Developed by Dr. Norma Leslie 

There was a time in our society when women’s complaints about their sexuality fell on deaf ears. And there is still much that we do not know about women and their sexuality.

However, because of the research in male sexuality and the development of Viagra, researchers are beginning to develop theories about female sexuality.  Women’s sexuality is different than men in many ways. The Kinsey Institute has completed a study on women in heterosexual relationships, aged 20-65 years.  General well-being was the important variable to increased sexual function in women. Women have to first take care of themselves and create a sense of well-being before they can be sexually available to their partners. 

Female Sexual Dysfunction

 Female sexual dysfunction may involve an inability to experience sexual desire, arousal and pleasure.

Symptoms can include one or more of the following:

Lack of sexual desire

Lack of vaginal lubrication

Failure to achieve orgasm

Painful intercourse.

Adolescent Sexuality

The adolescent begins production of estrogen and progesterone at menarche

And they also begin to feel sexual desire. Adolescents are passionate about their feelings, although their feelings change daily.

 Adolescents do feel their sexual desire.  However, they have a tendency to confuse sexual desire with love.  One teen said to me, I thought I was in love, I had this wonderful rush when I was with him.”  The relationship could develop into a love relationship.  But what she described is a physical sexual turn on.  Adolescents need to understand the physiological sexual response cycle.  It is normal to feel the rush, the tingling in the pelvic area.   It happens because they are feeling sexually turned on, and blood is rushing to the vagina/or penis. They need to understand the normalcy of this feeling.  Strive to help them understand that love is another dimension, and requires more than a physiological response. The number one request from adolescents is, “How do I have good relationships”?  Most teenagers will tell you that they don’t know what to expect of others in relationships.  They may believe that attachment is more important than a sense of self.

Teach your teenager those healthy relationships: 

·        Are equal and fair,

·        Are interdependent.  Each person should have a sense of freedom,

·        Give you a voice.  Learn how to set limits, and not be scared of losing the other person,

·        Are not threatening,

·        Are not jealous,

·        Are not in your face, clingy or needy,

·        Should give each person the opportunity to be him or herself,

·        Should talk before acting, and

·        Do not require sex to be a prerequisite.

What causes decreased sexual desire?

Sexual desire is one of the most important, but least talked about conditions of a relationship.  It is sometimes the cause of depression or feeling blue.

Lack of Sexual desire is age dependent and is related to physical, emotional, relationship difficulties, and/or  feeling about your self and sexuality.

All long  term relationships will have times when the passion is at a low level. Remember that we are forever changing, physically and emotionally. This is normal. Don’t throw in the towel and be realistic about your expectations.


 Fatigue and stress will reduce your sexual desire to zero.   

What do you do to take care of yourself? Have a physical examination to determine if your fatigue is the result of low thyroid or anemia. If your physical is normal, then take an inventory of how you don’t take care of yourself, and write yourself a prescription for better care.  For example, you may need to exercise or eat healthier or change your attitude.


The lack of estrogen causes the vaginal tissues to become dry and fragile, which causes painful intercourse.  This can occur if you are breast feeding, or post-menopausal.  Ask your health care provider about estrogen replacement.  The use of water soluble lubricants can also help. Some post menopausal women experience a decrease in their testosterone levels, which can be a cause of decreased libido.

Painful Intercourse

Painful intercourse can be caused from  vaginal infections, lack of lubrication, bladder infections, redness and irritation of the vulva and vaginismus (contracting of the pelvic muscles.) Pain with intercourse is not normal.  Always seek help from your health care provider if your are experiencing pain with intercourse. More than likely, the pain will not just go away.  


Drugs, alcohol, and medications  can also impair your sexual desire. 

Admit it if you are drinking too much alcohol.  Ask for help.  Even, if you are not addicted to alcohol, alcohol is a depressant and also can cause sexual arousal problems in men and women. Men may not be able to have an erection and/or ejaculate.  Women have difficulty becoming aroused, lubricated and orgasmic.  


We could include the symptoms of depression.  

Depression can also cause a lack of desire and the drugs used to treat depression may cause decreased sexual arousal and orgasmic responses. Before changing your antidepressant medication make sure that it is not your depression that is causing  your lack of desire.. Your provider may want you to reduce the dosage, switch drugs or take a drug holiday. This involves taking some time off from the drug to see if your libido is revived.

