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July 2007 – Sexuality Issues Throughout a Woman’s Life
A woman may experience changes in sexuality at different times in her life, according to Medical College of Wisconsin urologist Margarita R. Kressin, MD.
“Women are influenced by many things when it comes to sex,” Dr. Kressin said. “These include their upbringing (attitudes about sex at home, religious and cultural background), history of sexual abuse and/or incest, their first sexual encounter and their current relationship.”
Dr. Kressin is fellowship trained in female and male sexual function and dysfunction, and a team member of the Women’s Incontinence and Sexual Health Program at Froedtert & the Medical College.
Many physical and psychological factors can also influence a woman’s sex drive (libido), from the time of her first sexual experience to post-menopause. These factors include:
- Medical problems (cardiovascular disease, high blood pressure, diabetes, and other problems)
- Aging
- Certain medications
- Hormonal levels (affected by pregnancy, birth control pills, breastfeeding, menopause, surgery, chemotherapy and radiation)
- Psychological factors (depression, a woman’s self-image and relationship issues)
The Benefits of Sex“There are many physiological benefits to sexual activity,” Dr. Kressin said. “It increases one’s heart rate, provides good exercise, and increases endorphins, substances produced by the brain that have painkilling and tranquillizing effects on the body. Sex also prompts people to take better care of themselves to enhance their body image for their partner.”
Love and Sex“When a woman is in a new relationship, high levels of the hormone dopamine are present in her brain,” Dr. Kressin said. Dopamine is a neurotransmitter that is found in areas of the brain related to a very high reward system. This then contributes to an increased desire for sexual activity. “As time passes, the dopamine level starts to decline (usually after a couple of years), as does the excitement for sex with the same partner. The key, therefore, is to keep the excitement in a relationship going to increase dopamine levels in the brain.”
A small percentage of women who take oral birth control may find that their libido is reduced. That’s because oral contraceptives raise SHBG, a carrier protein that binds testosterone. Testosterone levels are then reduced, resulting in decreased desire.
During the course of a relationship, a woman and her partner often discover cycles when sex becomes more or less important to the health of their relationship.
Pregnancy and SexA woman’s sexuality and libido often change during early pregnancy, either in a positive or a negative way. For some women, the pregnancy brings a sense of joy and freedom from worrying about getting pregnant. But other women may be too tired or nauseated to desire sex, especially during the first trimester. In the second and third trimesters, desire can drop as the pregnancy progresses.
“Many women don’t feel sexy or attractive when they’re pregnant,” Dr. Kressin said. “Physical discomfort, fatigue, hormonal changes and a changing body image can cause a decreased desire for physical intimacy.”
Motherhood and SexSexuality may decline after giving birth, as a woman copes with the challenges of caring for a newborn. Mothers who also have an outside job often are just too tired to have sex.
Breastfeeding also plays a role in sexuality. During breastfeeding, prolactin, a hormone that stimulates milk development, is released by the pituitary glands. Prolactin causes a reduction in the level of testosterone in the body, which in turn, suppresses a woman’s sex drive.
Menopause and SexDuring menopause (usually between ages 45-55), the production of estrogen and progesterone stop, and the production of testosterone greatly declines. These hormones are all essential for sexual health. Besides lowered libido, a lack of hormones can lead to vaginal dryness and irritation, genital atrophy, urinary issues, decreased vaginal blood flow, decreased sensation to the genital and other erogenous areas, and a decrease in or absence of orgasm.
Attitudes on sex before the onset of menopause can also influence what happens after menopause, Dr. Kressin said. “If a woman had a satisfying sex life before menopause, it’s more likely that her sex life will continue after menopause.”
The Effect of Men’s Sexual ProblemsWomen can be affected by a man’s sexual issues, such as erectile dysfunction (ED). A man with ED might feel embarrassed and reject advances from his female partner. This can, in turn, reduce the woman’s sex drive.
Women’s Incontinence and Sexual Health ProgramThe Women’s Incontinence and Sexual Health Program provides comprehensive care for women experiencing sexual health issues. Dr. Kressin and other team members explore the physical and psychological reasons for sexual health problems and create individual treatment plans. Women’s partners may participate in the program as well.
Treatment may include lifestyle changes (diet, exercise and alcohol use), treating an underlying medical or hormonal condition, medication, pelvic physical therapy, and psychological counseling to address emotional and relationship issues.
The Women’s Incontinence and Sexual Health Program treats the whole woman — body and mind. If you are a women concerned about a sexual health issue, call 414-805-3666 or 800-272-3666 or Contact Us for more information.
ResourcesSmall Stones, a health resource center of Froedtert & the Medical College of Wisconsin, offers the following resources on women’s sexual health:
Books
Sex and the Seasoned Woman by Gail Sheehy
For Women Only by Laura Berman and Jennifer Berman
The V Book by Elizabeth G. Stewart, MD
Better Than I Expected — Straight Talk about Sex after 60 by Joan Price
Passionate Marriage — Keeping Love and Intimacy Alive in a Committed Relationship by Nerve.com
Our Bodies Ourselves — Menopause by The Boston Women’s Health Book Collective
Products Sweet Spot Intimate Grooming Products
Very Private Intimate Moisture
Author: Marla Fraunfelder Date: July 1, 2007 | Medical Reviewer: | Margarita R. Kressin, MD | | Medical College of Wisconsin urologist |
Online Editor(s): Christopher Sadler
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