may seek treatment because she has never experienced an
orgasm, is experiencing long delays in reaching
orgasm, or has become unable to reach orgasm. Treatment usually begins with
medicine that is known to affect orgasm. (Talk to your
doctor before you stop any medicine you are taking.)
It is also
important to understand what a normal sexual stimulation phase would be for
that woman. If a woman is experiencing a delay or absence of orgasm after
adequate sexual stimulation, treatment may include:
Self-stimulation, along with erotic fantasy. If a woman is able to become highly aroused but is unable to have an orgasmic release, the use of a vibrator may help.
Talking and listening to each other more.
This includes talking openly about sex, what each of you needs, and what you
want to do differently together.
Learning more about sexual response. For example, it may help to learn that most women find it easier to have an orgasm from direct clitoral stimulation and that most couples do not have orgasms at the same time.
inhibition with fantasizing, distractions, and/or listening to music.
Treatment for pain during intercourse
intercourse often is caused by a physical reason, such as vaginal dryness or
infection. This is why treatment must start with finding out the cause of a sexual problem. If a physical condition is the cause, treatment of
that condition may eliminate the pain. But pain during intercourse may have
more than one cause, including psychological causes such as anxiety or the
memory of sexual assault.1
Pain that occurs during initial penetration
by the penis may be caused by involuntary contractions of the vagina
(vaginismus). Vaginismus is more common in young, inexperienced women and is
sometimes related to a lack of education or preparedness for sexual
intercourse.3 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 an anatomical condition. If so, getting rid of the pain
will require treating the physical reason.
Pain that comes from the vestibule, which is the area around the opening of the vagina, may be from localized vulvodynia.
menopause, it is common to have vaginal dryness. This
can cause pain during initial penetration or after intercourse has begun and
the penis is in the vagina. Try using liberal amounts of vaginal lubricant. If
this does not work as well as you need it to, talk to your doctor about
vaginal estrogen, which can reverse vaginal dryness
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 an
inability to relax. An open and trusting relationship with your doctor will enable you to explore the cause of the pain and decide on a
course of treatment.
Treatment for aging and menopause-related sexual problems