Patient education: Sex problems in females (The Basics)

What types of sex problems can females have? — Sex problems can happen in people of all genders.

In females, problems might include:

●Pain during sex

●Not becoming aroused or "excited" during sex

●Not having an orgasm during sex

●Not wanting to have sex (also called "low desire" or "low libido")

Sometimes, problems come and go, and might not cause distress. But if you have pain or are worried about your problems, there are treatments that can help.

Some people have problems with sex throughout their adult life. Other people develop problems later in life.

What causes sex problems? — Sex problems can be caused by many things. For instance, you might have sex problems if you have problems with your partner or your relationship.

Sex problems can also be linked to medical events. For instance, sex can be painful in the weeks or months after childbirth. You might lose interest in sex or have pain with sex as you get older or after you go through menopause. (Menopause is the time when you stop having monthly periods.)

Certain conditions can also lead to sex problems. These include:

●Dryness or pain in the vagina

●Pain in the lower belly, such as from an infection, past surgery, or a condition called endometriosis (people with this condition often also have painful periods)

●Changes in the muscles near and around the vagina

●Mood problems, such as depression

●Medical problems, such as cancer or heart problems

Sex problems can also be a side effect of certain medicines. For example, medicines to treat depression or heart disease sometimes cause sex problems.

Is there anything I can do on my own to improve my sex problem? — Yes. If you are having relationship problems, you can try to improve your relationship with your partner. For example, you can:

●Talk to your partner about how to make sex better.

●Make an effort to have more fun together by having a regular "date night."

●Read books or websites about sex.

●Go to counseling, either alone or with your partner.

If you have pain or dryness during sex, it might help to use vaginal "lubricants." These are sold without a prescription (sample brand names: Astroglide, K-Y Jelly). Lubricants are used during sex. If using a lubricant is not enough, you can also use a vaginal moisturizer. Vaginal moisturizers are used several times a week, but not necessarily during sex. You can also buy these without a prescription (sample brand names: K-Y SILK-E, Replens).

It is also important to stay as healthy as possible and get treated for any medical problems that you have. People who feel healthy and happy are more likely to be happy with their sex life.

Should I see a doctor or nurse? — If you don't know why you are having sex problems, talk to your doctor or nurse. This might feel embarrassing, but these problems are common, and your doctor or nurse can help. They will talk with you and do an exam to try to figure out what might be causing your problem.

How are sex problems treated? — Sex problems can be treated in different ways. These include:

●Using vaginal lubricants and moisturizers or a prescription cream (usually estrogen) to treat vaginal dryness

●Getting treatment for mood problems, if you have mood problems

●Working with your doctor to change any medicines you take that might be causing sex problems

●Having physical therapy to work on the muscles around your vagina, so that you do not have pain during sex

In addition, some people who have gone through menopause are helped by taking hormone medicines.

Most people do not need other medicines. But in some cases, doctors will suggest medicine to help with "low desire" or "low libido." There are 2 medicines that are approved for this in the US. Both are meant only for certain people who have not yet gone through menopause and who have a low desire for sex that is causing them stress. Both medicines must be prescribed by a doctor. They can help some people want to have sex more, but there can be serious side effects, too. These medicines are:

●Flibanserin (brand name: Addyi) – This medicine comes in a pill that you take every day. Some people who take it have problems with tiredness, nausea, dizziness, or headache. Alcohol, as well as certain other medicines, can increase the risk of side effects. If you have 1 or 2 alcoholic drinks, you should wait at least 2 hours before taking flibanserin. If you have 3 or more drinks, you should not take flibanserin at all that day.

●Bremelanotide (brand name: Vyleesi) – This medicine comes as a shot that you give yourself about 45 minutes before you plan to have sex. Side effects can include nausea, vomiting, flushing (when your skin turns red and hot), or a rise in blood pressure. People with high blood pressure or heart problems cannot take this medicine.

Some treatments are not recommended by doctors. For example, doctors do not usually recommend that females take the medicines that males take for sex problems. Also, most doctors do not recommend trying herbal treatments to improve sex.

Some medicines for treating sex problems are sold on the internet. However, these are not always safe, and they can even contain harmful ingredients. Talk with your doctor or nurse if you want to know more about treatment options.

More on this topic

Patient education: Sex problems in males (The Basics)
Patient education: Sex as you get older (The Basics)
Patient education: Bartholin gland cyst (The Basics)
Patient education: Sjögren's syndrome (The Basics)
Patient education: Vulvar pain (The Basics)

Patient education: Sexual problems in females (Beyond the Basics)
Patient education: Vaginal dryness (Beyond the Basics)
Patient education: Menopausal hormone therapy (Beyond the Basics)