If sexual desire in a woman continues with arousal, it ends with orgasm and resolution phase, following a fixed phase with body changes.
During orgasm, involuntary and violent contractions in the vagina, anus and pelvic floor muscles are added to contractions in the uterus.
All these contractions create orgasm in the woman's brain with an intense feeling of pleasure. Orgasm is not only a reward for the woman, but also an event that helps pregnancy by contributing to sperm motility.
A wide variety of factors can cause orgasm disorders in women. These are respectively;
a. Medications or drug side effects
b. Diseases that may prevent the contraction of the pelvic muscle structure (Diabetes, Multiple Sclerosis, etc.)
c. Hormonal changes (menopause, hypothyroidism, etc.)
d. Relationship problems
e. Psychosocial causes (age, education level, social class, religion)
While biological causes generally cause sudden onset, psychosexual causes cause longer-term and even lifelong orgasm disorders.
In the treatment, after medical, hormonal, neurophysiological and pharmacological causes are investigated and excluded, mostly psychological treatment programs are applied with body awareness, education on anatomy, appropriate stimulation techniques. In more challenging cases, psychoanalysis and cognitive-behavioral treatments may be required. There are also various medical devices available to assist in treatment.
Hypoactive Sexual Desire Disorder
It is the persistent or frequently recurring absence of sexual thoughts and feelings that are necessary for sexual activity.
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This situation manifests itself outside of acceptable periods in the life cycle and may become a problem for the woman and her partner.
It can be considered a sexually active period. The incidence rate in women between the ages of 18-60 is around 30-35%.
Causes:
a. Medical:Chronic diseases, especially thyroid disorders, diabetes, hypertension, urinary incontinence, arthritis, neurological diseases Many diseases with a similar course can cause this problem. In addition, drug groups used in the treatment of some diseases may also negatively affect women in this direction.
b. Psychological:Many reasons such as bad experiences related to sexuality, stress and fatigue, inability to focus, anxiety, depression, low self-confidence, and insecurity about body image can lead to this problem.
c. Problems related to the relationship:The sexual problems of the partner, inadequacy in the relationship, and the inability to communicate with the partner about sexuality are issues that should be emphasized.
d. Cultural:The society and culture in which the woman lives, her perception of sexuality, the roles and restrictions imposed on women in sexuality may be effective.
Therefore, when evaluating such a problem in women, the issue should be examined from multiple perspectives and the cause or reasons should be revealed.
Many options can be used in its treatment, starting from patient education, many hormonal or non-hormonal drug treatments, and psychological therapy techniques.
Sexual Arousal Disorder
It is generally described as a situation where permanent or frequently recurring changes in the sexual organ are not observed during sexual activity. However, changes in the sexual organ may be observed even if the woman does not feel sufficient stimulation. This situation should be identified as arousal disorder.
Causes:
a. Medical:Drugs used in the treatment of neurological diseases that affect the autonomic nervous system, diabetes that has begun to show its effects on the vascular and nervous systems, damage caused by surgical intervention or radiotherapy, recurrent urinary tract or vaginal infections, and various diseases.
b. Psychological: Acute and chronic stress, inability to focus, anxiety, depression, body image concerns.
c. Relationship factors: Sexual dysfunction of the partner, monotony in the relationship, inadequacy in the bilateral relationship, lack of sharing interest in sexuality.
It is a problem in which the patient needs to be evaluated in a multifaceted manner, from a medical, sexual and psychosocial perspective.
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In the treatment of psychological therapies, hormonal or non-hormonal While non-drug treatments are used, some alternative treatment methods (lubricating creams, vibrators, clitoral therapy devices) may be recommended to a well-evaluated patient.
Sexual Pain Disorders
Sexual pain in women is examined under the heading of dyspareunia and vaginismus.
Dyspareunia: It is the woman's feeling of pain during sexual intercourse. It is a disorder that can be seen in 1-2 out of every 10 women. This pain may be superficial or deep. In other words, the pain may be either at the entrance to the vagina or in the lower abdomen and groin. These pains may occur with the woman's first sexual experience or may begin later.
The reasons may include:
- Infection
- Age-related sexual organ changes
- Congenital disorders
- Changes that various systemic diseases may cause on the vascular and nervous structure
- Surgery, radiation, etc. treatments performed in areas close to the genital organ
- Malfunction of the lower abdominal muscles
- Being exposed to sexual abuse
- Problems with partner
Treatment requires careful listening to the patient and a multifaceted approach.
Vaginismus: It is an involuntary contraction of the lower abdominal muscles that develops in women due to fear of sexual intercourse. Growing up with incorrect or incomplete sexual information has a great impact on the development of this fear. There is no problem in terms of sexual desire and arousal in women. It unintentionally prevents the sexual intercourse phase. Unfortunately, it is a problem for many women around the world. Actually, it is a couple problem in general. If the couple who cannot have sexual intercourse does not seek help, the issue is gradually postponed. The couple may become indifferent towards each other. Sexual problems may also occur in the partner of the woman experiencing this problem.
The most important part of the treatment is for the couple to first reach the point of seeking help. Many couples avoid this because of the negative emotions they experience or feel helpless because they do not know the health institution and relevant branch to apply to.
Many women and of course couples have the right Unfortunately, this problem, which can be easily solved with therapeutic approaches, grows like a snowball between the couple and becomes an irreparable situation. The result may be marriages in which the union does not take place or the separation of the couple.
What is our Genital System?
The female genital system consists of external and internal parts. It is more accurate to examine it in two separate sections.
1- External Genital Organs
There are various sections in this region, also called the vulva, in women:
a- Labium Majus:They are protrusions filled with fatty tissue on both sides.
They cover the inner part. It is a structure that is generally clearly visible when viewed from the outside.
b- Labium Minus: These are two thin skin folds located just inside the large lips. It has many glands in its structure that secrete the fluid that provides lubrication upon stimulation. They come together in the front part to form a sheath on the clitoris.
c- Clitoris: It is a very sensitive part that has a structure that fills with blood and hardens with sexual stimulation, like the penis.
d- Urinary hole: It is the opening of the urinary canal (urethra) that opens to the outside, which allows the bladder to be emptied.
e- Vaginal entrance: It is usually thin and one part is open. It is the part where a membrane (hymen) is located. With the onset of sexual life, it generally remains as residual tissue.
2- Internal Genital Organs
a- Vagina: Approximately 7 years old. It is a very flexible organ with a length of -10 cm. The lubricating fluid produced by the glands in its structure allows the penis to enter during sexual intercourse.
b- Uterus: It is the structure in which the baby grows during pregnancy. It has a layer (endometrium) that develops in each cycle and prepares for pregnancy. If pregnancy has not occurred, it is expelled by bleeding at the end of the cycle. This is called menstruation.
The uterus is connected to the vagina through an opening called the cervix.
c- Tube ( Fallopian tube): Connection with the eggs on both sides of the uterus. These are channels that provide heat and vary in length between 10-15cm. It is mostly the area where sperm and egg first meet.
d- Ovary: They are the organs located on both sides of the uterus, which produce sexual hormones in the woman and mature the fertilized egg every month.
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