A woman's sexuality is influenced by her physical, psychological, and emotional state. Women have varied and interrelated reasons for feeling sexual. Women may be sexually active to:³

• Feel an emotional connection.
• Satisfy sexual hunger.
• Nurture and experience commitment.
• Feel attractive and be attracted.
• Enjoy physical pleasure.

With all of these reasons to be sexually active, a woman may engage in sexual activity as much for emotional reasons as for physical ones. In addition, a woman's sexuality is influenced by her society and culture, as well as by her medical and sexual history. Throughout a woman's sexual life, her sexuality is a complex web of mental, physical, and emotional signals.³

Physical influences

• Women normally experience a physical change during sexual arousal, as blood engorges the vulvar area. If a woman is aware of the exact places in her vulvar area where she feels increased sexual intensity (erectile tissue), her sexual pleasure may be increased by genital stimulation. It is possible for a woman not to be aware of this engorgement. It is also possible for a woman not to be aware of the spots that are most sensitive and responsive to stimulation.
• Any history of pain during intercourse may cause a woman to avoid sexual activity.
• Women who experience pain during intercourse may choose to continue to have intercourse, even though the experience is unpleasant and results in low sexual desire.
• Ongoing (chronic) illnesses, such as diabetes and arthritis, can affect sexual desire, enjoyment, and performance. Medicines for many medical conditions also affect desire and arousal.

Partner and emotional influences

• A partner's level of sexual skill and attention can play a big part in a woman's sexual enjoyment.
• A positive, respectful connection between partners sets the stage for sexual interest and arousal. Relationship problems can lower sexual interest and response.
• Living situations that give couples very little privacy can interfere with feelings of arousal.
• The physical changes that signal sexual arousal may for some women be accompanied by feelings of guilt, embarrassment, shame, or self-consciousness. Any of these emotions can reduce or negate physical arousal.
• Positive sexual experiences help build a healthy sexuality. On the other hand, a woman who has had a forced sexual experience is likely to have mixed feelings about sex. In one study, 1 in 5 women reported having been forced to do something sexual. This was most often done by someone they were close to.²

Age-related influences

• A decline in sexual activity as women age is most often caused by the lack of a partner.⁴
• Sexual problems are most common among young women and tend to decrease with age and experience.⁵
• Women may note a decrease in sexual desire after menopause. In mild cases, the change may be almost unnoticeable; in more severe cases, there may be a decrease in mental and physical responsiveness to sexual stimuli.
• Many older women experience other changes in their sexuality. It may take longer to feel sexually aroused, and orgasms may be briefer. But, orgasms still will offer mental and physical pleasure to most women.⁴
• Women can feel sexual pleasure throughout their lives. But those who stop sexual activity after menopause have more shrinking and drying of the vagina than women who continue sexual activity.²