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Three sexual health concerns for women: exposed

Lankenau Medical Center March 16, 2015 General Wellness

Although you’re supposed to be able to talk to your gynecologist about anything, some women are still hesitant to bring up questions or concerns regarding their sexuality.

“Sexual issues are very common to women of all ages. If there is something that’s bothering you or affecting your relationship, then it’s absolutely worth getting evaluated and seeking treatment,” says Lynn Wang, MD, a gynecologist and certified sexuality counselor at Lankenau Medical Center. “Healthy sexuality is an important part of quality of life.”

Below, Dr. Wang outlines three common sexual issues that women have, and what you can do to solve them.

Vaginal dryness

When estrogen levels drop during a women’s lifetime, this causes a women’s vaginal lining to thin out and result in vaginal dryness. This may occur with breastfeeding, but is particularly common before and after menopause. Certain medications, such as allergy drugs and cancer treatments can also worsen the condition. Common symptoms are burning, itching and soreness, but dryness can also cause pain and light bleeding during intercourse. The first line of treatment for dryness is an over-the-counter moisturizer or lubricant.

"Vaginal moisturizers are used two to three times per week to keep the vaginal lining supple," explains Dr. Wang. "Lubricants, on the other hand, are used only with sexual activity. Look for lubricants that are water or silicone-based, as oil-based products can break down latex condoms."

If your symptoms of vaginal dryness persist, talk to your doctor about other options.

Painful intercourse/penetration

Painful intercourse or penetration occurs in nearly a third of all women at some point in their lifetime. Many women are familiar with some causes, like endometriosis, uterine fibroids, or vaginal dryness. But a lesser-known cause of pain is called vaginismus, or vaginal muscle spasms. Women often describe the condition as though there is a "wall" in the vagina during intercourse or penetration.

"Vaginismus can stem from a number of different things: emotional, physical, or sexual trauma, gynecologic surgeries, gastrointestinal and urologic problems, and more," says Dr. Wang. "Fortunately, there is treatment for this, and it doesn't necessarily involve added pain, surgery, or medication."

Talk to your gynecologist about any pain you feel during intercourse or vaginal penetration. They can help you determine the cause.

Lack of desire

Lack of desire is the most common sexual problem that women report.

“It’s important to understand what is normal female sexual functioning first,” explains Dr. Wang. “Some women have desire, which then leads to arousal. However, many other women, especially older women or those in long-term relationships, do not have much desire until after they are aroused. Either way, both of them are completely normal."

If, however, a low level of sexual interest is bothersome, or affecting your relationship, there are things that you can do to change it. Dr. Wang suggests exercise, which has been found to boost testosterone levels, as well as purposely creating time for reconnection, setting aside the digital devices, and mentally turning off your 'multi-tasking mode.' If your symptoms persist, then a thorough evaluation of any biologic, psychological and relationship factors will help tailor treatment options.

“A good place to start is your gynecologist, or primary care doctor, if they are comfortable with women's care,” says Dr. Wang. “They may make some recommendations, or refer patients to a sex counselor or sex therapist, depending on the primary issue. Sex counselors are usually health care providers trained to address the biological aspects of sexual health, and sex therapists are mental health care providers trained to address the psychological issues. In truth, many sexual issues have a combination of biological and psychological contributors, and so a multidisciplinary approach is one of the best ways to address sexual issues.”