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- recent or secondary
- situational rather than generalised
- due to performance anxiety
- not associated with any major psychological or relationship dysfunction.
Medical: vaginal infections or causes of painful intercourse and vaginismus should be treated if present [See: Painful Sex in Women]. Where vaginal dryness is a problem, especially after the menopause, treatment with oral estrogen [hormone replacement therapy] may be recommended for a short period, as well as an artificial lubricant. Vaginal tablets of low dose estrogen are recommended after the menopause. Check this out with your doctor.
The United States Food and Drug Administration [FDA] has recently approved a device designed to improve female sexual function. This is known as EROS clitoral therapy device [EROS-CTD], and is designed to treat female arousal disorder and is approved for women who experience reduced sensations and lubrication, and inability to achieve orgasm. It is available on prescription in USA.
It is a small vacuum pump that is placed over the clitoris to apply gentle suction to that area and increase blood flow, aiding sexual arousal [3].
Water based lubricants are recommended to ensure that intercourse is comfortable, especially if lubrication takes a long time, and should be used as part of foreplay. [KY Jelly, Astroglide, Nature Fresh Personal Lubricant, Sylk]
The medications that are used for men with erectile dysfunction [Cialis, Levitra and Viagra] have not been found to be effective except in a small study in women who had genital arousal disorder.
Relationship therapy: is usually indicated to reduce guilt, anger and resentment, and change attitudes and ensure effective communication.
Sex therapy: encourages you to learn about your own body and about the sex response cycle, how to pleasure yourself and to feel good about yourself, and then share what you have learned with your partner. This will include: self discovery, self stimulation, sensate focus, genital and intercourse exercises, and the use of fantasy and a vibrator to enhance stimulation. Kegel’s exercises may improve vaginal muscle tone and also increase feelings of vaginal containment for both partners [see: Sexual Assignments]
Once sex becomes unsatisfying it is common for a woman’s avoidance of sex to spread to other areas of the relationship, and to avoid all forms of intimacy ‘in case it leads to sex’. This sets up a vicious cycle where, as there is no sexual or sensual contact the potential for arousal diminishes even further, and it is difficult to get going again. The old saying “if you don’t use it you lose it” applies!!
It is important to maintain intimate contact with your partner, and allow the natural unfolding of your sexual response to develop during lovemaking.
Arousal disorder is common and treatment is available, it may be as simple as using a vaginal lubricant, a vibrator or guiding your partner more effectively to gain the maximum possible stimulation that feels good for you on each occasion, or you may need to see a psychologist or sex therapist for treatment.
Sex therapy should increase responsiveness and abandonment in sexual activity as well as the ability to communicate sexual desires, and reduce anxiety about performance and sexual avoidance, and enhance the pleasure of your lovemaking.
