It's not just that we're having less sex – problems between the sheets (or wherever you have sex) are common, even among young people, if countless surveys, problem pages and pieces of anecdotal evidence are to be believed. The most recent National Survey of Sexual Attitudes and Lifestyles (Natsal) quizzed more than 15,000 British people about their sex lives and found that 42% of men and 51% of women had experienced at least one sexual problem for three months or longer in the previous year; and the figures for 16-21-year-olds weren't much lower (34% of men and 44% of women).
Evidently, women of all ages are more likely to experience sexual dysfunction than men, with symptoms ranging from a lack of interest in sex to painful intercourse and difficulties climaxing – but studies of male sexual dysfunction vastly outnumber those on issues that affect women, whose needs are frequently neglected by the scientific community, many experts believe.
Because many of women's sexual dysfunction symptoms are psychological ... treatment is often more complex than it is for men.
Because many of women's sexual dysfunction symptoms are psychological – such as diminished arousal, a lack of enjoyment during sex, feeling anxious during sex and difficulty reaching orgasm – treatment is often more complex than it is for men, whose issues can often be solved with a single drug: Viagra. This is according to Dr David Goldmeier, consultant in sexual medicine at St Mary's Hospital and chair of the British Association for Sexual Health and HIV's sexual dysfunction special interest group.
"Up until recently there were no medications for low desire in women," he explains. "Giving women sildenafil (Viagra) does engorge the genitalia, but this does not translate to increased desire. Desire in women is much more of a primarily cerebral event." However, hope is on the horizon for women, Dr Goldmeier adds: "There are two candidate medications that may appear in the UK at some time that address this: flibanserin and bremelanotide."
In the absence of drugs to treat their sexual problems, many women turn to their NHS doctor or sexual health clinics. But government cuts to these services in recent years and a general lack of specialist training among health professionals means that women are left with few places to turn.
"There is little money in the NHS [and] treating women’s sexual issues is time consuming. It has been neglected really because of lack of resources," Dr Goldmeier explains. "Psychological therapies are the mainstay for low desire and other female problems. These are time and personnel expensive and require specialist units. [Whereas] GPs can easily hand out male medications."
A lack of interest in sex (low libido) (34%), difficulty reaching orgasm (16%), an uncomfortable or dry vagina (13%), and a lack of sexual enjoyment (12%) are the most common issues women experience in the bedroom, according to the most recent Natsal statistics, with over a fifth of women (22.4%) experiencing two or more of these symptoms. Painful sex – which can be caused by conditions such as vaginismus, endometriosis and lichen sclerosus, and hormonal changes – is also an issue for 7.5% of women.
Dr Leila Frodsham, consultant gynaecologist and lead for psychosexual services at Guy’s and St Thomas’ hospital, says women who have given birth within six months and those going through the perimenopause, are particularly susceptible to painful sex as a result of reduced oestrogen levels. But these groups can also "feel reluctant to talk about sex with their specialists," so the issue may be even higher than suspected. "Some say that sexual difficulties are only relevant if they last for six months or longer... In reality, it can take longer than six months for most to access specialist help."
Around a fifth of referrals to gynaecology clinics are for sexual pain, Dr Frodsham explains. "Women with sexual difficulties will most commonly be referred to gynaecologists. They are unlikely to have had specialist training in this area."
Many women with sexual difficulties are learning to adapt their sex lives accordingly – by accepting that they won't reach orgasm through intercourse because of anorgasmia, or by diverting their focus away from climax as an end goal entirely, for instance. But others are coming up with alternative ways to address the issue and improve understanding on women's sexual experiences. Twenty-two-year-old Caroline Spiegel, the younger sister of Snapchat CEO Evan Spiegel, last month launched a non-visual porn platform for women after experiencing sexual difficulties during her junior year at Stanford University, which arose from an eating disorder.
There are about 30 FDA-approved drugs for sexual dysfunction for men but zero for women, and that’s a big bummer.
"I started to do a lot of research into sexual dysfunction cures," Spiegel told TechCrunch. "There are about 30 FDA-approved drugs for sexual dysfunction for men but zero for women, and that’s a big bummer." In the absence of adequate medical help for women with problems in the bedroom, Spiegel hopes that Quinn, her platform of erotic stories and sexy audio clips, will inject some fleeting pleasure into their lives.
Others are breaking the taboo with comedy. Fran Bushe's new musical comedy Ad Libido at London's Soho Theatre, which runs from 7th-11th May after a sellout Edinburgh run last year, explores Bushe's own experience of sexual dysfunction through her past and present sexual experiences – including men who offer their 'magic penis' to fix her, dubious remarks from medical professionals, dangerous remedies and gadgets, and even a sex camp that the writer attended "after feeling as if there was no help available," as she told the Guardian recently.
Some argue that the narrative about women's sexual health has been hijacked by pharmaceutical companies to sell their products, and that given how common the symptoms of female sexual dysfunction are, the 'condition' shouldn't be classed as a medical issue at all. "In contemporary sexual culture, it seems the line between dissatisfaction and dysfunction is increasingly blurred," wrote journalist Sarah Hosseini last year.
"Women with any level of sexual decline or discontent have been cleverly convinced they are defective and need treatment. As such, feminists and clinicians have started to question the possibility that [female sexual dysfunction] was constructed by pharmaceutical companies through inflated epidemiology and our culture’s sexual illiteracy."