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Not in the Mood

Sexual dysfunction has many causes, but it’s almost always treatable.

From a lack of sexual desire, to painful intercourse, it’s not uncommon for women to experience some form of sexual dysfunction. Research suggests about 43 percent of women will experience sexual concerns or complaints at some point in their lives.

Many problems can keep women from enjoying sex, including:

  • Lack of sexual desire
  • Inability to become aroused
  • Lack of orgasm
  • Pain during intercourse

Talk to Your Doctor
Occasional problems with sexual function are common. But if a problem lasts more than a few months or becomes a concern for you and your partner, talk to your doctor about it.

“It’s important to talk with your physician about any concerns you might have,” said Terri L. Woodard, M.D., a reproductive endocrinologist and infertility specialist with DMC Women’s Health Services. “I don’t think women always realize how their concerns and complaints might be interrelated. For example, I once had a woman tell me she had no desire for sex. But when we talked some more about it, I realized what she really meant was that it hurt when she had sex.” A physical exam soon revealed the patient had vaginal atrophy, a thinning and inflammation of the vaginal walls due to a decline in estrogen. The condition is not uncommon in menopausal women — and fairly easy to treat with a localized hormone preparation.

Of course, no two women are alike. Some women benefit from pelvic floor physical therapy and education. Others require medical treatments and localized hormone therapy. Still others may need to talk with a sex therapist or psychiatrist. But the first step is having an open conversation with your physician.

Dr. Woodard believes many women have misconceptions about sex. “A lot of what I do is simple education, whether it’s about sex itself or about a woman and her body,” she said. “Some women don’t really have a clear idea of what their anatomy is down there. Sometimes it can be as simple as taking out a mirror and showing her what’s what and dispelling some myths that many women have about sex and their bodies.”

Realistic Expectations
While there are many treatment options for sexual concerns, Dr. Woodard also believes it’s important for women to have realistic expectations for sex. “We watch Sex and the City and think that our sex lives should be like Samantha’s,” Dr. Woodard said. “But that’s not necessarily a realistic portrayal of sex and it shouldn’t be our goal. The goal should be healthy sexuality — being able to connect with someone and experience pleasure in whatever form that takes.”

While it’s commonly used in medical terminology, Dr. Woodard doesn’t really like the term “sexual dysfunction” because it implies there is normal and abnormal sexual function. “But what is normal? What’s normal for one woman may not be normal for another. That’s not really dysfunction,” she said. “Instead, I think it’s important to look at the strengths that an individual or couple has and use those strengths to improve their experience and enjoyment of sex.”

To make an appointment with Dr. Woodard or another DMC Women’s Health Services specialist, please call 1-888-DMC-2500.

Facts about Female Sexual Dysfunction
  • 43 percent of women will experience sexual concerns or complaints at some point in their lives

  • Smoking, alcohol and drugs can affect sexual response in both men and women

  • Common causes of sexual concerns for women include:
    • Aging o Hormonal changes
    • Stress and anxiet
    • Relationship problem
    • Illnesses including depressio
    • Past negative sexual experience
  • A lack of sexual desire is the most common sexual concern reported by women.
  • Many women do not feel that they want to have sex until they begin to engage in sexual activity and become aroused. A lack of sexual desire is only considered a disorder when a woman:
    • Does not want to engage in any type of sexual activity, including masturbation
    • Does not have or has very few sexual thoughts or fantasie
    • Is worried or concerned about her lack of desire
  • To increase arousal, women often find it helpful to:
    • Be well rested 
    • Spend more time on forepla
    • Use a vaginal lubricant
    • Do Kegel exercises (contracting and relaxing the pelvic muscles
    • Quit smoking
  • Not having an orgasm during sex may not be a problem. Sharing love and closeness without orgasm is satisfying for many women. Other women may feel not having an orgasm is a problem and may want to find a solution.
  • Women with orgasmic disorders may have never had an orgasm or they may have had them at one time but no longer have orgasms despite healthy arousal.

Source: American College of Obstetricians and Gynecologists

Terri Woodard, MD
Assistant Professor of Obstetrics and Gynecology


Dr. Woodard
serves as a clinician educator at Hutzel Women’s Hospital and Wayne State University School of Medicine. In this role, she devotes a substantial amount of time to educating medical school students and residents. Her areas of clinical interest include women’s reproductive health and fertility. She currently is a Women’s Reproductive Health Research (WRHR) Fellow with the Department of Obstetrics and Gynecology at Wayne State University School of Medicine. She has been involved in clinical research, including a study of fertility preservation in women undergoing cancer therapy.  She is a member of the American Medical Association (AMA), the American Society for Reproductive Medicine and The Society for Reproductive Endocrinology and Infertility.

Education: University of Pittsburgh School of Medicine, Pittsburgh, Penn., M.D., 2002

Residency: MetroHealth Medical Center and the Cleveland Clinic Foundation, Cleveland, Ohio, 2002-2006 

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