Sexual Problems
Symptoms
Male and Female: Decreased sexual desire, interest in sex and/or sexual response (difficulty achieving orgasm).
Male: Premature ejaculation, erectile dysfunction and/or fear of hurting partner.
Female: Itching, burning, pain and/or bleeding with intercourse and/or vaginismus (involuntary pelvic muscle contraction as a response to fear of pain).
Complications
Loss of intimacy in relationship, avoidance from all sexual activity and/or feelings of inadequacy and being less desirable.
Risk Factors
Hysterectomy and other pelvic surgeries
Mastectomy which can cause changes in body image
Illness or disability of self or partner (heart disease, arthritis, diabetes, chronic pain)
Lack of available sexual partner
Anxiety, depression, other psychological disorders
Prescription drug side effects
Partner’s decreased sexual desire and/or decreased sexual function
Hormonal changes resulting from breast feeding, menopause, low testosterone
Alcohol intake which can affect central nervous system and affect sexual function
Fatigue
Relationship problems
Infertility
Chronic pelvic pain, endometriosis
Bladder or prostate problems
Treatment Options
- Open, supportive communication with partner
- Medical evaluation by a qualified healthcare provider
- Avoid sex that hurts
- Expand your sexual repertoire
- De-emphasize orgasm as the goal of sexual intimacy
- Counseling- relationship, sex therapy
- Biofeedback to train voluntary pelvic muscle relaxation and contraction
- Vaginal weights, Kegel exercises to strengthen pelvic floor muscles
- Relaxation techniques
- Water based vaginal lubricants
- Testosterone therapy, erectile dysfunction medications, penile injections, urethral suppositories, penile surgical implant, noninvasive penile vacuum devices for men
- Systemic and/or vaginal estrogen therapy for women
Resources
National Vulvodynia Association – www.nva.org
Vulvar Pain Foundation – www.vulvarpainfoundation.org
American Association of Sex Educators, Counselors and Therapists – www.aasect.org