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Dr Sacrifice Chirisa Mental Health Matters
Sexual disorders in women are more common and rarely addressed. They are usually related to a past event or trauma that has paired with sexuality and causes issues or difficulty with sexual activity such as a rape. Female Sexual Arousal Disorder is characterised by persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, a lack of adequate lubrication-swelling response of sexual excitement.

The disturbance causes marked distress or interpersonal difficulty. Contributing factors of female sexual arousal disorder are:

• Menopausal
• Atrophic vaginitis
• Diabetes mellitus
• Radiotherapy of the pelvis
• Sexual myths and lack of knowledge about one’s body
• Relational conflict
• Anger
• Fear
• Guilt
• Lack of sexual stimulation
• Lack of physical intimacy
• Lack of emotional intimacy and closeness

Female Orgasmic Disorder is characterised by persistent or recurrent delay in, or absence of an orgasm, following a normal sexual excitement phase.

Many women have difficulty climaxing with a partner, even after ample sexual stimulation.

In fact, orgasmic dysfunction affects approximately one in three women. Women may have difficulty reaching orgasm due to physical, emotional or psychological factors. Contributing factors might include:

• Older age
• Diabetes
• Gynaecological surgeries, such as a hysterectomy
• Medications (some)
• Embarrassment or shyness
• Guilt about enjoying sexual activity
• History of sexual abuse
• Depression or anxiety
• Stress
• Poor self-esteem
• Relationship issues

Sometimes, a combination of these factors can make achieving an orgasm difficult. The inability to orgasm can lead to distress, which may make it even harder to achieve orgasm in the future.

Dyspareunia is characterised by recurrent or persistent genital pain associated with sexual intercourse in a female. The disturbance causes marked distress or interpersonal difficulty.

It is not a condition in itself but is caused by medical conditions or psychosocial problems.

Dyspareunia is almost exclusive to women. It may result from abnormal conditions of the genitalia, dysfunctional psycho physiologic reaction to sexual union, forcible coition or incomplete sexual arousal. Dyspareunia is also associated with hormonal changes of menopause and lactation that result in drying of the vaginal tissues and with endometriosis, which may result in painful adhesions around the vagina and ligaments, decreasing their flexibility during intercourse.

Symptoms include a burning, ripping, tearing or aching sensation associated with penetration. The pain can be at the vaginal opening, deep in the pelvis, or anywhere between. It may also be felt throughout the entire pelvic area and the sexual organs and may occur only with deep thrusting.

When pain occurs, the woman experiencing dyspareunia may be distracted from feeling pleasure and excitement. Both vaginal lubrication and vaginal dilation decrease. Inflammation or infection may be the cause; such as a yeast infection, urinary tract infection or inflammation of the vagina. Injury to the vagina and the surrounding area can also cause pain. So, sexual relationships are meant to be enjoyed not endured. The right thing to do is to seek professional help from your psychiatrist.

Next week I will focus on deviant sexual behaviours.