Do We Have to Have Sex?

Female Sexual Dysfunction

By Lisa A. Goldstein

Wanting a baby means having regular and sometimes more frequent sex. For some, this might be a turn on, but for others, it's not. Female sexual dysfunction is a real problem that might be keeping you out of the bedroom and away from your dreams of conceiving.

Some women have always had less-than-good sex lives, while other women have had good sex lives until they started trying to conceive. It's important to separate not liking sex and wanting to get pregnant, because they are quite different, says Erica Neuman, M.S., sexual wellness coach and certified sex educator at MyPleasure.com. After all, the desire to get pregnant is not going to help a woman get over her aversion to sex. "She may force herself to have penile-vaginal intercourse so she can get pregnant, but that would probably exacerbate her desire problem," says Neuman.

Hormonal treatment of a sexual desire disorder may also interfere with fertility and therefore hamper the ability to conceive.

If a woman views her feelings about sex as a problem, however, the first step is to determine her sexual dysfunction and underlying causes by seeing a sex therapist. Neuman says the woman's hormone levels should be checked, especially her testosterone levels. Once the cause of dysfunction is identified, she can begin treatment.

Women can experience four types of sexual dysfunctions at different points in their lives, says Neuman. She lists lack of sexual desire, lack of sexual arousal, inability to orgasm (the most common problem for women) and sexual pain disorders (the least common).

Treatment is important for another reason, says Nili Sachs, Ph.D., a family psychotherapist. In terms of the different kinds of female sexual dysfunction, she says, "there is a physical, uncomfortable or painful sexual intercourse, and there is lack of desire. In both cases, the causes may be trauma in the past. The trauma may be psychological or [it could be] sexual abuse."

Indeed, in patients she's treated for sexual dysfunction, Sachs found a history of sexual abuse. Because there can be a lot to work through, she urges women to wait until they're mentally ready and fit for parenting before conceiving.

Enjoying the act of sex is also key to the process of conceiving. "When both partners are involved in lovemaking, it is easier on Mother Nature to do her thing," Sachs says. "When one or both partners are anxious about the process, there are obstacles that can translate in the human body from the attitudes to the cellular level – mind over body."

Treatment can also uncover an underlying ambivalence toward motherhood or the partner if the woman is subconsciously trying to sabotage the whole thing.

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• Talk about it!