Abuse by your partner. Physical or emotional abuse from your partner is a serious threat to the entire relationship, not just the sexual component. Neither type of abuse should be tolerated. If you have suffered or been threatened with physical abuse by your partner (including sexual activity without your consent), seek help as soon as possible. Many community outreach groups and safe shelters for victims of domestic violence are available to help you deal with immediate threats and explore your options for the longer term. See “Resources for More Information” at the end of this program for more information.
Emotional abuse—such as bullying, intimidation, or a pattern of intentionally upsetting comments—is usually more subtle but can be just as damaging to your self-esteem and well-being. Emotional abuse can seep into the sexual aspects of a relationship through criticism of a partner’s attractiveness or sexual performance. Other times broader relationship problems can lead the abusing partner to withhold sex or become manipulative about some aspect of sex as a way of gaining the upper hand or demeaning the other partner. Emotional abuse and the anger and resentment it can generate can certainly undermine sexual motivation, dampen arousal, and take the pleasure out of sex for the abused partner.
Emotional abuse is not acceptable for a healthy relationship, so steps should be taken to end the abuse and overcome the issues underlying it. Communication with your partner is a prerequisite for this, but often it will not be enough. Individual or couples counseling—including sex therapy, if appropriate—can be helpful, as discussed in the next section of this program.
About 1 in 6 women report experiencing a rape or attempted rape at some point in their lives.
Past sexual abuse. Many women have been sexually abused, and this abuse often has long-lasting effects on their feelings about sex. Experts believe that roughly 20% of girls experience childhood sexual abuse, defined as sexual activity (including fondling) for which the girl did not give consent, is not prepared for developmentally, or cannot understand. Because children often keep sexual abuse to themselves, this figure is likely an underestimate. Furthermore, about 1 in 6 women report experiencing a rape or attempted rape at some point in their lives, and this too is likely an underestimate because of frequent underreporting of rape.
Sometimes sexual problems will crop up suddenly in a survivor of sexual abuse after years of a good sexual relationship.
Sexual abuse is traumatic and can result in a general aversion to sex that lasts for many years. In other women it can result in physical effects, such as chronic pelvic pain or the involuntary contractions of vaginismus. Sometimes sexual problems will crop up suddenly in a survivor of sexual abuse after years of a good sexual relationship with her partner, often as a result of an important change in the relationship, such as marriage, the birth of a child, or menopause.
The complexity and deep psychological underpinnings of abuse-related sexual problems can require a counseling plan for both the abused woman and her partner, either separately and/or in couples therapy or sex therapy.