Difficulties in becoming aroused
The nature of arousal problem
Some women want to engage in sexual activity but find that, when they do, they experience little or no sensation. The physical signs of sexual arousal in women are flushing of the skin; increased genital and breast sensitivity; hardening of the nipples; the clitoris swelling and becoming erect; wetness or lubrication (often hidden inside the vagina); a sense of swelling, warmth or tingling in the vulva and vagina; and an elongating of the vagina. Arousal also happens in the mind, as pleasure, feeling sexy and perhaps thinking sexual thoughts. In some women, these changes are partial or absent; this is the equivalent of erectile dysfunction in men and may be due to an insufficient blood flow or nerve supply to the genital area.
Physical causes can include certain medications, pelvic surgery, spinal injury, diabetes mellitus, high blood pressure, heart disease and multiple sclerosis. If the problem is more specifically insufficient lubrication, this is often due to low oestrogen and may be linked to contraception or the menopause.
Psychological issues (such as depression, stress, fear or guilt around sex and poor body image) can also prevent sexual arousal from taking place. Problems in the relationship, lack of sexual attraction or a lack of sexual technique are likely causes if a woman can become aroused during self-pleasuring but not with her partner. For some women, physical arousal occurs but is not experienced subjectively. The woman does not recognise what is happening to her body, perhaps because of anxiety or negative associations with sex or with her partner.
Treatment for arousal problems may include the following:
Treating any underlying medical problems
Psychosexual therapy, including coaching on stimulation techniques
A sexual growth programme, which can help a woman feel better about her body and learn about what is pleasurable to her (see ‘Personal Sexual Growth’)
Use of lubricants, vibrators, clitoral stimulators and other products to increase arousal (see ‘Sexual Resources’ for more information)Learning pelvic floor exercises to increase blood flow and muscle tone in the area (Ask your therapist for ‘Pelvic floor exercises for women’ )
You might be surprised to learn that being overweight can also affect a woman’s arousal and desire levels, not only from a psychological angle (if you don’t feel good about yourself) but also physically.
This is for two reasons:
Fatty deposits in the blood vessels leading to the vaginal and clitoral area can impair blood flow, making the area far less responsive (and poor arousal, as we’ve seen, is very likely to lead to
a lack of desire for sex);
The more body fat you have, the higher your levels of a natural protein called sex
hormone binding globulin (SHBG). This protein binds to the sex hormone testosterone. The reason that this is
significant is that the more your testosterone is bound to SHBG, the less there is available to stimulate desire.
The really good news is that research suggests that a healthier, low-fat diet, with plenty of fresh fruit and vegetables, can provide a real boost to your sex drive. The effect is especially marked if you manage to lose 10 pounds or more, but there will probably be an effect even if you don’t lose weight. What’s more, any exercise that increases blood flow to the pelvic area and buttocks (such as yoga, brisk walking or cycling) is also likely to produce better arousal and lubrication, leading to a heightening of sexual desire.