We have a long way to go with respect to understanding female sexuality in general and problems that women encounter. We don't even have a good handle on the language women should use in talking to doctors and nurses or therapists in describing their frustrations and symptoms. We do know, however, that women - and particularly baby boomers born between 1945 and 1965 - are very frustrated with the lack of responsiveness they have experienced and lack of access to experts in the healthcare delivery system for these problems.
Because so many sexual complaints are intertwined with bladder control problems, specifically incontinence, and pelvic floor dysfunction, specifically prolapse, and pelvic pain, we as an association have expanded our mission in recent years to accommodate and address the needs of men and women with these problems.
Male sexual dysfunction, specifically erectile dysfunction, is an unwanted outcome of radical prostatectomy for the surgical removal of a cancerous prostate gland. Because erectile dysfunction resulting from the surgical trauma and nerve damage is easily witnessed, it is simpler to recognize. And multiple remedies have been developed, from medications to penile implants, to help address this problem.
Female sexual dysfunction is much more complex and symptoms are hidden from view. It may relate to the "front end" of sexual relations, such as lack of desire or difficulty in being sexually aroused. Or it may affect the "back end" in which women have desire and are aroused but can't achieve orgasm. Or they experience pain upon penetration or pelvic pain in general when having sex (dispareunia). Few clinicians are trained and comfortable speaking with their female patients about such experiences. And even fewer know how to best advise such patients. NAFC recently published a newsletter article on this topic.
Sometimes, the lack of desire or loss of momentum towards climaxing is due to fear of pain or fear of embarrassment. This is especially true if urine leakage occurs while intimately engaged with a partner. If this is suspected because urine leakage occurs at other times, particularly when laughing, coughing, sneezing, or lifting a heavy object, you could well have stress urinary incontinence. There are both surgical and non-surgical remedies for symptoms, none of which will negatively impact your ability to enjoy sexual relations. In fact, pelvic floor muscle exercises can only enhance your sexual experience and heighten your partner's.
Above all, don't allow anyone to dismiss your feelings as entirely psychological. In fact, recent research published by Johns Hopkins Department of Gynecology and Obstetrics shows that sexually related personal distress in women is significantly associated with dyspareunia, depressive symptoms, and decreased arousal during sexual activity, illustrating how multi-faceted the problem can be.
Engage your partner in discussions about what you are experiencing. This will enable you to open up and talk more freely to your gynecologist or nurse practitioner about any symptoms you may be witnessing. If leakage is a problem, get that addressed and then tackle any other obstacles. The problem is sufficiently complex, in most instances, that there may well be multiple factors to consider and dissect before resolving them all.
Published On: September 27, 2010