Midlife Sexual Dysfunction

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“Female sexual dysfunction” is a general term for a problem with a woman’s response to sex or interest in it. Sexual problems fall into four categories but some women may have difficulties in more than one area. The categories are:

  • Desire Complications
  • Arousal Difficulties
  • Orgasmic Dysorder
  • Sexual Pain


Lack of desire or interest in sexual activity, also referred to as a decreased libido, is the most common sexual concern reported by women. A lack of desire before having sex is normal for some women. They may not feel that they want to have sex until they begin to engage in sexual activity and become aroused.

Interest in sexual activity sometimes decreases with age which can be a cause for concern if one partner desires sex more than the other, however, the decrease in sexual desire as women age is not abnormal because the natural decrease in hormones can influence sexual desires. A lack of desire is considered a disorder when a woman does not want to engage in any type of sexual activity or does not have sexual thoughts or fantasies.

Increasing Desire

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To help increase sexual desire, work together with your partner to resolve relationship concerns, relationship stresses, misunderstandings about sex and other issues that may be affecting the relationship. One way to increase sexual desire is to make time to focus on intimacy.

Lack of desire may also be a manifestation of a previous negative experience with sex. In these cases, women should talk with their partner to express feelings and seek understanding. If the situation does not improve, contact your Rosemark provider or seek professional counseling.


Arousal is the name given to the physical and emotional changes that occur in the body as a result of sexual stimulation. When a woman has a desire for sexual activities but is unable to become aroused, she may be suffering from an arousal dysfunction. Arousal can be affected by many things, including medications, alcohol, smoking, illegal drug use, and medical conditions.

Improving Arousal

Women who have medical conditions or are taking prescription drugs that may be impeding sexual arousal should talk with their Rosemark provider to see if medications can be modified. Women with medical conditions should make sure that their condition does not prohibit sex. Women who are cleared for sexual activity, should make sure they are well rested prior to engaging in sexual activity. During sex, make sure ample time is spent on foreplay with a focus on enjoyment and sexual pleasure. In cases of vaginal dryness, use a lubricant to prevent vaginal pain.

Women who smoke, drink alcohol or use recreational drugs, are using substances that can slow down blood flow in the sexual organs and can cause arousal problems. To improve sexual arousal in these situations, limiting or eliminating their use can be helpful.


Not having an orgasm during sexual activity may not be a problem for some women. Sharing love and closeness without having an orgasm is satisfying for many women. However, other women may feel that not having an orgasm is a problem.

Women with orgasmic disorders may never have had an orgasm from sexual encounters, or they may have previously had orgasms but no longer have them despite healthy arousal. The intensity of orgasms may have also decreased, which can occur with age.

Orgasmic disorder may be caused by age, poor body image or a fear of losing control. It also may occur when a woman does not trust her partner. It is common for women who do not have orgasms to also have arousal problems.

Improving Orgasmic Ability

To help increase arousal and ability to experience orgasm, a woman should make sure to be well rested, increase the time spent on foreplay, use vaginal lubricant for dryness, and do Kegel exercises to increase the strength of the pelvic muscles. It may be helpful to improving orgasm ability or intensity by increasing sexual stimulation during foreplay or using mental imagery and fantasy. This may increase sensitivity and arousal levels to aid in sexual pleasure and in producing an orgasm.


Painful sex may be a lifelong or short-term condition. Pain that occurs during intercourse is called dyspareunia. Most sexually active women have experienced pain during sex at some point in their lives.

At certain times in a woman’s life a decrease in estrogen levels such as during perimenopause and menopause may cause vaginal dryness and lead to pain during intercourse. The vaginal dryness can decrease the desire for intercourse.

Decreasing Sexual Pain

Using vaginal lubricants for dryness can substantially reduce pain. A woman can also decrease sexual pain by taking ample time for foreplay, trying different positions, or embracing sexual activities that do not involve intercourse.


There are a variety of situations that cause sexual dysfunction in women. Decreased libido, hormonal changes, stress, anxiety, relationship problems, illness, depression, or past negative sexual experiences can all have an impact sexual desire. Sexual arousal can be affected by medications, alcohol, smoking, illegal drug use, and medical conditions. Orgasmic disorder may be caused by a poor body image, a fear of losing control, or lack of trust with a partner. Sexual pain may be cause by vaginal dryness due to a decrease in estrogen levels.

In each of these situations, your Rosemark healthcare provider can treat sexual disorders in a professional environment without embarrassment. If you are experiencing any of these situations, call Rosemark for an appointment.