Sexual dysfunction in women - a bloke's guide

Up to 70% of couples will have a problem with sex at some time in their relationships but many find issues around sex very difficult to discuss. Kathryn Colas explains how.

What's going on?

Menopause is a very emotional time in a woman’s life, both physically and mentally. The menopausal transition and the ageing process bring about numerous physical and psychological changes in a woman that can impair sexual functioning. A reduction in the hormone oestrogen can lead to loss of libido plus vaginal dryness and thinning of the vaginal wall which can also make sex very uncomfortable.

These symptoms - along with the hot flushes, night sweats and mood swings more commonly associated with the menopause - can hugely affect sexual relationships. Your partner may be unsure how to deal with the changes she is undergoing and embarrassed to discuss them with you. In turn, you may sense her lack of enthusiasm and feel increasingly rejected which can lead to reluctance to initiate sexual activity. Before long sex is no longer a regular feature of the relationship and you may not feel as close to your partner as a result. It is a difficult time but there are solutions available and things you can do to help.

But it's not just menopause. Many things can cause problems in your sex life.

How can I help?

Good communication can unlock closed doors in the bedroom, so start by talking to your partner about physical and emotional intimacy. It’s important not to get cross when you are rejected and instead look to understand the reasons behind her reluctance and help discover what you can do about it. Find out what you both enjoy about sex; it is not all about full penetration. Remember that for women, sexual response is complex and involves a mind-body connection; with older women often particularly sensitive to compliments and reassurance about their desirability.

Often, it becomes important for partners - ie you - to learn to be gentler, more patient, and more flexible in their approach to love making. In addition, raising the level of sexual stimulation with lubricants and other sexual aids can be helpful. If pain is the problem, together you can work to find a position that is more comfortable. If desire is the problem, try re-energizing your sexual routine. Be creative. Sometimes something as simply as a change in the time of day, perhaps when your partner feels more relaxed, can help. Topical application of oestrogen cream may also help enhance sexual functioning.

If after trying these methods your partner is still experiencing pain during sex, encourage her to talk to her doctor. He or she can help you both to find the cause of the pain and decide what treatment is best. The majority of women can be helped if they are willing to talk openly to their healthcare provider and determine the best treatment for their specific problem.

What about male sexual dysfunction?

Let us not forget, you may also be experiencing unwelcome changes as you age that are affecting sexual performance. Most men experience erectile dysfunction at some time in their life, but it becomes increasingly common in older age due to reduced testosterone levels.

Erectile dysfunction can be a symptom of other medical conditions such as diabetes, high blood pressure or high cholesterol. Any of these can be a warning of future heart disease. Less commonly, it can also be a symptom of problems with the prostate. Don't be afraid to talk to your doctor, particularly if you suspect an underlying health problem. It may seem difficult to initiate a conversation with your doctor about sex, but it is a very common problem and they can help ensure that you get an accurate diagnosis and the treatment that you need.

Viagra is an option but should be taken with caution as it can cause headaches, dizziness and visual disturbances and chest or muscle pain. Please also always consult your doctor before you take any medication to ensure it is appropriate for you.

Some men benefit from psychosexual therapy; a form of relationship therapy in which you and your partner can discuss any sexual or emotional issues or concerns. Improved communication and understanding of the symptoms you may both be experiencing during this difficult time should see you both reconnecting and becoming a happier and better informed couple. You can contact the Sexual Advice Association, Relate, sexual health charity FPA or your GP to ask for more information.

• Kathryn Colas's life was turned upside down by ten years of menopause madness. She edits Simply Hormones. This article first appeared on YourDoc Medical.

References

• Bartlik, B & Goldstein, M (2000). Practical Geriatrics: Maintaining Sexual Health After Menopause. Psychiatr Serv 51:751-753. http://psychservices.psychiatryonline.org/cgi/content/full/51/6/751
• Colas, K (2010). SimplyHormones.com.
• Mattar et al., (2008). Sexual Health in Menopause. Ann Acad Med Singapore 37:215-23. Retrieved from:
• Net Doctor (2008). Viagra (sildenafil).
• Phillips, N (2000). Female Sexual Dysfunction: Evaluation and Treatment. American Family Physician. Retrieved from: http://www.aafp.org/afp/20000701/127.html)
• Rodriguez, D (2010). Sexual Dysfunction in Men and Women. Everyday Health.