Women's Sexual Health By Douglas H. Kirkpatrick, MD   A sense of sexuality and a healthy sexual response can have a positive impact on a woman’s quality of life. Sexual function varies from woman to woman and can change many times over a lifetime. It is not uncommon for women to occasionally encounter problems with sex. In fact, studies suggest that 35%–45% of women believe they have sexual problems that make sex difficult. A woman’s sexual response can be negatively influenced by emotional and physical factors. Daily stresses or conflicts at work, with family, or her partner can dampen a woman’s sex drive. Sexual function can be affected by pregnancy and the postpartum period; menopause; the use of birth control pills or other medications; or chronic health conditions such as depression, cancer, diabetes, multiple sclerosis, or high blood pressure. Women with a history of sexual abuse may also experience difficulty with sexual response. Lack of sexual desire—or low interest in sex—is the most common sexual problem among women. Other frequently reported complications include trouble achieving orgasm, not becoming lubricated enough before sex, having pain during or after sex, body image concerns, unmet sexual needs, lack of sexual knowledge, or being pressured to have sex. Some couples have sexual difficulties that are related to the male partner. Impotence occurs when a man cannot achieve or keep an erection. Like female sexual problems, impotence can have emotional or physical origins. If you are experiencing a new sexual concern or are in a new relationship, an honest conversation with your partner may be all it takes to relieve worries and clear conflicts. Women who are comfortable expressing concerns and asking their partners for what they want have a better chance of having a satisfying sex life. Talk to your doctor if you suspect your sexual problems stem from feelings you don’t understand or can’t cope with. You should also be sure to tell your doctor if you have any pain in your pelvic, genital, or vaginal area or if you think you have a health condition that is stopping you from enjoying sex. Your ob-gyn can provide information about how the body normally responds to sexual arousal and assess what may be causing low desire. He or she can suggest changes for you and your partner, and look at physical conditions that may be causing pain and medications that may be interfering with your sexual function. Your doctor may also refer you to an individual or couples’ sex counselor, support group, or other expert that can help. For more information, the ACOG Patient Education Pamphlet “Sexuality and Sexual Problems” is available in English and Spanish at www.acog.org/publications/ patient_education. _

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