Your Sexual Health

Frequently Asked Questions Expand All

• I'm having a problem with sex. Is this common?

  Yes. About 4 in 10 women have problems with sex at some point during their lives. Having a sexual problem can be worrying or upsetting, but there is often a solution. Some problems can be solved by you alone, with a partner, or with the help of an obstetrician–gynecologist (ob-gyn) or other health care professional.

• What causes sexual problems?

  Some common causes of sexual problems include:

  • Hormonal changes at certain times of life, such as during pregnancy, perimenopause, or menopause

  • Cancer treatments and their side effects

  • Some illnesses and medications

  • Relationship problems with your partner

  • Past negative experiences with sex

  • Depression, anxiety, or stress

• What types of sexual problems are there?

  “Female sexual dysfunction” is a general term for a problem with sex. Sexual problems fall into several groups, which often overlap:

  1. Lack of desire

  2. Arousal problems

  3. Orgasmic problems

  4. Sexual pain

  5. Sexual problems caused by medication or substances

• What are desire problems?

  Lack of desire is common and can happen at any age. It can be normal to not feel desire until sexual activity has started. But a lack of desire is considered a disorder when at least three of the following are true for at least 6 months and cause anxiety or sadness:

  • You do not want to engage in any type of sexual activity, including masturbation.

  • You do not have (or have very few) sexual thoughts or fantasies.

  • You do not want to initiate sexual encounters with a partner.

  • You do not have any pleasure during sexual activity.

• What are arousal problems?

  Arousal is the physical and emotional changes that happen with sexual stimulation. Sometimes you may not feel mental or physical excitement from sex. Or you may feel only mental excitement or only physical excitement.

  Arousal can be affected by many things, including

  • changes in how you feel about yourself or your body

  • pregnancy and breastfeeding

  • not getting enough exercise

  • not getting enough sleep

  • medications for depression

  • use of alcohol or drugs

  • relationship problems

• What are orgasmic problems?

  Difficulty reaching orgasm is common. Some people find enough satisfaction in sharing love and closeness during sex, even without having an orgasm. But others may feel that not having an orgasm is a problem. If you have an orgasmic disorder, you may

  • take longer to have an orgasm

  • have fewer orgasms

  • have less intense orgasms

  • have never had an orgasm

  • not recognize your physical experience as orgasm

  Orgasmic disorder may be caused by

  • a new health problem or mental health condition

  • a change in a relationship

  • surgery or radiation in the pelvic area (this is rare)

• What is sexual pain?

  When gynecologists or other health care professionals talk about sexual pain, they often refer to two conditions: 1) vaginismus and 2) dyspareunia. These conditions can cause several symptoms, including

  • tightening of the vaginal muscle that makes penetration difficult

  • tension, pain, or burning in the vagina when penetration is attempted

  • less desire or no desire for penetration

  • avoidance of sexual activity

  • intense fear of pain

  A pain disorder is diagnosed if the pain interferes with sexual function. Even if your sexual activity does not include penetration, you can also have a pain disorder. Some people develop sexual pain problems after pregnancy. Read When Sex Is Painful for more information.

• What medication can cause sexual problems?

  You may have sexual problems soon after starting or stopping some medications. Medications that may cause problems with sex include:

  • Anticholinergics—including medications to treat asthma, chronic obstructive pulmonary disease (COPD), diarrhea, dizziness, insomnia, nausea, overactive bladder, and vomiting

  • Hormone medications—including birth control pills and hormone therapy

  • Heart medications—including medications to treat high blood pressure

  • Mental health medications—including selective serotonin reuptake inhibitors (SSRIs)

  Using alcohol, marijuana, and pain-relieving drugs like opioids can also lead to problems with sex.

• What are some self-help options?

  There are many things you can do alone or with a partner to address a sexual problem, including:

  • Use lubrication. Lubricants reduce friction during sex and can make penetration more comfortable. If you use condoms, use only water-based or silicone lubricants.

  • Read books about sex.

  • Learn about your body and how it works.

  • Explore oral sex, touching with a partner, and masturbation with and without a partner.

  • Try nonsexual, sensual activities like massage.

  • Talk with your partner about what you like.

  • Try to reduce sources of stress in your life.

• What can I do to enhance desire?

  • Work on issues that may be affecting your relationship.

