All this month Dr. Kate, an OB/GYN at one of the largest teaching hospitals in New York City, is dedicating her column on EMandLO.com to the topic female sexual dysfunction, since that’s what she seems to get the most inquiries about. Click here for all the installments of her five part series being published every Thursday afternoon in January.
So you want to have sex, and you’ve found a willing, worthy partner. But what happens if your body isn’t paying attention to the signals your mind and heart are sending? Arousal is another stage in our sexual response; it may follow desire, or may be the lead-off hitter in response to your partner’s touch. Patients complain to me all the time that it takes “too long” for them to become aroused when fooling around with their partner. But what exactly is “too long?” There is no magic number for how long it should take to become aroused, or about how much you should be aroused. We don’t measure the amount of wetness you get, or how much blood flows to your vagina (though it would make for interesting studies!).
Arousal will vary from woman to woman, from partner to partner, from night to night. So you may find that (sometimes, often, always) it takes you longer than you’d like to feel turned on in bed. And I think that “too long” is too often defined as “longer than it takes him.” It’s okay to not feel aroused on every occasion that you think you “should”—whenever your partner is horny, when you’re watching porn, when you finally have time alone with your partner (especially if you’re a parent). It’s also okay to play around and see if desire and arousal follow—and if not, to feel free to shut it down and go to sleep if that’s what will make you feel best that night.
When does a low level of arousal signify a problem? If you consistently can’t maintain arousal during sexual activity, or if you frequently or always don’t become aroused despite a desire to have sex. Sexual arousal disorder is the second most common sexual problem among women, affecting an estimated 20 percent of women, though it most frequently occurs in postmenopausal women. Also called hypoactive sexual desire disorder, this condition may be due to depression, drug use, or medical problems, as well as stress, fatigue and certain medications (most commonly antidepressants and anti-hypertensives). And like other sexual disorders, negative emotions in your relationship—jealousy, fear, mistrust, you name it—can also lead to lack of arousal.
But the good news is that sex therapy can really help a woman combat arousal problems. When you work with a qualified therapist (who may be a social worker, a psychologist, or a medical doctor), there are multiple techniques that can be tried — imagery and fantasy, sensate focus, mindfulness. Ask your gyno if she’s knowledgeable about these techniques, or if she can refer you to someone who is.
— Dr. Kate
Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. Check out more of her advice and ask her a question at Gynotalk.com.