The World Health Organization recognizes sexuality as one of the pillars of quality of life, being a central aspect that permeates the entire life of human beings.
It is known that the physiology of the sexual response is complex, dynamic and still not completely understood. It is mediated by a complex interaction of psychological, environmental and physiological factors (hormonal, vascular, muscular and neurological).
First, let’s understand how the phases of the Female Sexual Response Cycle work.
- Desire: Sexual desire is similar to an appetite. Organic or emotional interference can alter the perception of desire. Experienced in different ways and intensities in men and women.
- Arousal: State of the body that reacts favorably to sexual stimuli. Physical changes occur in the body. Body response to desire – preparation for sex. The woman is lubricated and there is an increase in blood circulation in the vulva region
- Orgasm: Intense sensation of pleasure that is accompanied by physiological reactions such as rhythmic and involuntary contractions in the vagina. Peak of pleasure.
Unlike men, women can be multiorgasmic, that is, they are able to experience, after the first orgasm, one or more additional orgasms, within a short period, when properly stimulated.
Sexual dysfunction is persistent or recurrent difficulty or change in some of the phases of the sexual response cycle that causes discomfort and personal distress. It is multifactorial, and can affect 20 to 76% of women.
What are the main sexual dysfunctions?
HYPOACTIVE SEXUAL DESIRE
What it is: Decrease or absence of sexual interests and fantasies. There is no motivation for the sexual act to take place. It is the most prevalent sexual dysfunction in women.
Causes: Stress, relationship and/or sexual difficulties with the partner, psychological factors, age, menopause, previous illnesses, drug treatment, depression, anxiety, low self-esteem, insomnia, fatigue, cancer treatment, religious beliefs, traditions and cultural attitudes, among others.
What it is: Involuntary contraction of the vaginal muscles that prevent penetration of the penis, finger, or gynecological speculum or even a tampon. The woman cannot control the movement of contraction, despite wanting the sexual act. It can be primary or secondary to some biopsychosocial change.
Causes: Anatomical alteration, mechanical barrier (fibrotic hymen), violence / sexual abuse, infections, family and religious education, bad sexual experiences, culture, among others.
What it is: Recurrent or persistent genital pain associated with sexual intercourse, causing disturbance with marked distress or interpersonal difficulty.
Causes: Chronic pelvic pain, endometriosis, menopause, nonperforated hymen, vaginal septum, infections, vulvodynea, trauma, chronic intestinal constipation, surgeries, radiotherapy, perineoplasty, cystitis, urethritis, arousal disorder, hypoactive sex drive.
What it is: Anorgasmia is the difficulty of surrender, concentration and lack of autoeroticism, delay or recurrent or persistent absence of reaching orgasm. Its prevalence reaches around 30% of women, and it may occur more frequently in those in long-term relationships.
Causes: Menopause, diabetes mellitus, partner hostility, fear of losing control, lack of desire and self-awareness, coitus pain, chronic diseases, estrogen deficiency or neurological disorders, surgical injuries and trauma, thyroid, kidney or gland problem pituitary, weakness of the vaginal muscles, and some medications such as antidepressants can lead to anorgasmia.
In many cases, the approach to treating sexual dysfunctions must be interdisciplinary.
Pelvic Floor Physiotherapy can help all the aforementioned dysfunctions, emphasizing the Reeducation of the Pelvic Floor muscles – rehabilitation of the structure where our organs rest and which influences the sexual function.
The objectives of physiotherapy, depending on each case, are:
- increase awareness and proprioception of the intimate region;
- improve pelvic floor muscle relaxation;
- normalize pelvic floor muscle activity at rest;
- desensitize painful areas;
- improve blood circulation and sensation of the intimate region;
- increase sexual pleasure;
- improve vaginal muscle control (pelvic floor muscles);
- improve security, self-esteem and awareness of women with their bodies.
Do you have any of these sexual problems? Get in touch and I will be happy to help you!
Basson R., Leiblum S.,et al. Revised Definitions of Women’s Sexual Dysfunction. J of Sexual Medicine Vol. 1, N. 1, 2004
Abdo.Sexualidade Humana e seus Transtornos. 2010