Women's sexual problems: contributing causes

Abstract

The thesis investigates influences which contribute to women's sexual problems within marriage. The literature is examined for important themes and these are then tested against data from 54 women who with their husbands attended the Sexual Dysfunction Clinic at Porirua Hospital, Wellington between 1977 and 1981. Introductory chapters trace the historical background and developments in the classification of problems. An extensive literature review of surveys, research and clinical reports examines the multi-disciplinary contributions to knowledge about women's sexual response. The section on physiology reviews neurological, hormonal and biochemical influences and the effects of muscle tone, pain, illness and drugs. Psychological factors cover childhood influences and adult experience including personality and relationship issues. The socio-cultural section brings together the findings on sociological differences and describes cross-cultural variations including cultural norms in New Zealand. Major themes from the literature are then summarised and related as hypotheses to specific research questions. Simple analysis of contingency tables is used to examine data collected from case-history material. The first research question examines items associated with problems at the different stages of sexual response, identified as libido stage, (physiological) arousal stage and orgasm stage. The second question focuses on the development of secondary problems, that is those which occur later in the woman's experience following earlier satisfactory sexual function. The third question addresses the common casework problem of women who report they are avoiding marital sex. Results of the data analysis are set in the context of sample group frequency scores on sexual history items compared with general population surveys. The characteristics are described of the women within the sample group who came with no personal sexual problem except to participate in treating their husband's problem. These findings suggest that problems in general are associated with: childhood molestation; lack of home sex education especially preparation for menstruation; bad experiences of childhood family life and relationships with both parents; and low incidence of masturbation. There is a trend for problems in general to be linked with lack of confidence. Results on specific problems show that (1) Primary libido problems are associated with being penetrated in incest; and secondary libido problems with having their origin at childbirth. (2) Arousal problems are linked with no sex education and with not fighting fair in marital arguments. (3) Orgasm problems in general are associated with having had psychiatric treatment for depression or for a behavioural control issue, and with fears of being lesbian; secondary orgasm problems tend to have been present since the beginning of the marriage. (4) Relationship is affected by a sexual problem when the woman has good libido but has an orgasm problem. The most disturbance to the marital relationship occurs with secondary orgasm problems. Women with low libido report improved marriage relationships in spite of their sexual problem. (5) Avoidance of intercourse was associated with: a husband with an ejaculation problem; avoidance of communication; the problem commencing at childbirth; having had premarital sex with the spouse; no preparation for menstruation; and having been raped. The conclusion integrates these results with the literature review and suggests particular areas for future research.