Sexual disorders in women

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What are sexual disorders in women?

In the past, sexual displeasure, "anorgasmia" or the lack of sexual need in women were summarized under the umbrella term frigidity, which actually means "cold feeling". This disorder manifests itself as a lack of sexual desire and decreased enjoyment during sex. While in men sexuality takes place more on the physical level and orgasm is the goal, in women sexuality mainly takes place in the head. That is why her psyche, mind and body have to be in harmony if the sexual experience is to be enjoyable.

At any stage in life, sexual activity and desire can be impaired. A distinction should be made between decreased appetite, i.e. lower desire, and disorders of sexual arousal, orgasm disorders and other functional disorders. Only in very few women are sexual problems due to purely physical causes.

What are the sexual disorders?

Sexual Appetence Disorders: Women with this disorder have few or no sexual fantasies or needs. In some cases, these women even develop a real aversion to the sexual part in a relationship. Sexual appetite disorders do not rule out sexual arousal or satisfaction, but they do mean that sexual activities are initiated less often.

»Disorders of sexual arousal: Despite sexual stimulation, little or no vaginal fluid is formed, so that sexual intercourse is often painful. In addition to these physical symptoms, women also subjectively feel a lack of excitement and desire.

»Orgasm disorders: After the arousal phase, the affected women have no or only a delayed orgasm. In sexual medicine it has not yet been fully clarified whether this is an actual disorder. It can also be a variant of female sexuality. The women often do not suffer from the lack of orgasm, but rather enjoy the form of sexual affection and tenderness and do not feel unsatisfied. You are normally excitable.

»Pain during sexual intercourse: There are two forms to be distinguished: firstly, dyspareunia, which is pain in the vagina or in the lower abdomen that occurs during or after sexual intercourse during normal arousal phase. The other phenomenon is vaginismus, in which there is involuntary cramping of the vaginal muscles when the man tries to insert the penis or a finger into the vagina. Sexual intercourse is impossible or painful.

What are the causes of the disturbances?

A combination of emotional and physical causes is responsible for the sexual disorders. Basically, the women concerned seem to put themselves under a certain pressure to perform or are very critical in their self-observation.

»Upbringing: During upbringing, the parents impart values ​​that can affect later sexual behavior. If sex is viewed as immoral with a strictly conservative upbringing, it is unlikely that one can enjoy sex in adulthood.

»Partnership problems: Many women have problems in their partnership. It can be the daily arguing or the lack of communication about sexual needs that stand in the way of lust.

»Traumatic experiences: If previous sexual activities were experienced as frightening or humiliating, the later pleasurable experience of sexuality is made more difficult. Experiences of abuse play a serious role in this regard.

»Insufficient information: If you have not had any experience with your own body, for example during self-satisfaction (masturbation), or if you have no knowledge of the physical processes during sexual arousal, this can lead to self-insecurity and thus impairment of sexual intercourse.

»Physical factors: Pain during sexual intercourse often occurs with changes in the external genitals, for example due to inflammation, scars, etc. The dryness of the vaginal entrance can also be a cause of pain. A vagina that is too dry can be traced back to insufficient arousal or a lack of estrogen after menopause.

»Other influences: Inadequate contraception and fear of pregnancy affect sexual feelings. Likewise, in today's world, fear of sexually transmitted diseases can lead to tension during sex. Another factor is that many women cannot break free from traditional societal ideas about female sexuality. They behave passively, make no demands on partner sex and do not express any wishes of their own in this regard.

What treatment options are there?

In principle, partner therapy (separate sessions) should take place. The prerequisite for this is the consent of both partners. If the causes of the disorders lie in the relationship itself, couples therapy (joint sessions) should be considered.

The aim of therapy is that both learn to enjoy intimacy and sexuality. The aim is to deal with each other in a more relaxed manner and to reduce any pressure to perform. Both partners should learn that not all tenderness has to end with sexual intercourse. The sexual needs and preferences should be researched.

»Partnership exercises: Similar to the therapy for premature ejaculation, there is also a step-by-step program in which the partners learn anew to treat each other tenderly. Tenderness without sexual intercourse: one partner takes on the active role, the other behaves passively - then roles are swapped. The partner's hand is guided. Touching the genital organs is allowed, as is mutual sexual stimulation, but no sexual intercourse. In the following stage, sexual intercourse can - but does not have to - take place. The focus is on everything that is experienced with relish. The woman should choose the position that is particularly good for her.

»Information: In parallel to the partnership exercises, it is important that the partners inform themselves about sexuality, for example about sexual practices and positions. You should learn to express your own wishes and resolve any conflicts. It is particularly recommended that women - if they have not yet had any experience with it - get to know their bodies better through masturbation. This can also be easily incorporated into the partnership exercises already mentioned. It is also necessary to address any physical difficulties that may exist. An estrogen deficiency can be treated well with creams and the lack of moisture can be compensated for with water-soluble lubricating creams.

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