Sexual Conditions Health Center

Many sexual problems can be managed when you understand what is causing them. Effective management requires a high level of comfort between you and your doctor, possibly along with your partner.

Because a sexual problem often has multiple causes, treatments cannot be universally applied-what works for one woman may not work for another. An effective plan will address and manage the cause. And if you have a partner, your plan will also include ways to build and strengthen intimate communication between you and your partner. The best results will help you find methods of having a satisfying sexual life.

Treatment may include:

• Medical treatment for any cause.
• Education about your body, your sexual signals and receptors, and changes in sexuality as you get older.
• Communication counseling for you and your partner.
• Psychological therapy. Therapy for sexual problems often involves cognitive-behavioral therapy.
• Sex therapy.

Treatment for decrease of sexual desire

A decrease in your level of desire might be expressed by fewer sexual thoughts and/or a reluctance to engage in sexual activity. Treatment for physical causes can include:

• Changing from a medicine that has been curbing your interest in sex.
• Relieving pain, illness, or sleep problems that are curbing your interest in sex.
• Hormone therapy with estrogen. After menopause, low levels of estrogen in the body cause vaginal dryness. This can be painful during sex. Estrogen reverses this.
• Testosterone. Normally, a woman's testosterone slowly declines with age. It drops suddenly when a woman has surgery to remove the ovaries (oophorectomy, causing surgical menopause). Testosterone is sometimes used after natural or surgical menopause to improve sex drive. When taken in too high a dose, testosterone causes male-type side effects, such as a deepening voice, thinning scalp hair, and growth of facial and body hair. Testosterone risks are not fully researched.
• Exercise, to improve your mood and increase natural testosterone levels.

Your doctor can treat physical or hormonal causes, and you can work on other facets of sexual desire. For example:

• Changing your setting and routine can improve your time together. Do you have enough privacy and time? Are you interested in trying something new?
• Having a partner you feel comfortable and nonstressed with plays a big part in your desire level.
• Getting counseling as a couple can help strengthen your emotional connection with your partner. Improving a stressed relationship is likely to improve your sexual relationship.

It is normal to lack desire for a partner who forces sex or is verbally abusive or physically violent. For more information, see the topic Domestic Violence.

Treatment for decrease of sexual arousal

A decrease in the level of arousal might be noticed as an inability to feel or maintain sexual excitement. A woman's sexual arousal often is enhanced by, and is sometimes dependent on, stimulation in areas other than the genital area, especially the breasts. Treatment for a decrease in your sexual arousal may include:

• Increasing the level of intimacy and sexual arousal with your partner before penetration.
• Liberal use of vaginal lubricants.
• Masturbation, possibly with the aid of a vibrator and/or with your partner.
• Education about the role that emotions play in sexual arousal.
• Counseling, to help adjust expectations of sexual activity. If too much pressure is put on partners to perform, arousal may be reduced.
• Treatment changes for other conditions, if needed to eliminate side effects that decrease arousal.

Treatment for an inability to reach orgasm