved one, personal financial problems or serious illness – all can affect a woman’s response or desire for sexual activity.

Unfortunately, no “magic pill” exists to treat female sexual problems. Many women require a combination of treatments that may include counseling, education, physical therapy, medications and biofeedback training.

Don’t let go

To help regain sexual function also consider:

  • Keeping an open line of communication with your partner. If your partner understands why you are the way you are he or she is less likely to see your lack of loving as rejection.
  • Resuming intimacy slowly. If you’ve gone a long time without intimacy, no matter the reason, start at a comfortable place with cuddling. Gradually progress to more intimate activities if and when you’re comfortable.
  • Explore other ways to be intimate. Intimacy doesn’t have to be limited to penile/vaginal intercourse.

When you’re unsatisfied with your sexual health, seek help. What’s important is addressing your concerns with your health care provider so you can be referred for evaluation and treatment as soon as possible.

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Heather is an OB/GYN physician assistant at Marshfield Clinic. She focuses her care on female reproductive and urinary health (gynecology), and pregnancy health for you and your unborn baby before, during and after birth (obstetrics). Marshfield Clinic provides a full spectrum of medical care for women and girls from childhood through menopause.


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