In today’s society, you can’t escape sex. Everywhere you turn—on TV, in the movies, in magazines and every other ad—sex is a focal point. The media tends to portray sex as a carefree activity everyone enjoys all the time. But the reality is that sometimes sex isn’t as carefree or enjoyable as society might lead you to believe. In fact, most women will experience some type of sexual problem at some point in their lives. Sexual problems include a wide variety of sexual issues ranging from lack of desire to pain during intercourse. Women often feel uncomfortable discussing sexual problems with others, including their partner, friends or doctor. Sex is a vital part of your life, and your sexuality reflects a careful balance of physical and emotional health. Sometimes, your overall health is directly reflected in your sexuality. Diet, exercise, illness and emotional well-being can all have serious effects on your sex life. Similarly, if you’re experiencing sexual problems, your general health and day-to-day life may be negatively affected. It’s important for all women to realize the crucial role sexuality plays in their health, and to stop being embarrassed about discussing sex with a healthcare provider. Your provider can help you to overcome sexual problems by discussing viable health options.

A woman’s sexual identity is built up over a lifetime of influences. The components that affect your sexual identity and personal relationship with your sexuality may include:

• Early role models
• Early sexual experiences
• Religious teachings
• Relationship patterns
• Sexual behavior patterns
• Body image
• Health

Sexual problems may be influenced by a negative sexual identity, and the interaction of biological and emotional factors. Biological factors that negatively affect your sexuality include:

• Hormonal imbalances
• Vaginitis and other infections
• Medications with sexual side effects
• Chronic illness such as diabetes or multiple sclerosis
• Age

Emotional factors that may negatively affect your sexuality include:

• Negative “sexual identity”
• Relationship with partner
• History of abuse/ bad memories
• Power and gender role issues
• Body image and your view of yourself as a sexual person
• Fears (of pregnancy or STDs)

These biological and emotional factors work together with your sexual identity and may cause sexual problems. A sexual problem may occur at any time during a woman’s “sexual response cycle.” According to the American College of Obstetricians and Gynecologists (ACOG), the sexual response cycle consists of four steps: desire, arousal, orgasm and resolution.

A lack of desire is the most common sexual problem in women. Certain hormonal treatments are available for women who experience a lack of desire. Many times this problem is simply a product of the everyday stresses of living and can be helped through relaxation and therapy.

Most women are able to have an orgasm. The orgasm may be experienced through sexual intercourse, or through any other manner of stimulation. Some women have difficulty experiencing an orgasm. This problem may be related to stress, preoccupations, fears, bad memories or trauma, especially related to sex and sexual abuse or rape.

Pain during intercourse is another common sexual problem. The scientific name for pain during intercourse is dyspareunia, and can be experienced at any point during sex, in the surface of the vagina or deep, along the middle of the pelvis. This pain can be caused by a number of issues, but the most common cause is a lack of lubrication in the vagina.

If you experience a sexual problem, don’t hesitate to talk to your provider or your ob/gyn. Your ob/gyn is there to help you not only with reproduction, but also with sexual health. If you are experiencing a problem with sex, remember that there are people with the training, skills, and experience to help you.

Unhealthy and dangerous sexual habits such as practicing unsafe sex with multiple partners can contribute not only to sexual problems but also illness and disease. Talk to your doctor about birth control and protection methods to prevent the transmission of disease and to engage in a healthy sexual lifestyle.

Menopause
As women approach menopause, their sexuality changes—and this varies greatly from woman to woman. In some women, sexual problems may develop or worsen. You may lose desire slowly, experience difficulty with arousal, and feel pain during sex. This is an effect of the lack of estrogen that occurs before and after menopause, which leaves your vagina dry and your sexual appetite lessened. On the other hand, many women feel a renewed sexuality after menopause, fueled by newfound confidence and freedoms.

As you get older, remember that sexual health is an important part of your life at all ages. Age never rules out sex. In fact, a healthy and active older woman can experience a lively sex life well into her eighties. As you age, your level of sex hormones is fluctuating, and it's generally lower than it is higher. Perhaps chronic medical conditions or medication are making it more difficult for you to enjoy sex. You can find remedies for these problems, and it all begins with general good health. Maintaining a healthy and active lifestyle in older age contributes to a healthy sex life. Your sex life can in turn promote good health in other areas of your life and body. Don’t forget to practice safe sex throughout your life to avoid sexually transmitted diseases.