It is important to discuss this issue with your health care provider and together make a decision about your antidepressant. 

Sexual abuse or other trauma 

Sexual abuse can also impair sexual function.

If someone has sexually abused you or caused you other sexual trauma, give yourself permission to ask for help.  Find a counselor that can help you reclaim your sexuality.  

Body Image

How you feel about yourself is a key to sexual pleasure.  If you are loathful, and can’t see the beauty of your body and sexuality, then it will be difficult to allow your self to “tune in and turn on.”   

Relationship Issues 

In a mature relationship, Sex is an expression of affection not just a physical release.

However, men and women are rarely honest about sex.  We are afraid of failure, misconnection, and hurting our partner.  We do think a lot about our sexual selves and our partner’s sexuality. It is interesting that we can talk, talk, talk, but females have difficulty talking about their sexual issues.  Why?  Women have been socialized to not talk or feel their sexuality. Women also become easily embarrassed about their sexuality. 

One woman said:

“I want to feel the desire of my adolescence, the fluidity of my sexual soul, and the unabashed feelings of love and attachment.” 

Another said, “sex is like a heavy snowfall, beautiful to look at, but can be messy.-physiologically and emotionally.”

Most of us are angry because of what we are not getting---It is easy to let it out and turn it on to your partner.  Love and desire is often destroyed with criticism.  John Gottman in his book, says that when a couple has more negatives than positives, and the nature of their relationship is criticism, contempt stonewalling, and there is an 85 percent chance they will divorce  Many times after you are the most critical, you will feel a rush of s sexual desire returning.  That is because you resolved your anger, but you created a stagnant pool of resentment in your relationship. 

Relationships loose their glue –sense of attraction-when they loose their pleasure bond.  It is more important to be friends and have pleasurable times together 

You can’t build intimacy by just paying bills or raising children together. Think about it.  When people have affairs, they spend a lot of time and energy thinking about and arranging times to see the other person.  

The security of a long term relationship can turn us into “taking it for granted” relationship or better said-slobs. This can mean cleanliness.  Unclean bodies, are huge turnoffs.   

Rejuvenating Sexual Desire 

Be kind to your sense of self and body image.

Give up the need to be perfect.  Enjoy the essence of you.

Make time for a sexual relationship

Plan for get always and get-togethers with your partner.

Ask yourself, what do I need to do to stay tuned in and turned on.

What do I need to communicate to my partner about both of us staying tuned in and turned on.

Be honest with each other.

Show your emotions.

Let the fluidity of your sexual soul flow.

Communicate---Expression is a real turn on. It is like getting to know your partner all over again, and maybe learning something new.  

Talk to your partner about what you want.  Sometimes, it is helpful to keep a relationship journal. The idea is for the two of you to express your feelings to each other in writing.  It helps to clear your head, build trust, and express your self .  Be creative, but express yourself.  Tell him what you want, and ask him to listen. 

Talk about your feelings in a non-judgmental way.  Sometimes you are unsatisfied, but don’t know why.  Talking helps to clear the air. 

Most of the time, those words stay within us and are acted out in ways that are damaging to our selves and our relationship.   

Sometimes we tell each other what we want to hear because it is too scary to tell each other how we feel .  Sometime it is because we are not in close contact with our feelings. Remember, the largest and most important sex organ is your brain 

Save some energy for sex, and plan ahead.  Send yourself a coupon.  

Take care of yourself.  Do something just for you.  Give yourself permission to take care of you. 

Things that men want women to know: 

They are socialized to be sexual and successful.  If you take either one away, they may have anxiety and/ or depression. 

They would like women to initiate sex.  They also want women to be honest. Don’t fake orgasms. This causes a trust issue in the relationship and anger and resentment. It makes it difficult to build intimacy and the pleasure bond.  

Most men know little about female sexual response.  Teach them.  Men complain that women don’t teach them to be good lovers. When I was studying sex therapy, One of my instructors came to class and announced with great gusto, “I am the best lover in the world.”  We all looked at each other with a disgusted look.  He continued with his essay.

And then he said, “The reason I am the best lover in the world is because my partner has taught me.”  He made his point.  

Men often blame themselves when there are sexual problems.   

What about sexual celibacy?

