Sexual Dysfunction: A Need For Difficult Discussions

By Misti Crane
The Columbus Dispatch, Ohio.

You might think that once you’ve been in the stirrups in your gynecologist’s office, anything would go conversation-wise.

But many women don’t bring up their sexual troubles, experts say. And not all doctors are stellar at starting the conversation.

Another problem is that there’s no little blue pill that promises everything will be better for women in the bedroom.

Meanwhile, they go without help for all kinds of sexual problems, from diminished libidos to painful sex.

Sexual problems are common and can arise and change throughout a woman’s life, said Dr. Margery Gass, an OB-GYN and consultant at the Cleveland Clinic Center for Specialized Women’s Health.

Aging, hormonal changes, stress, relationship trouble, illness (including depression and gynecologic and breast cancers) and a history of negative sexual experiences all can contribute.

Sexual problems in reproductive years can be linked to contraception, childbirth and breast-feeding, the last of which drops estrogen levels. Menopause also brings a precipitous decrease in estrogen, which can lead to vaginal dryness and uncomfortable sex, said Gass, executive director of the North American Menopause Society.

Research has shown that as many as 43 percent of women will experience some sort of sexual problem at some point in their lives, and that most think they’ll embarrass their doctor if they bring it up, said Dr. Brett Worly, an OB-GYN who focuses on sexual health at Ohio State University’s Wexner Medical Center.

“This is something that’s really common, and it’s really difficult to talk about,” said Worly, who recently lectured on the topic.

Sexual-health problems are complex, though. They can arise from physical problems, but also often are deeply linked to psychological obstacles and the health of relationships.

“It’s really complicated, and it’s variable for each individual,” Worly said.

On top of that, what constitutes a healthy sex life is not some static, easily definable thing. It’s different for each woman.

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