According to the Journal of the American Medical Association, 43 percent of all American women suffer from some form of sexual dysfunction. In addition, of these 43 percent, more than half have marital problems or difficulties resulting from their sexual dysfunction.

The Mechanics of Sex Drive
Watch nearly any daytime soap opera or late evening drama, and there likely will be people in the throes of passion. Unfortunately, while sexual acts abound in the world around us, there are few places women can go to educate themselves about how their body responds – or isn’t responding – to arousal.

The fact is, sexual arousal is comprised of two basic parts: response to physical sensation and response to mental or emotional conditions. These two types of response work together, and in most women's lives, they must be equally considered when understanding arousal and arousal problems.

According to Dr. Steven A. Brody, medical director of reproductive endocrinology at Alvarado Hospital Medical Center in San Diego, Calif., the main reasons women lack sexual excitement or desire fall into three categories: psychological, physiologic or physical. "There are many reasons for a feeling or presence of sexual dysfunction," says Dr. Brody.

The following are explanations of common causes behind sexual dysfunction:

1. Psychological or emotional – may be represented by an inner conflict, relationship problems, depression, stress or anxiety. More than men, women seem to connect their sexuality with their partners. Sometimes this is conflated with love. In addition, negative experiences can certainly hinder a woman's ability to become aroused. These experiences range from embarrassing and uncomfortable to frightening and damaging. Many women need to feel safe before letting go into arousal. Bad experiences undercut this feeling of safety.
2. Physiologic or hormonal – the result of an abnormality in steroid levels in the body, in thyroid function or systemic diseases. Hormone imbalance can cause diminished libido in women. Specifically, women's testosterone levels gradually decrease as women mature. Although testosterone is thought of as a “male” hormone, it is important for women, too. "Testosterone is an androgen, meaning that it is produced in both women and men," says Marla Ahlgrimm, CEO and founder of Women's Health America and author of The HRT Solution. "In women, testosterone ignites that sexual spark. Low testosterone levels can mean that women experience a lessening of their sex drive. If it is revealed that the testosterone level is below normal range for her age, a woman and her physician can discuss low doses of natural testosterone, given via cream, gel or transdermal (skin) patch."
3. Physical or anatomical – can be due to pelvic adhesions, ovarian cysts, fibroid tumors, cervical or uterine abnormalities, skin abnormalities, infection or most commonly, endometriosis. Many women don't orgasm during vaginal penetration and don't get strong enough clitoral stimulation from intercourse alone. Extra clitoral stimulation may make the difference, as can increased moisture. Once considered only a problem for menopausal women, vaginal dryness can be experienced by women of all ages – even young women. "While this condition is more prevalent among older women, it can and does occur throughout a woman's life for a variety of reasons," says Dr. Adelaide Nardone, gynecologist and medical advisor to the Vagisil Women's Health Center. "The causes in younger women include taking over-the-counter allergy medications, normal monthly hormone fluctuations, using the wrong soap and taking oral contraceptives. This condition is often not discussed, and instead, younger women think there is something wrong with them or their relationship."

Overcoming Dysfunction
There are many things a woman can do alone to overcome sexual dysfunction. According to Dr. Brody, the first step is to take a physical and emotional assessment.

"A woman should start by getting a mirror and examine her genitalia," says Dr. Brody. "She should know her own anatomy and make an honest assessment of her stress, anxiety or depression, as that can affect sexual interest. One way to overcome sexual dysfunction alone is to consider using sexual fantasy, masturbatory techniques, gels and vibrators to explore ways to achieve orgasm."

Just as there are things you can do alone, there are also things you can do with your partner to conquer sexual dysfunction. It can be as easy as having a night without the kids.

"If you have children, trade babysitting with some friends," says Jan Price, a relationship communication consultant from Salt Lake City, Utah. "Have a 'date night' every week, taking turns planning the date. I recommend to my couples that they pretend that they are in high school and they can't have sex ... they can only ‘make out.’ This brings some of the excitement back into the relationship and is non-threatening. If there is a lack of emotional intimacy, trust needs to be rebuilt. And always begin and end your day with a kiss. Kissing is more intimate than sex. Kissing is powerful."

Once the situation leads to a sexual situation, Dr. Brody states that the key may be experimentation. "Couples should experiment with different sexual positions," says Dr. Brody. "Depending on the orientation of the uterus, intercourse could be painful, so change as you need to. Foreplay is the key."

Seeking Help
While there are many methods and techniques to try both alone and with a partner, there are times when professional medical help is necessary. "A woman should always seek professional help if she experiences continual or consistent pain during or after intercourse," says Dr. Brody. "Also, if there are signs of infection such as discharge, redness, burning during urination, then medical intervention is needed."

Sexual dysfunction does not have to be forever: Woman know thyself. "The key is that a woman becomes empowered by knowing about her own body," says Dr. Brody. "If she knows how her body functions and what can go wrong, then she can overcome many of the emotional and psychological causes that have blocked her in the past, thus overcoming her sexual dysfunction and leading to a happy, healthy, satisfying sex life."

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