Sexuality & MS: a guide for womenSection 1: A woman's sexual response
A woman's sexual response is influenced by many things. This may include hormonal changes such as the menstrual cycle, pregnancy or menopause; many women notice that their attitude towards sex changes at different times of the month and different stages of their life. External factors, such as who you are with, the circumstances and any distractions can all play a part in how you feel at any time.
Sexuality
The term 'sexuality' is difficult to define and our sexual identity is unique to each one of us.
Sexuality is concerned with how you express your sexual identity, how you feel about yourself as a woman, your femininity, your sense of self-worth and self-image. It links to the way you project yourself and communicate with others including your partner or potential partners.
Your sexuality is formed within your background, cultural or religious beliefs and is shaped by sexual experiences and individual preferences. In short, your sexuality is reflected in your individual personality and your lifestyle, and goes far beyond your ability to engage in and enjoy sexual intercourse.
The sexual response
The terms 'sexual functioning' or 'sexual response' relate to the physical act of engaging in sexual activity, sexual intercourse or other forms of intimate contact. This can include non-touch activities such as cyber or telephone sex.
Arousal generally begins in the brain following erotic stimulation from sight and thought, such as sexual images, remembering or picturing sexual situations; in fact, depending on your preferences, just about anything! Following these stimuli, the brain then processes and relays messages to the sexual organs along the nerve pathways of the spinal cord. Other parts of the body, such as the circulatory system, are also involved so there are many opportunities for things to become problematic. There are different ways of explaining the female sexual response. These are the most common concepts:
Sexual interest/desire:
Desire (libido) can be an important factor in the female sexual response and can be affected by a number of physical and mental factors. The way you feel sexually is closely connected to your state of mind – some have described the brain as the most powerful sexual organ. A whole range of mental factors can affect sexual desire, including self-esteem, how you or your partner are feeling in terms of mood, stress levels and attitude to one another. Confidence in your physical self, trust and safety to play out fantasies or say what is exciting or pleasurable all play a part.
Although some women do not initially experience desire, they can still respond to and enjoy sexual activity.
Sexual arousal and orgasm:
When you experience desire, blood flow increases to the genital area and particularly the clitoris. The clitoris is a sensitive area located in the female external genitalia that responds to touch by swelling with blood and increasing in size. It is the most important part of the female anatomy when it comes to sexual pleasure: over two-thirds of women in the general population cannot orgasm by vaginal penetration alone and require stimulation of the clitoris to achieve full arousal and orgasm. As the clitoris swells, so do the tissues or lips (labia) that surround the entrance to the vagina. The labia open slightly, increasing access to the vagina during intercourse. The internal structure of the vagina elongates and balloons at the top to allow for penetration.
At the same time, the vagina produces more lubrication to make penetration easier and more comfortable. Lubrication is really important for comfortable and enjoyable sex, but the amount of lubrication present in the vagina does not necessarily coincide with a woman's degree of arousal or her desire for intercourse.
Nipples can also become erect, breasts enlarge slightly and the veins in the breast may appear more visible.
As sexual arousal builds, there is an increase in energy within the nerves and muscles in the genital area and other parts of the body, causing the muscular contractions that lead to orgasm. Many women do not reach orgasm every time they have sex and, as already stated, the majority of women cannot achieve orgasm solely through vaginal intercourse.