1. Our Bodies, Ourselves; Chapter 8
Women’s Health Issues
23 September 2013
•It is important to remember
that there is no right amount of
•It is normal to sometimes want
a great deal of sexual activity
and sometimes be uninterested.
•Fluctuation in sexual desire is
true for many women.
•Some women experience a lack
of desire and an inability to get
aroused or have an orgasm.
• These are long lasting
problems and can cause
stress which can have
negative effects on a
• Medical research on
these problems is
•Pharmaceutical companies and
medical researchers are searching
for a medication that will enhance
a woman’s sexual desire.
•This research is important for
women who’s sexual desire may be
impacted negatively by a
physiological problem that could
use medical attention.
•We need to keep in mind that in
order to increase profit drug
companies will do what they can to
sell this drug.
•Women mustn’t forget that there
is no amount of sexual desire that
is considered “normal.”
•Women must keep in mind that
there may be other factors
influencing a low libido.
•Testosterone treatments may be
offered to women who mention to
their health care provider that they
are experience a lack of sexual
•Testosterone supplements for
women have not been approved by
the FDA, but doctors can prescribe
these treatments legally for
women in the US.
•Because these treatments aren’t
approved for US use, doctors must
guess at the right dosage when
prescribing testosterone for
•Doctors may prescribe an
ultralow dose of AndroGel or
Testim, commercially available
testosterone gels for men.
•They also may prescribe
methyltestosterone capsules to be
taken orally, but this is not
recommended because of negative
effects on lipid levels and the liver.
•Because measuring a woman’s
sexual desire is so difficult the
evidence supporting use of
testosterone is limited.
•Women must be sure to get their
blood tested for low testosterone
levels before beginning treatment.
•There are many negative side
effects of being treated with
testosterone. Some are increased
acne, increased facial hair, and
decreased scalp hair.
•Intercourse that is desired by
both partners typically should
not be painful for either party.
•If penetration is painful, it is
important for women to find out
what is causing the pain.
•Gynecologists can help
determine whether or not the
reason for painful penetration is
physical and they can give
advice on treatments and
practices that will make
intercourse more comfortable.
•Open communication with
your partner is important
through times such as these,
and there are plenty of
alternatives while women are
•In most women, the vaginal
walls usually respond to arousal
that produces a liquid that
moistens the vagina making
penetration easier. For some
women, however, there is not
•Women can give themselves
more time to become better
lubricated for a more
•Lower levels of estrogen can
also cause insufficient
lubrication. Hormone therapy
• Low levels of estrogen
can be caused by
•Some vaginal infections like
yeast infections can be present
and the friction of penetration
can cause the infection to flare
up causing painful intercourse.
•The vaginal walls may also
become irritated due to birth
control foam, cream, or jelly.
When the vaginal walls are
irritated, intercourse may
become uncomfortable. Latex
allergies due to use of condoms
can also cause irritation.
•Local infections can usually be
treated with antibiotics and
irritation can be avoided by
using alternatives to whatever
may be irritating the area.
•In some situations a man with
a large penis and a woman with
a small vagina may have a hard
time having sexual intercourse.
•Vaginismus, a strong,
involuntary tightening of the
vaginal muscles, a spasm of the
outer third of the vagina, can
cause difficulty with
• These spasms and
tightening are not fully
• They can happen with
penile, and penetration
with an object.
•Pelvic pain can happen with deep
thrusts of penetration.
•This pain can be caused by tears
and lesions to the ligaments that
support the uterus.
• This can be caused by a
variety of reasons
• Mismanaged childbirth
• Improperly performed
• Pelvic surgery
• Excessively rough penetration
• Infections of the cervix,
uterus, and tubes
• Pelvic Inflammatory Disease
• Cysts or tumors on the ovaries
• Shortened vagina
• Tilted pelvis
•Vulvodynia is a term that
describes any and all chronic
•It takes time to determine why
the pain exists and how to best
•Localized pain can also be called
vestibulodynia. It is marked by a
sharp sensation in and around the
opening of the vagina.
•Reducing or eliminating the pain
is possible with some practices.
• Pelvic floor physical
• Hormonal Creams
• Low dose tricyclic
• Surgery is a last resort
•Medications can effect sexual desire and
the ability and intensity of orgasms.
•Women should keep in mind that when
they begin and over the counter or
prescription medication that their sexual
functioning may change. If this does
happen, they should realize that there
could be a connection. Depending on the
severity of the change they should seek
help if needed.
•Hormones like estrogen, progesterone,
and testosterone are hormones that
effect a woman’s sexual desire and
•These hormones and sexual changes
might not necessarily be a problem.
•If a hormonal change leads to a drop in
desire or sexual pleasure a women may
become dissatisfied and is able to explore
her other options.
•Hormone changes can also come with a
woman’s menstrual cycle, taking the pill,
or other medications, pregnancy,
13. Quote that “jumped out”
• “Some disabilities also make us more susceptible to
depression by causing changes in brain chemistry
and hormone and activity levels, causing us to
withdraw from sexual activities. These feelings can
be made even worse by the medications prescribed.”
• I was surprised by this quote because I never
thought of medications making things worse for
people. When thinking of medications I think of a
person getting better. I never thought of
medications making a person worse.
14. Discussion Question
• Something that struck me in this chapter was
that many of the disorders that cause women to
have uncomfortable sex are highly
misunderstood by practitioners. If you were in
this situation yourself would you become
frustrated at not knowing why you are so
uncomfortable during sex?