Treatment will depend on the type of sexual problem you're having. Treatment may include:
- Treatment of any physical causes.
- Education about your body, your sexual signals and receptors, and changes in sexuality as you get older.
- Counseling for you and your partner.
- Psychological therapy. Therapy for sexual problems often involves cognitive-behavioral therapy.
- Sex therapy.
Treatment for decreased sexual desire
Treatment for physical causes of this problem can include:
- Changing a medicine that has been lowering your interest in sex.
- Relieving pain, illness, or sleep problems that are lowering your interest in sex.
- Low-dose estrogen. After menopause, low levels of estrogen in the body cause vaginal dryness. Estrogen reverses this.
- Flibanserin (Addyi) may help increase sexual desire in some premenopausal women who have low sexual desire that is not caused by medical or psychiatric problems, other medicines, or relationship problems. It is not understood how this medicine works.
- Testosterone. Testosterone is sometimes used after natural or surgical menopause to improve sex drive. But long-term use of testosterone has not been shown to be effective in increasing sexual desire.3
- Exercise, to improve your mood and increase natural testosterone levels.
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.
There are also steps you can take at home that may raise your sexual desire. To learn more, see Home Treatment.
Having a partner you feel comfortable and nonstressed with plays a big part in your desire level. It's normal to lack desire for a partner who forces sex or is verbally abusive or physically violent.
Treatment for decreased sexual arousal
Treatment for decreased sexual excitement may include learning about the role emotions play and about how a woman's arousal sometimes depends on stimulating other parts of her body, especially her breasts.
Treatment may also include:
- Changing treatment for certain illnesses, if that treatment has side effects that lower your arousal.
- Counseling, to help adjust expectations of sexual activity. If too much pressure is put on partners to perform, it can affect arousal.
- Steps you can take at home, such as use of vaginal lubricants or masturbation.
Treatment for inability to reach orgasm
Treatment usually begins with changing any medicine that is known to affect orgasm. But don't stop taking your medicine without talking to your doctor first.
If you're having trouble with orgasm or it takes much longer than it used to, you can try a number of things at home, such as self-stimulation and fantasy.
It may also help to find out more about sexual response. For example, most women find it easier to have an orgasm from direct clitoral stimulation. And most couples do not have orgasms at the same time.
Treatment for pain
If pain is caused by a physical problem, treating that problem may get rid of the pain. But pain during intercourse may have more than one cause, including psychological causes such as anxiety or the memory of sexual assault.2
Pain when penis enters the vagina
Treatment may include a program of progressive muscle relaxation and gradual vaginal dilation, possibly including psychotherapy.
But pain during initial penetration also may be caused by vaginal irritation or another physical problem. If so, getting rid of the pain will require treating the physical reason.
Other pain during intercourse
If the pain is caused by the deep thrusting of the penis, the cause may be a pelvic disease. But it may also be caused by not being able to relax. Being able to talk openly with your doctor will help you explore the cause of the pain and decide on treatment.
Treatment for aging and menopause-related sexual problems
Vaginal dryness after menopause can sometimes be treated at home with lubrication.
If home treatment doesn't work as well as you need it to, talk to your doctor about using estrogen. This hormone can be used in several forms to help menopause-related problems. To learn more, see Medications.