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From the author: Despite the abundance of literature on sexological topics, when communicating with people on sexological topics, I often notice signs of some kind of sexological illiteracy. In this article I would like to highlight the issue of female sexological problems. FEMALE SEXUAL DISORDERS Disorders of sexual function in women are much more common than is commonly thought. But many women do not understand their sexuality, do not know who and where to turn for help, or are simply embarrassed to discuss sexual problems even with a specialist. But women have even more sexual problems than men. Unfortunately, most sexologists are focused on providing assistance with male sexual disorders and are not ready to solve the problems of female sexuality. Meanwhile, most sexual dysfunctions in women can be successfully corrected. A woman’s first sexual experience has a huge impact on her sexual life, because it sets the stage for her entire future sexual life. A woman’s sexuality is also influenced by upbringing, family attitudes, and moral ideas. Very often fear prevents free entry into sexual relations. This could be fear of pain, fear of pregnancy or sexually transmitted diseases, fear of becoming dependent on a man, fear that others (children, parents) may witness the act. Factors that reduce female sexuality are also resentment and feelings of guilt due to sexual satisfaction. There is a close relationship between sexual satisfaction and the presence of gynecological diseases. Therefore, all women with complaints of sexual dysfunction are subject to a gynecological examination. The causative factor of sexual dysfunction in a woman can be systematically practiced interrupted sexual intercourse, which can lead to congestion in the pelvic organs, which is harmful to the woman’s health. With interrupted sexual intercourse, 67% of women never experience orgasm. One of the causes of female sexual disorders is the incorrect behavior of the husband (or permanent partner), who cannot provide the necessary arousal for the woman in order for her to experience sexual satisfaction. The predominant forms of female sexual disorders are decreased desire and sexual coldness (frigidity), problems with orgasm (anorgasmia), painful sexual intercourse (dyspareunia). Frigidity (alibidemia) is the absence or loss of sexual desire. Lack or loss of sexual desire is expressed in a decrease in sexual fantasies and thoughts about the sexual side of life, accompanied by a subjectively pleasant emotional connotation, as well as in a decrease in the search for sexual stimuli. The ability to notice attractive potential partners is lost. Mental and physical discomfort (sexual withdrawal) disappears when you refuse sex. There is no desire to be sexually active. Frigidity can be temporary or permanent, occurring both from the beginning of sexual activity and during the process in women who have previously experienced orgasm. A distinction is made between primary and secondary frigidity. Primary frigidity includes all those variants that arise for psychological reasons. Some of the reasons are: previous sexual trauma, a bad opinion about one’s appearance, the disappearance of emotional intimacy in a couple, incorrect psychological attitudes due to excessive strictness of upbringing, transference of unresolved childhood anger towards parents to the partner, etc. Secondary frigidity is more common than primary frigidity. It develops in connection with endocrine, nervous, and gynecological diseases. Example: V., 24 years old, came in regarding loss of sexual desire. She has been in a civil marriage for 3 years. During sexual intercourse with a partner, the couple does not use any protection, and therefore V. has already had 4 abortions. Partner refuses to use condoms and refuses to drinkV. is afraid of contraceptive drugs, because “my girlfriends say that these drugs make you fat and your mustache grows.” She is very afraid of getting pregnant again, does not know how to persuade her partner to use a condom. V. doesn’t want to have children yet. Diagnosis: Primary (psychogenic) frigidity. Violation of communication processes in a married couple. Treatment: Consultation with a gynecologist is recommended to select the necessary contraceptive. During marital psychological and sexological counseling, V.’s partner was explained the negative consequences of abortion for a woman’s health, as well as the reasons for V.’s loss of desire to have sexual intercourse. The reasons for the disruption of mutual understanding processes in a couple were identified and worked out. In some cases, frigidity may be accompanied by painful sensations or aversion to sexual intercourse (aversion). In sexual aversion or aversion, impending sexual intercourse with a partner causes strong negative feelings, fear or anxiety, which are sufficient to lead to avoidance of sexual activity. If sexual intercourse does occur, it is accompanied by strong negative emotions and an inability to feel satisfaction. People suffering from aversion are able to establish close relationships with people of the opposite sex, but when these relationships become more intimate and trusting, then such people develop a fear of sex. They begin to look for excuses to avoid sexual intercourse or blame their partner for something in order to justify their reluctance to have sex. Fear of having sexual intercourse can even manifest itself at a physiological level, when severe sweating, nausea, diarrhea, and palpitations occur. The reasons for aversion may be: a squeamish attitude towards sex, experienced sexual trauma, the partner making unacceptable sexual demands and coercion. Anorgasmia is a repeated and persistent delay or absence of orgasm after a phase of normal sexual arousal, which the specialist finds adequate in focus, intensity and duration . Anorgasmia is divided into absolute (in all situations and with each partner) and relative (in certain situations or with a certain partner). Anorgasmia is often combined with decreased or absent sexual desire. And the stronger the libido, the less often anorgasmia occurs. Women with anorgasmia are divided into two groups. In the first group, orgasm during coitus is possible in principle, but for reasons unknown to the woman, it is absent. That is, with a high level of arousal during coitus, “something prevents you from finishing” and orgasm does not occur. As a rule, such women are not satisfied with their sexual relationship with their partner, although they were previously capable of orgasm with the same partner. Women in the second group say they feel almost nothing during intercourse. They can experience clitoral orgasm, often with specific stimulation (shower jet). Since such sensations cannot be produced during sexual intercourse, women cannot become aroused, but at the same time they have practically no dissatisfaction with sexual intercourse. Example: P., 30 years old. Complaints of frequent lack of orgasm. Married for 8 years. P. My husband cheated on me 2 years ago. P. forgave him, and doesn’t even remember his betrayal outside of sexual intimacy with her husband. But in the first six months after the betrayal, during sexual intercourse, thoughts of “how he did it with that same girl” obsessively entered P.’s head and orgasm did not occur. My husband felt guilty every time. Now P. does not have such thoughts in her head, but nevertheless she experiences orgasm very rarely. Upon detailed questioning, it turned out that P. does not experience orgasm whenever she believes that her husband has done something wrong to her. The absence of orgasm gives P. the opportunity to manipulate her husband. Diagnosis: Anorgasmia of the 1st degree, psychogenic origin. Treatment: individual.

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