Female sexual problems

A reduced sex drive (loss of libido), affects some women at certain times of life, such as during pregnancy, after having a baby, or during times of stress. But some women experience it all the time.

A loss of libido can have a range of physical or psychological causes, including:

• Relationship problems.
• Depression.
• Previous mental or physical trauma.
• Tiredness.
• Diabetes – both type 1 and type 2 diabetes.
• Hormone disorders such as having an underactive or an overactive thyroid gland.
• Excessive alcohol consumption or drug use.
• Certain medicines, such as the SSRI type of antidepressants.

Libido can also fall if a woman's natural testosterone levels drop. Testosterone is produced in the ovaries and adrenal glands, so levels can drop if these are removed or they're not functioning properly.

These can be divided into two types:

• Primary – when a woman has never had an orgasm.
• Secondary – when a woman has had an orgasm in the past, but can't now.

Some women don't need to have an orgasm to enjoy sex, but an inability to reach orgasm can be a problem for some women and their partners.

Reasons why a woman can't have an orgasm can include:

• Fear or lack of knowledge about sex.
• Being unable to "let go".
• Not enough effective stimulation.
• Relationship problems.
• Feeling depressed or stressed.
• Previous traumatic sexual experience.

Psychosexual therapy can help a woman overcome orgasm problems. It involves exploring her feelings about sex, her relationship and herself.

For further information about what is an orgasm? visit the NHS website.

Vaginismus

Pain during sex, also called dyspareunia can be caused by vaginismus.

Vaginismus is when muscles in or around the vagina go into spasm, making sexual intercourse painful or impossible. It can be very upsetting and distressing.

It can happen if a woman associates sex with pain or being "wrong", or if she's had vaginal trauma, such as an episiotomy during childbirth.

It can also stem from relationship problems, fear of pregnancy, or painful conditions of the vagina and the surrounding area.

Depending on the cause, it may be treated by focusing on sex education, counselling and using vaginal trainers, also known as vaginal dilators.

Vaginal trainers are cylindrical shapes that are inserted into the vagina. A woman will gradually use larger sizes until the largest size can be inserted comfortably. Some women may wish to try using their fingers instead.

Sex after menopause

Pain during sex is common after the menopause as oestrogen levels fall and the vagina feels dry.

This can affect a woman's desire for sex, but there are lubrication creams that can help. Ask your GP or pharmacist.

For further information about menopause see the NHS website.

Female genital mutilation

Women who have experienced Female Genital Mutilation (FGM) can find it difficult and painful to have sex.

FGM is where female genitals are deliberately cut, injured or changed, but there is no medical reason for this to be done.

It can also result in reduced sexual desire and a lack of pleasurable sensation.

Talk to a GP or another healthcare professional if you have sexual problems you feel may be the result of FGM. They can refer you to a therapist who can help.

To find out what is causing a sexual problem and how to treat it, a doctor, practice nurse or therapist will need to ask you questions about your medical, sexual and relationship history.

A GP or practice nurse may order tests to check for underlying health conditions.

If your problem is related to lack of hormones, such as testosterone or oestrogen, Hormone Replacement Therapy (HRT) may help.

For further information about HRT see the NHS website

Treating other conditions, such as diabetes or depression, may also alleviate symptoms of sexual dysfunction.

Sex therapy

Sexual therapy can help. Talk with your partner about your problem, and see a therapist together if you can. Do not be embarrassed. Many people experience sexual dysfunction and there are ways to get help.

Your GP can refer you to a therapist, or you can see one privately. Look for a therapist who is an accredited member of the College of Sexual and Relationship Therapists.

This means they will be fully qualified and able to advise on physical, psychological and medical factors that can affect sexual wellbeing. 

If needed, they can also refer you to a GP or another medical practitioner who can do the required tests or examination.