How to Talk About Sex with Your Doctor
By: Dr. Alyssa Dweck
Surprisingly, women have never been too keen on bringing sexual concerns to their health care provider’s attention. Some feel embarrassed or ashamed; while others suspect nothing can be done about their issues anyway, so why bother. One thing is certain; sexual issues can be quite distressing and do negatively impact quality of life.
Believe it or not, health care providers are not so great at asking their patients about sexual health either. They cite limited time, lack of sufficient training on the subject and paucity of available treatments to offer. These facts have been confirmed in research; but there’s good news, the tide is changing, ladies, and there has never been a better time to talk about sex!
Who better to discuss sexual concerns with than your gynecologist? After all, it’s not out of bounds to discuss contraceptive needs or to screen for sexually transmitted infections (STIs). These are surely sexual health issues. Moreover, your gynecologist has likely seen you through various, significant life stages, some very personal…your first sexual experience, your first pregnancy and even your transition hormonally towards menopause. This allows for a tight bond and trust.
The most common sexual health concerns have remained constant over time, although diagnostic and medical terms have varied. Low sexual drive, vaginal dryness and pain, dyspareunia or pain during intercourse and weakened or absent orgasm are typical complaints. Each can present itself as an isolated complaint, but more commonly they are interrelated. In fact, one sexual complaint often begets another. As an example, pain during sex due to vaginal dryness can eventually lead to avoidance and lower drive. Once the dryness is treated, the pain resolves and libido returns.
A direct conversation is usually best when dealing with complaints of this nature. Women should ideally come to their appointment prepared, with questions or concerns written down in case they feel nervous once in the office. Without counting on Dr. Google too much, do your homework so you are better able to articulate your needs. By the same token, your health care provider should ask specific questions during a patient intake. For example, something simple and straightforward, such as, “Are you sexually active and if so, do you have any concerns about it?” is a good icebreaker and normalizes the issue. Sexual activity refers to sex, partnered or solo. Sex can also mean intercourse or other activity aka “outercourse.”
A more detailed, thorough history may elicit specific information about pain, dryness or drive. In order to best understand and be able to help, a candid conversation is vital. Your doctor may have some general advice to assist. A common and usually easy fix for vaginal dryness and painful intercourse for example, might be a non-hormonal vaginal moisturizer, such as Revaree®, designed to be used every 2-3 days as needed, for the treatment of vaginal dryness and associated symptoms of burning, irritation and painful sex. Some women are looking to enhance their satisfaction, more specifically to improve their orgasm and physical arousal, and Ristela®, a dietary supplement designed to enhance blood flow to the genitals, has been clinically shown to accomplish this in the right candidates.* Many women have sexual concerns, and your gynecologist has probably heard yours before, so there is no reason not to be open with them about it.
Sexual health concerns are often complex with multiple variables to consider. With that said, don’t be surprised if your doctor suggests several visits to evaluate, treat and follow up. Oftentimes a second opinion or consultation with a sexual medicine specialist is advised.
All in all, sexual concerns are important. Since sexual health and general health go hand in hand, it behooves us all to discuss the subject without hesitation.
Alyssa Dweck, MS, MD, FACOG, Bonafide Medical Advisor, is a practicing gynecologist in Westchester County, New York. She provides care to women of all ages and has delivered thousands of babies. A graduate of Barnard College, she has a Master’s Degree in Human Nutrition from Columbia University and her Medical Degree from Hahnemann University School of Medicine in Philadelphia, now named Drexel University. Dr. Dweck currently practices in Mount Kisco, NY and Carmel, NY and admits to Northern Westchester Hospital in Mount Kisco, NY. She has been voted “Top Doctor” in New York Magazine and in Westchester County and has co-authored three books to date: “The Complete A to Z for your V,” “The Sexual Spark,” and “V is for Vagina.”