In the past, sexual unwillingness, “anorgasmia” or lack of sexual desire in women was subsumed under the umbrella term frigidity, which actually means “numbness.” This disorder is manifested by a lack of sexual desire and reduced pleasure during sex. While in men sexuality takes place more on the physical level and orgasm is the goal, in women sexuality takes place mainly in the mind. Therefore, psyche, mind and body must be in harmony if the sexual experience is to be pleasurable.
At any stage of life, sexual activity and sexual desire can be affected. A distinction should be made between decreased appetence, i.e., lower desire, and disorders of sexual arousal, orgasmic disturbances, and other dysfunctions. Only in very few women are sexual problems due to purely physical causes.
What sexual disorders are there?
“Sexual arousal disorders: Little or no vaginal fluid is formed despite sexual stimulation, so that sexual intercourse is often painful. In addition to this physical symptomatology, women also subjectively feel a lack of arousal and desire.
“Orgasmic disturbances: After the arousal phase, affected women have no or delayed orgasm. In sexual medicine, it has not yet been fully clarified whether this is an actual disorder. Likewise, it may be a variant of female sexuality. The women often do not suffer from the lack of orgasm, but enjoy the form of sexual attention and tenderness and do not feel unsatisfied. They are normally aroused.
What are the causes of the disorders?
A combination of psychological and also physical causes is responsible for the sexual disorders. Basically, the affected women seem to put themselves under a certain pressure to perform or are very critical in their self-observation.
“Upbringing: During upbringing, parents impart values that can affect later sexual behavior. If sex is considered immoral during a strictly conservative upbringing, it is rather unlikely to enjoy sex in adulthood.
” Partnership problems: many women have problems in their partnership. It may be the daily arguments or lack of communication about sexual needs that get in the way of pleasure.
” Traumatic experiences: If earlier sexual activities were experienced as frightening or humiliating, the later pleasurable experience of sexuality is made more difficult. Abusive experiences play a serious role in this regard.
“Physical factors: Pain during sexual intercourse often also occurs when there are changes in the external genitals, for example, due to inflammation, scars, etc. Dryness of the vaginal entrance can also be a cause of pain. A vagina that is too dry is due, for example, to insufficient arousal or also to a lack of estrogen after menopause.
” Other influences: Inadequate contraception and fear of pregnancy affect sexual sensation. Likewise, in modern times, fear of sexually transmitted diseases can cause tension during sex. Another factor is that many women cannot free themselves from the traditional social ideas concerning female sexuality. They behave passively, do not make any demands on partnered sex and do not express their own wishes in this regard.
What are the treatment options?
The goal of therapy is that both learn to enjoy intimacy and sexuality. The aim is to be more relaxed with each other and to reduce any pressure to perform. Both partners should learn that not all tenderness has to end with sexual intercourse. Sexual needs and preferences are to be explored.
“Partnership exercises: For this purpose, similar to the therapy for premature ejaculation, there is a step-by-step program in which the partners learn anew to be tender with each other. Tenderness without sexual intercourse: One partner takes the active role, the other behaves passively – then the roles are exchanged. The partner’s hand is guided. Touching of the sexual organs is allowed and also mutual sexual stimulation, but no sexual intercourse yet. In the following stage, sexual intercourse can – but does not have to – occur. The focus is on everything that is experienced as pleasurable. The woman should choose the position that is particularly good for her.
Author & source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been reviewed by medical experts.
