Finding confidence to talk to your provider
Dr. Sasha Davenport, OB-GYN and director of Atrium Health Women’s Care Sexual Health, and Rachel Murray, nurse practitioner at the same practice, want to provide women with more information about their sexual health and give them the confidence to talk about it with their provider.
Davenport and Murray say there are estimates that 43% of women, or even likely more, experience some type of sexual issue – ranging from painful intercourse to lack of desire, arousal or orgasm. Some suffer indefinitely, but women still struggle to discuss it with their doctor. Often, they convince themselves there’s nothing to do but accept the unacceptable.
Davenport and Murray want to change the way women view and talk about their sexual health. This starts by addressing some of the key questions women often have.
Am I alone?
“Patients are often surprised by how common female sexual issues are,” says Davenport.
Most people associate these issues only with menopause, which officially starts once you go a year without a period. But Davenport notes that women can experience sexual issues at any age. It’s particularly common under these circumstances:
- Pregnancy and postpartum
- Chronic conditions like diabetes or heart disease
- Acute medical conditions such as cancer
- Major life events or stressors, including marriage, job change, fertility treatment, miscarriage or other loss
- Post gynecologyor urogynecology surgery
“It is not uncommon to see women at our practice who have been struggling for years with pain, low libido and arousal,” Davenport says. “They think they have to live with this dissatisfaction, but that is far from the truth.”
What is female sexual dysfunction?
Women who find these issues are affecting their quality of life are typically diagnosed with female sexual dysfunction. According to Davenport, about 12% of women fall into this category. They can suffer from four types of female sexual dysfunction:
- Interest and arousal disorders:You have a reduced libido or trouble being aroused by sexual activity
- Geneto-pelvic pain and penetration disorder:You experience pain with sexual intercourse, most often during or after menopause.
- Orgasmic disorder:You aren’t able to reach climax, or orgasms are less frequent or intense than desired.
- Medication-induced dysfunction:A prescription drug causes the issue, in particular those that treat high blood pressure, allergies, depression, anxiety, bi-polar disorder or seizures.
“It is also important to note these issues are common for women who undergo treatment for cancer or cancer for prevention,” says Murray. “This pertains to women who have both ovaries removed prior to menopause, surgery for cancer or any medications that may be used to treat the problem.”
How is female sexual dysfunction diagnosed and treated?
Once your provider knows you’re having problems with sex, they’ll likely screen you to pinpoint your concerns or issues. Next, your provider will take a comprehensive medical history that includes questions about your sexual past and present. A physical exam follows and possibly some lab work if it’s warranted.
Treatment for female sexual issues or dysfunction varies depending on what you’re experiencing. Davenport and Murray recommend a multidisciplinary approach. This often includes a therapist who can help identify any non-anatomical causes, as well as work on improving communication between you and your partner.
Dr. Erika Warren a physical therapist at Atrium Health Women’s Care Sexual Health, says that pelvic floor physical therapy is a great option to address any musculoskeletal issues that may be contributing to your symptoms. This can include exercises and modalities to relax or strengthen the pelvic floor muscles, depending on your specific needs.
Lifestyle changes are another important component of treatment. Physical and mindfulness exercises can help alleviate stress and improve sleep patterns, moods and body image issues, all of which can contribute to female sexual dysfunction.
In addition, there are two FDA-approved drugs that treat lack of female sexual desire: Addyi and Vyleesi. Women suffering from painful sex might be prescribed vaginal estrogen creams, trigger point injections or erbium laser therapy to relieve dryness, discomfort and pain. There are also some surgical options that your doctor may recommend.
What can I do if I’m having a sex-related issue?
Davenport encourages women to talk to their gynecologist at their next well or sick visit. If your physician doesn’t bring up sexual health during your appointment, she suggests using the following icebreaker: “I have a few questions about my sexual health. Is it okay to discuss that today, or would you like me to make a separate appointment?”
Davenport and Murray have put together a reading list for issues related to sexual health that includes:
- Come as You Are by Emily Nagoski
- Sex Matters for Women by Sallie Foley, Sally A. Kope and Dennis P. Sugrue
- The Body Keeps the Score by Dr. Vessel Van Der Kolk
- Heal Pelvic Pain by Amy Stein
To make an appointment call Atrium Health Women’s Care Sexual Health practice at 704-304-1176.
