Psychological Causes of Female Sexual Dysfunction

General Description

Our emotional and psychological being is vitally important to our sexual well being. Any kind of psychological or emotional stress can cause sexual dysfunction, even when we do not suffer from a medically diagnosed mental condition. The psychological causes of sexual dysfunction are numerous and diverse. Each of the conditions described below can be a factor in sexual dysfunction.

Depression is a serious disease that affects twice as many women as men, usually between the ages of 18 and 44. It can be caused by a chemical imbalance in the brain, severe stress, grief, family history, emotional conflict or any combination of these factors. Depression often causes a loss of interest in sex as well as function.

Dysthymia is a more common, subtle, lower-grade form of depression that is not easily diagnosed, often because a woman in functioning adequately and doesn't know she has it. A woman with dysthymia may feel sad, isolated, overwhelmed and unappreciated. She has a tendency to feel so unattractive and unloved that she doesn't want to let anyone else in and often withdraws from sex.

Stress: Many women experience far more stress than men particularly when they are full-time working mothers. Stress causes a woman to have far more interest in sleep than in sex and can inhibit her ability to become aroused and reach orgasm. For a woman to feel sexual, she needs some time to nurture and pamper herself, but even chronically exhausted women are much less likely than men to put their own needs first.

Sexual or emotional abuse: Women who have been sexually or emotionally abused in childhood or adolescence often face a range of sexual difficulties. For some women, it is terror whenever they are in a sexual situation. For others it is an inability to stay "present" or connected to their partners while making love. Conversely, some women become overtly promiscuous pursuing multiple, meaningless sexual encounters, trying to replace a lost love object or an unexplainable void inside.

Drug and alcohol abuse tend to have complicated emotional, relational and even sexual pasts. The substance abuse may allow for the numbing of the real pain, but that pain often carries into the sexual relationship. Many women who leave rehabilitation centers not only have to learn how to live sober, but also how to relate sexually to others while sober.

Sexual addiction is a compulsive, driving need for sexual contact that can destroy family life, work life, and a person's ability to function. Among the symptoms is a preoccupation with sex that interferes with normal sexual relations with a loved one and a repeated need for a "high" followed by feelings of guilt, anxiety, or depression. Sexual addiction is similar to addictions to drugs or alcohol, although its classification as an addiction is controversial in the medical community.

Body image and self-esteem problems: Fashion magazines promote such unrealistic images of beauty that we find that even younger women feel they can't live up to them. These are the same women, along with older ones, who turn out the lights during sex, and sometimes even while undressing. Self- esteem plays an important role in a woman's sexual function. If a woman doesn't feel good about her body or herself, or doesn't feel as in control or powerful, it's extremely hard for her to let go and sexually respond to a partner.

Relationship problems: A conflicted relationship with a partner usually means there is a conflicted or nonexistent sex life. Communication problems, anger, a lack of trust, a lack of connection and a lack of intimacy can all adversely affect a woman's sexual response and interest. Couples in marriage and long-term relationships often have unrealistic expectations. They feel that moving from an initial infatuation stage (when a couple can only think of each other and sex is thrilling) to the deeper, more calm stage of attachment (not all-consumed with sex) is somehow wrong. Real love is built on communication and intimacy; sex becomes a part of the whole relationship, not the center of it.

What Can You Do?

First, if you feel your sexual complaints are rooted in emotional or relationship conflicts, don't think that your whole life has to be falling apart before you seek help. The sooner you start to address it, the better your treatment will go.

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Regardless, we believe strongly that a therapeutic evaluation with a trained sex therapist should be a first step in treating any sexual function complaint, even when you are also seeking medical treatment for it. Of course, this is not saying it's all in your head. There might be a very real medical cause or factors as well. However, unless you attend to the context in which you experience your sexuality (how you feel about yourself, your body, and the person you're with), no amount of medical intervention will work.

For a general individual or couples therapist, we suggest contacting your local chapter of the American Psychological Association or National Association of Social Work for a trained and board certified therapist. You may want to ask them if they have a listing of marital and family therapists if you have a couples issue you want to discuss. If you are seeking a sex therapist, the American Association of Sex Educators Counselors and Therapists (AASECT) can give you a list of trained sex therapists in your area.

Next:: More About the Causes and Treatments of Female Sexual Dysfunction

Written in 2002. Last reviewed: 9/05

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