The female sex cycle has four main parts. Problems may occur in one or more of these areas. The first is desire. This includes romantic feelings, sexual urges and an interest in seeking intimacy. The second is arousal which occurs prior to intercourse when sexual excitement climbs and there is increased vaginal sensitivity, swelling of vaginal tissue analogous to the male’s erection, and vaginal lubrication. The third phase is orgasm where there is a peak of pleasurable sensation and contraction of vaginal muscles. The fourth and last phase is resolution where the changes developed during the earlier phases return to normal and leave a subjective positive sensation.

 Sexual interest and function change throughout a woman’s lifetime. There is a strong sexual drive in the teens and twenties. Studies over the last 10 years have found that all ovaries normally produce testosterone at a level 1/10^th that seen in men. In many women that testosterone level is associated with libido or sexual interest. In mid cycle or ovulation, all women have a brief testosterone surge. Such a surge, may promote more interest in sexual intercourse at a time of greatest fertility. After children, particularly after the second child, recent research suggests a woman’s testosterone level declines and so does libido.

 For women in the late thirties to mid forties, hormone levels though in the normal range are often lower that when that women was younger. Sexuality here is more a multi-factorial issue rather than just a hormonal one and involves relationship, financial, business, general health and self image issues as well as biological status. Problems that occur in this age range require a careful evaluation of all these variables and a woman’s problem may involve more than one part of the sexual cycle.

In the later forties and fifties the signs and symptoms of menopause occur with both physical and emotional stresses. Increasingly, aggressive treatment of women with adequate estrogen replacement therapy will address the common problems. However, testosterone is not usually replaced and libido may suffer. The menopausal ovary still produces some testosterone but not to levels seen in youth. Women with hysterectomies and ovarian removal, even with estrogen replacement, lose all their testosterone suddenly and may see a significant drop in libido subsequently. Also, hormone replacement therapy often is not adequate to supply the level of estrogen needed for normal vaginal tissue tone. As a result, vaginal dryness develops which can cause pain at the same time interest is reduced. These problems, all of which is easily treatable, can result in avoidance of intimacy, changes in the relationship and a loss of the interpersonal bond that intimacy reinforces.

Despite the views of the young, women of all ages continue to desire and enjoy sexual intimacy. There is not age sexual interest naturally stops. Women in their eighties and even a few in their nineties remain sexually active. This is a minority of all women. Many have stopped for diverse reasons. Sexual function in maturity is a choice not an imperative. However, I feel that because of correctible problems too many women as well as men chose to avoid sexual relations. As a result they lose an important part of the interpersonal relationship which has been a rich and satisfying part of their lives.

Our scientific understanding in the area of human sexuality is expanding. Much more will be forthcoming in the future. Even now, at all stages in a woman’s life there are tools and methods to help improve many sexual function problems and preserve not only relationships but also personal satisfaction and happiness. Women who are experiencing any of these problems should contact their primary care doctor and/or gynecologist to discuss them.

Contact the Sexual Wellness Group to find out more about how you can eradicate these problems in your life.