“Female sexual arousal disorder (Fsad) really)really ?? what are you talking about… the woman just has to be there… its the man who does all the work …” is a very common and rather ill informed comment. At the risk of sounding crude we have to start thinking of women as more than a receptacle and then probably one would not have so many unhappy couples in the clinic.
What is FSAD?? It is commonly referred to as frigidity, and basically means the woman does not attain sexual arousal .or it is inadequate, with no lubrication till the end of sexual activity.
This lack of response may be lifelong, or acquired, generalized or in certain situations, with certain partners. It has both psychological and physiological causes, and is not the figment of her imagination as most husbands think. Since sexual intercourse can be painful,women will try to avoid it only making things worse.A recent review of the medical literature, however, found that 22 — 43% of women experience some form of sexual dysfunction.
William Masters and Virginia Johnson were the first researchers to examine extensively the physical components of human sexual arousal. They recorded four stages of sexual response: desire (arousal) excitement, plateau, climax (or orgasm), and resolution. FSAD affects arousal and excitement in a woman.
Normally, when a woman is aroused and sexually excited, the first physiological change that she experiences is expansion of the blood vessels in the pelvic region, allowing more blood to flow to her lower abdomen and genitals. Some women notice this as a feeling of fullness in the pelvis and either consciously or involuntarily contract the muscles in the genital area. The increased blood flow also causes a phenomenon called transudation, which refers to the seepage of fluid through the walls of the blood vessels.
Lubrication of the vagina can happen very rapidly, within a minute. For a woman with FSAD, these responses may either be lacking, or be incomplete, thus making her sexual involvement dull and painful.
Much as husbands like to think the wife is avoiding sex, there are quite a few physiological (functional) causes that may bring this about over the years. It could be due to any damage or injury to the pelvic areas, any surgeries,lactation, menopause, hormonal disturbances like thyroid, medical conditions like coronary artery disease, reducing blood to the pelvis, or hypertension or as a side effect to certain medications (anti depressants, anti psychotics).
Treatments for this condition may vary from estrogen based hormone gels, to various lubricants to be used around intercourse. There are small clitoral pumps available for stimulation, and yet all these are off label treatments no one has yet understood a woman’s arousal!
One interesting point to note is a diagnosis of FSAD is not appropriate if problems with arousal are caused only by physiological factors thus there has to be a psychological element to it too.
Looking at the social conditioning of indian women when for any unmarried girl sex is taboo, and suddenly expecting her to accept and endure a physical relation ship with someone she has just met ,may itself be traumatic, and cause her to freeze — Both physically and emotionally.
To women who seem to clamp down on their sexuality, talk therapy and psycho therapy have known to help. Traditional psychotherapy focuses on problems in relationships, seeking to clarify problems, identify emotions, improve communication. couples are also motivated to interact with each other on a non sexual level to promote confidence and involvement.
Male sexuality is universal and has made Playboy and Victoria’s Secret a multi-billion dollar businesses, women though are not so forthright it may help to remember.. she has her fantasies too! If the male partner has the patience and the understanding that not all of a woman’s physical responses are in her control and seek medical attention in time maybe both their fantasies could come true!
(The writer is a gynaecologist and obstetrician practising at Happy Women Clinic. You can write in to her at firstname.lastname@example.org)