For many people, sexuality is complicated. In the past, it was common to grow up in homes or cultures where the word sex was only whispered. Sex education might have been limited to a stern warning not to get pregnant — or to get anyone pregnant. Early sexual experiences might have been met with insensitive comments from partners or followed with shaming words like “slut.”
So it’s understandable that many kids grew into adults who were unsure of how to reach orgasm or how to talk to their partners about sex.
“If you’re feeling anxious, shameful or having emotions like guilt around sexual activity, that is likely going to disrupt your body’s sexual response,” says Jennifer A. Vencill, Ph.D., L.P., a licensed psychologist and sex therapist.
“It’s going to be really difficult to experience sexual desire (libido). It might be difficult to experience physical arousal and orgasmic functioning, and might actually put you at risk for sexual pain, if you’re anxious and tensing up your body,” she says. “And certainly, if you’re feeling anxious with sex, it’s going to make satisfaction really difficult to come by.”
The team of health care professionals at the Mayo Clinic Menopause and Women’s Sexual Health Clinic want everyone to know that help is available. They encourage people to talk to their partners and health care providers about having a satisfying sex life — no matter their age or gender. Dr. Vencill, along with Carol L. Kuhle, D.O., M.P.H., and their colleagues, help people experience orgasms well into their 90s.
Sexual activity is good for overall health
It’s important to bring up any sexual health concerns with your health care provider because sexual activity, either with a partner or solo, can contribute to overall health. Sexual activity brings a physical release and can help people relax. It also increases blood flow and keeps the genital tissues healthy. And sex plays an important role in many relationships.
“There’s also the intimacy part of it that really helps people stay connected,” Dr. Kuhle says. “When we see partners struggle with sexual intimacy, it really does impact the relationship itself.”
Sexual activity is beneficial, healthy and doctor-recommended. It can help with:
- Stress release.
- Partner intimacy.
- Heart health.
- Immune system function.
- Pain relief.
- Bladder function.
- Restful sleep.
Libido is complicated
Sexual desire varies from person to person, regardless of gender. But sexual desire, sexual activity and even masturbation tend to be more culturally accepted and expected among boys and men than girls and women.
“Men have been given permission to orgasm,” Kuhle says. “Women often don’t figure that out until later. It’s an easier path for men than for women.”
She adds that she sees the shame and lack of awareness around women’s sexuality is changing with younger generations who are exposed to more information at younger ages.
During a sexual act, many factors can influence your response, including:
- Feelings toward your partner.
- Feelings about yourself.
- Your health.
- Your religious and cultural upbringing.
- Any past experiences or traumas.
Sexual desire changes over time
Sexual desire can change throughout your life, and there are many reasons desire may decrease. If you’re overwhelmed with parenting responsibilities or feeling insecure about your body, you might not have a strong desire for sex. Other reasons for reduced sexual desire could be:
- Physical. This could be body changes after a health condition or pregnancy.
- Hormonal. This can stem from pregnancy, breastfeeding or menopause, or health conditions like breast cancer or thyroid problems.
- Psychological. Stress and fatigue are the most commonly cited reasons for a decreased sexual interest, but anxiety, fear, depression and a history of trauma also may contribute.
For cisgender women, one of the most distressful times for their sex life tends to be around menopause, Dr. Kuhle says. Menopause is the loss of ovarian function, and the consequential loss of estrogen plays a significant role in sexual function.
“All of a sudden, interest in sexual activity changes,” Dr. Kuhle explains. “There’s vaginal dryness and arousal becomes more difficult. It’s harder to have an orgasm, and women get distressed with that. And it does distress the relationship sometimes because things, of course, are changing.”
Pain related to stimulation or penetration is another common reason why women disengage with sexual activity. Pain could be the result of hormonal changes that lead to dryness or discomfort. Your health care provider might be able to recommend lubricants or vaginal moisturizers to help. Trying different sexual positions also can alleviate pain. But if these measures don’t help, don’t push through the pain. Instead, talk about this pain with your health care team.
After menopause or an illness like cancer that changes the body, sexual desire can feel different, Dr. Kuhle says. Some medication also can make arousal more difficult. These changes may lead to feelings of inadequacy and sexual distress.
Relationship issues can be another complicating factor. Desire for sex often comes with a feeling of closeness for one’s partner. If someone isn’t feeling as cherished or supported by their partner as they’d like, sexual desire will likely suffer.
“Often misunderstood is that it is natural for sexual activity to diminish over time in long-term relationships,” Dr. Kuhle says.
Strategies to improve your sex life
No matter your age or gender, if your sexual desire takes a dive and if it’s bothering you or your partner, mention it to your health care provider. You also can seek out a specialist who is trained in sexual health.
Sexual health care providers have experience listening to concerns and helping people find solutions. They are nonjudgmental professionals who want to help. The International Society for the Study of Women’s Sexual Health (ISSWSH) is one organization that offers a directory of providers in your area.
For many people, a better understanding of their anatomy and better partner communication also can help improve their sex life.
Getting to know the female anatomy
Sexual activity can be unsatisfying for people who don’t reach orgasm. For some, getting comfortable with their anatomy can help. If you’re not sure what’s what, you’re not alone. In one survey, only 9% of adults could correctly label the parts of the female anatomy.
The clitoris is located at the top of the vulva and is as sensitive as the head of a penis. Because of where it’s located, the clitoris doesn’t get much stimulation from penetrative sexual intercourse, while a penis gets a lot.
“Most cisgender women were incorrectly taught that their orgasm will happen from penile-vaginal penetration alone but, in fact, this is extremely rare based on our anatomy. Clitoral stimulation is critical for most women’s orgasms,” Dr. Vencill says.
Women often need stimulation to the clitoris to reach orgasm. That’s why nonpenetrative sexual activities — with fingers, oral stimulation or vibrators — is so important. Ask your partner to give your clitoris some special attention (and show them where the clitoris is).
If you want to have a conversation with your partner about experimenting or trying something different, a sex therapist might help. A sex therapist can facilitate the conversation between partners or help an individual overcome their hesitations and insecurities.
Talking to your partner about your needs
While it might be uncomfortable at first, talking about sex can lead to satisfying improvements.
“We encourage folks to be gentle with themselves,” Dr. Vencill says. “If people grew up in a very sex negative or shame-based environment around sex, which a lot of us do, there is a slow unlearning of those messages that needs to occur. One of the best ways we can do that is talking about it.”
She recommends talking to trusted people in your life, like your partner, friends or a professional. To get started, consider following sex educators on social media. Helpful apps like Rosy and Coral can open up the conversation. Dr. Vencill also recommends the books Becoming Cliterate and When Sex Hurts. She also co-authored a book called Desire. An Inclusive Guide to Navigating Libido Differences in Relationships.
“Sex therapists often encourage people to have these conversations outside of the bedroom because of how vulnerable and anxiety-provoking they can be,” Dr. Vencill says. “If we are having sexual concerns, if there’s something that’s not working as well as it used to, or we’re wanting to try something new, it’s important to start normalizing those conversations outside of the immediate sexual experience.”
And it’s important to know that interest in sexual activity does not stop with age. It may slow down a bit, but it remains an important element to the quality of life throughout the life span.
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