  • Focus less on physical acts and more on emotional closeness.

  • Improve your sex knowledge and skills.

  • Make time for sexual activity and enjoying each other.

• What can I do to increase arousal?

  • Get enough sleep so you are well-rested.

  • Do Kegel exercises.

  • Increase time spent on foreplay.

• What can help me have an orgasm?

  • Spend more time on sexual stimulation, and try a variety of methods.

  • Try sex toys.

  • Focus on a sexual fantasy or visualization.

• How can I lessen sexual pain?

  • Use a vaginal moisturizer. There are several brands you can buy online or at your local pharmacy.

  • Use a lubricant. Lubricants reduce friction during sex and can make penetration more comfortable. If you use condoms, use only water-based or silicone lubricants.

  • Empty your bladder before sex.

  • Allow plenty of time for arousal before penetration.

  • Try different positions or sexual activities that do not involve penetration.

• How can I talk about sex with my ob-gyn or other health care professional?

  • “I am having some concerns about my sex life.”

  • “I do not enjoy sex like I used to.”

  • “Lately, I have been having trouble with physical intimacy. What can I do?”

  • “I am just not interested in sex. Do you have any advice?”

  • “I’m not satisfied with how often I have sex. What can I do?”

  It may help to track your symptoms in a journal. Then you can explain your symptoms to your ob-gyn or other health care professional.

• What should I expect at a health care visit for a sexual problem?

  Your ob-gyn or other health care professional may ask you a lot of questions about your physical and mental health. They may ask about:

  • Your sexual history

  • Your gender identity

  • When your pain or other symptoms started

  • Any self-help methods you have tried

  • Any experience with sexual abuse or violence

  You also may have a physical exam and a pelvic exam. If you have pain during vaginal sex, your health care professional may ask to try to recreate this pain by touching sensitive areas. This may help to find the cause.

• What should I expect during treatment of a sexual problem?

  Each type of sexual dysfunction is treated differently. Recommendations may depend on your symptoms:

  • Irritation of the vulva—You may need to avoid harsh soaps, douches, wipes, scented products, and pads worn in your underwear.

  • Vaginal dryness—You may be prescribed vaginal estrogen.

  • Difficulty with penetration—Your health care professional may suggest using dilators. Dilators are tube-shaped devices that help stretch the muscles in the vagina.

  • Pain or other pelvic problems—You may be offered pelvic floor physical therapy.

  • Sexual pain after menopause—Your health care professional may discuss medications to help with vaginal thinning and dryness. Some involve estrogen and others do not.

  You may also be referred to a sex therapist, even if you are also receiving medical treatment. Couples therapy or counseling on your own may be helpful.

• Glossary

  Bladder: A hollow, muscular organ that holds urine.

  Depression: Feelings of sadness that last for at least 2 weeks.

  Dyspareunia [dis-par-OOH-nee-uh]: Pain with vaginal sex.

  Estrogen: A sex hormone made in the ovaries.

  Foreplay: Sexual activity, like kissing and touching, that leads to arousal before sex.

  Gender Identity: A person’s sense of being male, female, or something else. This identity may or may not match the sex assigned at birth.

  Hormone: A substance made in the body that controls the function of cells or organs.

  Kegel Exercises [KAY-guhl]: Pelvic muscle exercises. Doing these exercises can help with bladder and bowel control as well as sexual function.

  Masturbation: Self-stimulation of the genitals.

  Menopause: The last menstrual period, often happening around age 51. Menopause can only be confirmed after 1 year of no periods.

  Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.

  Opioids: Medications that decrease the ability to feel pain.

  Orgasm: The feelings of physical pleasure that can happen during sexual activity.

  Pelvic Exam: A physical examination of the pelvic organs, including the vagina, cervix, uterus, and ovaries.

  Penetration: The act of inserting a penis, finger, or other object into the vagina or anus, or inserting a sex organ into the mouth.

  Perimenopause: The time period leading up to menopause.

  Selective Serotonin Reuptake Inhibitors (SSRIs): A type of medication used to treat depression.

  Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

  Vaginismus [va-juh-NIZ-muhs]: Uncontrolled contractions of the muscles in the lower vagina. This condition makes penetration by the penis, a finger, or other objects painful, difficult, or impossible.

  Vulva: The external female genital area.