What is the normal pattern of sexual response in women?

A woman’s sexual response has several stages:

• Sexual response starts with a desire for sexual intimacy. This is also called libido.
• During the excitement stage, your vagina gets moister and vaginal muscles start to relax as your body gets ready for sex. Your heart starts beating faster and your blood pressure goes up. You breathe faster.
• During the plateau stage, your vagina swells from increased blood flow. Breathing is heavier and your muscles start to squeeze.
• Orgasm is defined as waves of muscle contractions that happen in your vagina and throughout the body. It may last only seconds. Some women have orgasms regularly with sex and some women do not. This is normal.
• During the resolution stage, you start to relax. Your heartbeat and breathing slow down and the swelling in your genitals goes down. You may be sweating. You may feel sleepy.

What causes problems with sexual response?

Many things can affect your sexual response. For example:

• You may be under stress at work, school, or home.
• You may be tired, depressed, or angry.
• You may not find your partner attractive, or may not feel attractive yourself.
• You may drink alcohol or use drugs such as nicotine, narcotics, stimulants, blood pressure medicines, and some antidepressants that can affect sexual desire.
• You may have pain during sex. The pain may be caused by infection, hormone changes, or other physical problems.
• It may be hard for you to have an orgasm.
• You may feel uncomfortable with sex or disagree with your partner about what sexual practices are OK or enjoyable.
• You may feel pressured or have a fear of pregnancy.
• You may have a history of sexual abuse or rape.

What can I do to help myself?

Talking with your partner may be the most important part of a healthy sexual relationship. Open and effective communication can go a long way in solving problems with sexual response.

If you are concerned that you have a sexual problem, see your healthcare provider. Physical causes may be treated with medicine or, in some cases, with surgery. Therapy may help you deal with anxieties, fears, or poor body image.

You can get books to learn more about the emotional and physical aspects of sexuality and sexual response. Talking to a friend or family member may also be helpful.

You can get more information from:

• American College of Obstetricians and Gynecologists
  202-638-5577
  http://www.acog.org
• American Association of Sex Education Counselors and Therapists
  http://www.aasect.org
• Sexuality Information and Education Council of the United States
  212-819-9770
  http://www.siecus.org