 It is not a bad thing.  Depends on you and your partner.  Is it accepted, and both agree and have decided  you want to channel your sexual energy into other passions. Some couples say they can enjoy each other and build intimacy without a sexual relationship.  It is crucial that both of you agree, and do not let celibacy just happen.    

I don’t want sex, I want romance and intimacy. 

He wants sex, he doesn’t romance me. 

And the power struggle begins.  Why is it so difficult for couples to plan and implement romance in their relationships?  Romance takes  creativity.  Routine shuts down romance.

Also, the hidden anger kills romance.  It is difficult to love someone when you don’t like them. 

What to do? 

Examine your hidden anger.  What is bugging you?

Once you know your anger agenda, spend some quiet time and ask yourself?

Why am I denying myself of sexual pleasure and romantic interludes with my partner.

Then, schedule a time to speak with your partner about your new discoveries.  

Fear of intimacy is a major source of loss of sexual desire.

As we get closer to someone, there is a natural feeling of vulnerability, and we want to distance and run away.  We have a comfort zone or a love language that we learned in our families. This is a set amount of space  between us and others that we need to feel at ease. When we commit, intimacy requires us to peel back the layers and reveal the child within.  

Want to have a more intimate relationship? 

Write a short letter to yourself about what you learned about intimacy in your family.

This will give you clues to why you may have difficulty in intimate relationships

This helps you to discover your own fears of intimacy.

Be trustworthy and create a safe place for your partner and you to express your vulnerability.

Try to be open, even though it may hurt or be uncomfortable,.

Banish the blame from your relationship.  Sexual problems are relationship problems.  

Center those activities around building a friendship along with a pleasure bond.

A date night

A special activity

Have lunch together.  This can be an unhurried time, when both of you are not exhausted.

Dance with each other.  Plan dance nights.  If you don’t know how to dance, take lessons together.

Find a fun activity that you can do together.  Always look for humor in your relationship.

Do things that make you laugh.

Create a romantic environment that fits you.  A lady I know picked up her husband in a rented limousine, she went to his office, closed the door, flashed her naked body, and said ,”come on with me.”    This fit her, it may not fit you. The magic is in your mind and your heart.  

Ask yourself what are the issues related to not liking my partner.  Many times those issues have to do with what you don’t like in yourself.  We just shove it over to our partner.  

Begin to plan activities that build a pleasure bond between you.  Romance does not just happen.  There is no such thing as everlasting passion.  That is a thought from your adolescent days.  Grown up relationships require creativity, and putting forth the effort to stay “tuned in and turned on.” These words are not gender biased.  Both men and women have to put forth the effort.  

Evaluate the level of trust you feel in your relationship.  We want intimacy,. Yet fear the vulnerability. Evaluate whether you truly feel safe in your relationship.

If your partner is someone that is untrustworthy, it will affect your sexual pleasure.  


Stress, fatigue, drugs, alcohol, and certain medications can affect orgasm. Decreased orgasm is a frequent side effect of some anti depressants.

There is no “right way”  for women to reach orgasm. For example,

Many women do not have orgasms with intercourse.  Women and their partners worry about this issue.  However, if you take away the pressure, and allow yourself to reach orgasm before during and/or after intercourse.   

Mature Sexuality:  

 Aging and enjoying your sexuality. 

No need to stop enjoying your sexuality as you age. Remember, that as your body ages, your physical response will decrease. Just take your time, and enjoy the journey.  Talk to your health care provider about any medications that may impair your sexual response.  

Gizmos and Pills 

Viagra and Women

Viagra can affect your life in two ways. If your partner takes it and if you take it. Viagra works by increasing blood flow to the genital area .Increased blood flow increases arousal and sensation. This drug is not an aphrodisiac, and only works with stimulation.  

However, the FDA does not approve Viagra for women. Research continues to determine if the drug affects sexual arousal in women. At this time, the evidence is inconclusive. 

How DO I Find a Sex Therapist? 

Sex therapy is a specialized form of professional  counseling that helps women and men address concerns about sexual function, sexuality and sexual expression. A sex therapist is a  credentialed professional with specialized training and experience in treating sexual problems.  Most sex therapists have extensive education and background in another field such as psychology, medicine, nursing, marriage and family therapy  or social work. 

A good referral source is the American Association of Sex Educators and Counselors.



P.O. Box 238

Mount Vernon IA 52314

Phone: 319-895-8407

Fax: 319-895-6203


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