EXCLUSIVE: Most common sexual health problems women must be aware of according to a Gynaecologist

Updated on Jul 28, 2021 10:08 AM IST  |  121.6K
EXCLUSIVE: Most common sexual health problems women must be aware of according to a Gynaecologist

1 in 3 young and middle-aged women and around 1 in 2 older women would have some sexual health issues at some point in their lives. The reasons for sexual health issues in women could be physical or psychological or even hormonal. With awareness and guidance from the right healthcare professionals, all sexual health issues can be managed. However, the first step to addressing any health issue is to become more aware and proactive about your health.

Female sexual dysfunction
Female sexual dysfunction is an umbrella term that includes issues that inhibit satisfaction from sexual activity. When these problems become too recurrent and persistent, they could hamper your sex life and cause distress for both you and your partner.

The main types of sexual dysfunction include:
Reduced sex drive: With the loss of libido, you feel a lack of interest in sex.
Inability to get aroused: You find it difficult to get physically aroused or maintain arousal during sexual activity.
Lack of orgasm: You have difficulty reaching a sexual climax or orgasm even after enough sexual stimulation.
Pain during sex: In dyspareunia, you experience immense pain in the genital or pelvic area during sexual intercourse. In case of conditions like vaginismus, the painful vaginal muscle spasms prevent penetration.

There are many causes of female sexual dysfunction
Medical conditions: Suffering from chronic medical conditions like diabetes, heart disease, liver or kidney disease can lead to sexual dysfunction. Similarly, untreated STIs or vaginal infections and conditions like endometriosis, vulvovaginal atrophy, or lichen sclerosis can also cause sexual problems.
Psychological causes: Dealing with immense stress, anxiety, or depression can cause sexual problems. Having frequent conflicts with your partner or past sexual trauma can also hinder your sex life.
Hormonal imbalances: With ageing and menopause, your estrogen levels continually decline. The vagina becomes dry and itchy, and the vaginal walls become thinner and less elastic, making sex painful and uncomfortable. Loss of estrogen also takes a toll on sexual desire and the ability to become aroused.
Pregnancy: After pregnancy and during breastfeeding, the changing hormone levels cause vaginal dryness and affect your sexual interest. Vaginal trauma such as surgical incision made to aid childbirth can prevent you from engaging in sexual activity.
Medications: Taking medications like ​​high blood pressure drugs, antidepressants, antipsychotic medications, epilepsy drugs, cancer drugs, steroids can cause sexual dysfunction.
Insufficient foreplay: Lack of foreplay before penetration will not produce enough vaginal lubrication. It can cause painful sex and ultimately create a lack of desire for it.

How is female sexual dysfunction diagnosed?
The doctor may collect your medical and sexual history, followed by an evaluation of symptoms through various tests.  
Pelvic exam: The doctor may perform a pelvic exam to check the status of the reproductive organs.
Pap smear: This test is done to detect cervical cancer.
Blood tests: It helps rule out any medical problems that may be contributing to sexual dysfunction.
Sonography: Sonography or ultrasound is performed to assess the internal organs.
Psychological assessment: It is done to understand your thoughts regarding sex. It helps evaluate other possible contributing factors like fear, anxiety, past sexual trauma or abuse, relationship problems, alcohol or drug abuse.

Sexually Transmitted Infections (STIs)
Sexually Transmitted Infections (STIs), caused by bacteria, viruses or parasites, are passed from one person to another through sexual contact (oral/ anal/ vaginal).
They spread via the exchange of blood, semen and other body fluids during vaginal, oral, and anal sex or intimate physical contact. These infections can also be transmitted non-sexually from mother to infant during pregnancy or childbirth. Blood transfusions and sharing needles are possible risk factors too.

How are STIs diagnosed?
Since many STIs usually do not produce any significant symptoms, testing is the only way to detect them. A sexually active person should get tested at least once every year to prevent long-term consequences of STIs like pelvic inflammatory disease, infertility, cervical cancer.

How are women's sexual health problems treated?
There are various treatments and techniques available to manage sexual dysfunction.
Nonmedical treatment
Learn about your body: Getting equipped with information about the human body, sexual function, body changes, and sexual behaviours.
Communicate with your partner: Talking to your partner about your preferences and struggles.
Adopt healthy lifestyle habits: Limiting alcohol, being physically active and engaging in stress-relieving activities.
Go for sex therapy: Taking therapy is another way of resolving sex problems
Practice kegel exercises: These can strengthen your pelvic muscles and help you achieve a better orgasm.
Introduce changes in your sex life: You can make sex less painful and more pleasurable with the help of lubricants and trying sexual positions that allow the woman to control the depth of penetration. Using a vibrator for clitoral stimulation can improve arousal.

Medical treatment
Go for an annual sexual health check-up: By early examination and treatment, you can avoid complications. Hence, make sure to go for annual STI testing and sexual health check-up.
Get treated for other medical problems: If you have any other medical problems, take measures to treat them.
Hormone replacement therapy (HRT): A short course of HRT may improve certain conditions, such as loss of vaginal lubrication and genital sensation.

Alternative medicine
A few techniques like mindfulness, acupuncture and yoga may help in improving the blood supply to the pelvic region and enhance sexual function.
In conclusion
Sex should be pleasurable, but if you frequently connect it with the opposite attributes like pain and discomfort, it is time to seek help and prevent its negative impact on your relationship. As far as STIs are concerned, regular testing is recommended. Focusing on your sexual health is crucial for both you and your partner’s overall well-being.

About the author: Dr Nimmi Mahajan, Lead Gynaecologist, Proactive For Her

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