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The following section contains information on:

• What is arousal and how can it change?
• The possible effects of treatment on arousal
• Managing loss of arousal

What is arousal and how can it change?

Arousal is your mind and body becoming sexually excited and responding in anticipation to or during sexual activity. You could feel both mentally and physically aroused at the same time or just individually. Depending on your situation it can be frustrating when you feel turned on and your body doesn’t respond or vice versa when your body responds, but your mind doesn’t. It may feel the most frustrating if you want to be sexual and you don’t experience any arousal at all, either body or mind.

There are different things that can lead to you feeling aroused or turned on, you could be responding to something you’re reading or watching, something someone says to you, a smell or taste that triggers memories, or to being touched. How your brain receives and interprets the messages from your thoughts, emotions and senses will affect how your body responds; this is known as subjective arousal. If these feelings are positive they can stimulate sexual response in your body, but negative feelings can stop sexual responses from happening.

You may find that you can become aroused but can’t maintain that arousal long enough to complete sexual activity. This can be due to a combination of physical and psychological causes. Anxiety, stress and fear can impact on your ability to maintain subjective arousal, which, in turn, can affect your body’s physical responses.

It can be difficult to know if you are physically aroused, as unlike men, who get an erection; women’s sex organs are mainly internal. The physiological processes and responses of the body in genital arousal are the same whether the stimulus is physical, mental or emotional. The nerves in your body react to your thoughts (fantasies, interpretations and perceptions), your senses (touch, smell, taste and vision) and to physical stimulation, causing anatomical changes. These changes include an increase in your heart rate, narrowing of the blood vessels directing blood to your sexual organs, your clitoris enlarging, your uterus elevating, the top part of your vagina ballooning, the rest of your vagina expanding and becomes lubricated, a tensing of your pelvic muscles, your breasts possibly becoming enlarged and your nipples becoming erect.

Since your treatment you may not have experienced changes in your bodily response. For those of you who have, these will range from a minimal impact to a significant impairment in arousal.

The possible effects of treatment on arousal

Any physical changes in arousal will vary depending on your treatment.

Surgically, LLETZ (large loop extraction of the transformation zone) treatment should have no impact compared with the more radical treatments of trachelectomy, hysterectomy or exenteration. Any type of surgery could cause damage to the nervous system, reducing sexual arousal and lubrication. Also removal of your cervix, uterus or the upper part of the vagina may alter how you experience physical sensations. Exenteration will significantly affect how you experience genital arousal.

Radiotherapy can cause thinning, loss of elasticity and decreased lubrication in vaginal tissues. Other changes can include shortening of the vagina and vaginal narrowing (sometimes called stenosis, where the walls of the vagina can stick together), which can impair blood flow that, in turn, inhibit arousal.

Hormonal changes (such as going through early menopause) can also affect arousal, causing vaginal dryness, reduced lubrication and they can slow down your sexual response. Some medications, recreational drugs, alcohol and nicotine can also affect sexual arousal and inhibit lubrication.

Managing loss of arousal

Learning how your body works, including the possible changes will help you understand why you may be experiencing problems. Gaining further insight into the workings and interactions of your mind, body and emotions can help you move toward a more satisfying sexual experience. Plus, seeking help from your CNS or seeing a psychosexual therapist can help with arousal problems.

Mindfulness exercises, learning new ways of thinking about and experiencing sexual activities, and focusing on pleasure and intimacy should be explored in a safe place. Spending longer on foreplay often helps with arousal, as does introducing the tips suggested for intimacy in the earlier section.

You may like to visit our useful links page on sex and relationships.