It’s not unusual for women to experience issues related to sex, such as painful intercourse or lack of desire. But unlike male sexuality, which is freely discussed, female sexual health remains a largely taboo topic that keeps women from seeking help.

Women's Health | 5 months ago

Psst! Let’s Talk about Female Sexual Health

It’s not unusual for women to experience issues related to sex, such as painful intercourse or lack of desire. But unlike male sexuality, which is freely discussed, female sexual health remains a largely taboo topic that keeps women from seeking help. Sasha Sabir, MD wants to change that by providing women with more information about their sexual health and giving them the confidence to talk about it with their doctor.

As many as 43% of women 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.  

Sasha Sabir, MD, an obstetrician and gynecologist at Atrium Health Women's Care Sexual Health, wants 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 Dr. Sabir. Most people associate them only with menopause, which officially starts once you go a year without a period. But Dr. Sabir 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 gynecology or urogynecology surgery

What is female sexual dysfunction?

Women who are distressed by sexual issues for over six months are generally diagnosed with female sexual dysfunction. According to Dr. Sabir, 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.

How is female sexual dysfunction diagnosed and treated?

Once your doctor knows you’re having problems with sex, they’ll likely screen you to pinpoint your particular concerns or issues. Next, your doctor 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. Dr. Sabir recommends a multi-disciplinary approach. This often includes a therapist who can help identify any non-anatomical causes and also work on improving communication between you and your partner.

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 CO2 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?

Dr. Sabir 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?

The American College of Obstetricians and Gynecologists (ACOG) is another great resource for questions about female sexual health, including about menopause and painful sex. Dr. Sabir also offers her own reading list for patients that includes:

To make an appointment with a gynecologist or to learn more about Women’s Care at Atrium Health, visit online here.