Common Sexual Issues for Women
Today we are covering the most common sexual issues experienced by women, or people with vulvas. (AKA womxn, nonbinary vulva owners, trans men, and other gender expressions as well! You are all welcome here. For the sake of brevity, I will simply use the term “women” going forward.)
But this is in no way an exclusive discussion *just* for women. The topic of “women’s sexual issues” is relevant not only to the women that experience them, but also to the people having intercourse with these women!
So now that eeeevvverybody’s on board :) let’s dive in.
Hopefully we can all agree on one thing: Sex should be fun, right?
Well, unfortunately, it isn’t very fun if you are:
A) never in the mood
B) never reaching orgasm
C) always feeling like there are knives in your vagina
Yikes! You can bet that these issues will often send a woman or a couple straight to sex therapy.
So what do we do about these common issues? Here are some suggestions and words of guidance:
Low Libido/Desire for Sex
“Low” is a relative term, of course. It’s whatever you deem to be low, and whether you deem it an actual problem. You might be very happy with the amount of sex that you desire. Or… You might notice that your desire is lower than your partner (leading to “desire discrepancy”), or lower than it used to be, or lower than you’d like it to be.
It’s only a “problem” if you are unhappy with your current level of desire for sex. Clients might seek help with this issue if they are: A) having relational problems (read: their partner is wondering why they’re not having sex as much as they want), B) worried that something is “wrong” with them sexually or mentally, or C) wondering why they’ve never really wanted sex.
We could approach low desire a few different ways. For C), we want to assess for asexuality: It’s okay if you just don’t desire sex! But if you do, and you’re just wanting it less these days, then we can look to the areas of your life that might be taking top billing: Are you stressed? Worried about body image issues? Maybe your kids are taking all your energy? Having money struggles? Your brain is your biggest sex organ, so if your brain is preoccupied, it’s going to have a hard time readjusting when it’s sexy time. It might help to bring your awareness to the thoughts that are claiming your attention, try a mindfulness practice to center yourself, and then reapproach sex from a clearer headspace.
If it’s more of a relational problem, then we might suggest couples therapy to get to the heart of the matter. Often, it’s an issue of unspoken or mismatched desires between partners. Also, did you know that there are different types of desire? You can be “spontaneous” (easily turned on, often aroused by the thought or sight of something sexual) or “responsive” (needing focused attention, touch, play, or other forms of pleasure to get you interested). Neither way of existing is wrong! It just takes a little education, awareness, and effort to adjust to your body’s way of getting in the mood.
Inability to Orgasm
First, a clarification: Not having an orgasm is not a disorder in and of itself. It’s only considered “disordered” if you would LIKE to have an orgasm. And most people would like to, so let’s back up. Many people believe that having an orgasm is the whole point of sex, but that is inaccurate at best and harmful at worst. Orgasms are great, and they can feel like a relief. They can bring a sense of harmony and completeness. However, sometimes women/people find that they are content with not having them, and instead just enjoying the ride. And that’s okay.
But when women find themselves consistently unable to have them, even when they are happy with their partners and not otherwise experiencing a medical or substance-related reason – AND they are unhappy with this predicament – then that’s when we might want to look into what’s actually happening under the “hood” (Get it? Clitoral hood? ~high five~) and possibly diagnose with female orgasmic disorder.
Orgasms are a brain function. They signal the release of sexual tension, and they can happen in many different circumstances. There is a belief that “women just have a hard time having orgasms” that is perpetuated by lack of education about clitoral stimulation, societal/patriarchal norms, and of course the unhelpful and outdated trope that women live to “serve others.” These are all issues that we can get to the bottom of in therapy as we ponder together, what is causing the lack of orgasmic ability?
Pain During Intercourse
This can be an extremely distressing dilemma. You’re ready to begin a sexual encounter, you’re turned on, and you’re desiring your partner (or your vibrator/toy/self)… but then upon penetration (or even just external contact), you feel intense pain. This could happen anywhere around the vulva or inside the vagina, and there are many different names for “painful sex” disorders that fall under the umbrella diagnosis of “genito-pelvic penetration/pain disorder,” depending on the location/intensity/duration of pain. (i.e., vaginismus, vulvodynia, dyspareunia, etc)
My top recommendation is that you look into working with a team of specialists to receive a medical/clinical diagnosis and appropriate treatment. I recommend consulting with your gynecologist or primary care physician, as well as a pelvic floor physical therapist, in addition to a sex therapist.
Why so many different specialists? Pain with sex is a layered and complex issue. The pain might stem from complications with hormones, muscles, nerves, or simply thoughts. And it can be exacerbated by any number of intertwined issues. It’s not as simple as, “Here, take this cream” or “Hey, just try to relax.” And it’s not an issue that you should ignore or consider “normal” either. You DO NOT need to experience pain with intercourse (and should not continue having painful sex in the meantime just to satisfy your partner). Let’s figure out how it got to this point, so that you can go back to experiencing pleasure.
Final Thought
There will be ebbs and flows in your sex life, and no one is expected to be ready for sex all the time or to be perfectly orgasmic with every session. The most important part is that you are feeling connected, safe, and content.
But if you feel like you are lacking and want to make a change, sex therapy is a great place to work on this. Please reach out if you would like to work with me 1:1.