Sunday, April 4, 2010

Chasing the big `O'

About 43 per cent of women are sexually dissatisfied due to lack of arousal and elusive orgasms.

Recently, a young couple walked into my clinic with worried expressions. The couple who had been married for just about a year were under pressure to conceive. But the 22-year-old woman had no sexual desires at all,
which was posing to be a problem. “Doctor, ever since my college days I don’t get aroused, and I thought it was incurable,” she said. And although she had mentioned this to her family doctor earlier, he had chosen to ignore the issue. The anxious couple was worried they wouldn’t be able to enjoy a ‘happy married life’. This couple was not alone. There are several couples, where the woman is sexually dissatisfied. But with the right help, this problem can soon be solved.


According to a survey by the American Medical Association, 43 per cent women in the 20 to 50 age group experience problems with arousal, orgasm and sexual satisfaction or in other words known as Female Sexual Dysfunction. While there is no recorded data in India,
the percentage of the problem could be the same.


Urologists, behavioural scientists,
and psychologists are looking at medical, cultural and psychological reasons for women’s sexual problems.
The female sexual response cycle consists of four stages — excitement (foreplay), plateau (intense excitement with increase in heart rate and vaginal and breast swelling), orgasm (intense vaginal
and pelvic muscle contraction) and resolution (decrease in heart rate, relaxation of muscles and psychological
need for security). Disruption in any of these phases can lead to dissatisfaction.


While there are many causes the exact reason is still unknown. Alcohol, depression, a partner who can’t be bothered, anxiety, stress, smoking, sexual abuse at a young age, urinary leak, dry vagina are some causes.


The American Foundation of Urologic Disease recognises four causes of female sexual dissatisfaction.
◗ Sexual desire problem
◗ Sexual arousal problem
◗ Orgasmic disorder
◗ Sexual pain disorder
While the first two are treated by a psychologist, the others are treated by a gynecologist.


A vaginal plethysmography can evaluate the blood flow to the vagina, while a vaginal pH testing, commonly performed by gynecologists and urologists can be used to detect bacteria-causing vaginitis. A biothesiometer, a small cylindrical instrument, may be used to assess the sensitivity of the clitoris and labia to pressure and temperature. Readings are taken before and after the subject watches an erotic video.


Educating men and women on how to respond to a woman’s psychological and physical stimulatory needs is important. One of the methods used is Hormone replacement therapy (HRT) which aims at restoring hormone levels affected by age. A medical condition that causes diminished blood flow to the vagina must be addressed in light of female sexual dysfunction. There are solutions that can increase the blood flow by dilating clitoral blood vessels. There also a few handheld devices that can be used to increase blood
flow to improve sensitivity, lubrication, and the ability to experience orgasm.

The writer is the CEO of
Dr Ramayya’s Urology Nephrology Institute and Hospitals

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