Who hasn't compared her sex life with a friend's and wondered, "Why don't I have sex three times a day? Or five orgasms in one night? Is there something wrong with me or my partner? Am I sexually normal?"
Even though I am a physician, I learned more about sexuality from friends, partners and women's magazines than I did from medical school. The problem with these familiar sources of sexual education is that comparisons can sometimes lead to feelings of inadequacy, even if you are otherwise satisfied with your sex life. You start to wonder if you are normal, and what it means to be normal sexually.
The Elusive Definition of "Normal"
Why is it difficult to define normal sexuality? First of all, it is not as simple as checking a vital sign or lab test. While you can break down the female sexual experience into parts — desire, arousal, vaginal lubrication and orgasm — the problem is that you also need the right mental framework to make these parts work and to feel good about the experience. As many sex experts will tell you, your mind is your largest and most important sexual organ. Your mental state not only affects the physical function of your sexuality, but also interprets whether that experience is a satisfying or unsatisfying one.
Second, defining normal is difficult when there is a wide range of sexual experiences that satisfy different people. Intensity of sex drive or libido can be different for different people but nonetheless be "normal," or even change over time in one person. Some women have few or no orgasms, or no orgasms during vaginal penetration, yet are just as satisfied as women who have multiple orgasms. So the best response to the question "Am I normal sexually?" is often: "Well, do you feel you are normal sexually?"
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Questions To Ask Yourself
If you have doubts about whether your sex life is at its best, or are worried about the possibility of sexual dysfunction, here is where your physician, not your friends, can be your best source of help and understanding. Health care professionals screen for sexual dysfunction with a few basic questions:
- Are you sexually active?
- If no, does that bother you or your partner?
- If yes, then do you or your partner have a question, problem or concern about your sexual activity?
- Have there been any changes in your sex life?
- Do you have any discomfort or problems with intercourse?
- Are you having any difficulties such as decreased vaginal lubrication, pain with intercourse or diminished sexual desire?
If the answer is "yes" to any of these questions, it is worth making an appointment with your health care professional to ask why.
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What could it be? It might be an underlying condition that is dampening your drive or making intercourse uncomfortable. It also might be a hormonal change that is affecting your libido, vaginal lubrication or the vaginal wall. Other conditions or medications can interfere with sexual functioning. Some conditions that can affect sexual experience include:
- Pregnancy or hormonal changes from breastfeeding
- Hormonal problems, for example disorders of thyroid or prolactin hormones
- A previous surgery
- Sexually transmitted diseases
- Medical problems such as peripheral vascular disease, inflammatory bowel disease or irritable bowel disease
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It Takes Two
Whether or not you have a physical or hormonal problem, you also might benefit from the help of a psychologist or a sex therapist. In addition to sorting through any psychological or mental blocks affecting your sex life, you can learn to understand what makes your sex life satisfying and how to communicate your needs to your partner.
People often do not appreciate that sex is a learned activity, and each partner must learn how to satisfy the other person. Partners should expect to talk and listen to each other in order to get the best experience for both people. No matter how much experience either person has, a new partner often means starting over.
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The Bottom Line
In the end, there are no hard and fast answers to the definition of a "normal sex life." But if you have any doubts, it might be better to see your doctor than to look to friends, magazines or television. So, the next time you see your health care professional for a check-up, bring up the topic of sex. Ask your doctor, "Am I sexually normal?" You'll probably find that you are, and you may find ways to make your sex life even better.
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Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.