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Providence Health & Services
Swedish Health System | Seattle, WA
Kadlec Regional Medical Center | Richland, WA
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Women: Taking control of your sexual health

Sheryl A. Ross, M.D., “Dr. Sherry,” is an award-winning OBGYN affiliated with Providence Saint John’s Health Center. 

Women’s sexual health is important and often not put at the top of your “to do” list. Between motherhood, work, financial stress, relationship obstacles and choosing a good night’s sleep over sex before bedtime, women are not paying enough attention to their own sexual health. For millions of women in the United States, sex is no longer a fun or pleasurable experience.

Women are not talking about sexual health or making it a priority. It may give you comfort knowing that 40 percent of your girlfriends are having some sexual difficulties as well. Depending where you are in life, sexual health issues create a roadblock. It may surprise you that 10-to-50 percent of women have never had an orgasm. You may wonder how this is possible, but talking about sex and sexual dysfunction is not a comfortable conversation with your partner, your BFF or your health care provider. Half of women never share this information with their health care provider, or anyone else for that matter. 

Your 20s are spent trying to understand your body, your sexuality and your ability to feel and receive pleasure. Every woman in her 20s is quietly trying to figure out what is “her” normal. According to a recent study from the University of Montreal, sexual desires and behaviors that are considered abnormal in psychiatry are actually the norm. So, unfortunately, there’s no one-size-fits-all answer when it comes to sexual norm, but there is a way to help you understand your own normal—your own sexuality.

Our sexuality is as part of our lives as is eating and sleeping. Sexuality is an important aspect of our well-being, and in a healthy, romantic relationship it’s as important as love and affection. Enjoyable sex is learned. Sure, there’s instinct and maybe a dusting of magic involved, but you don’t magically have an orgasm without having an active role in making it happen. You and your partner have to acknowledge each other’s likes and dislikes, and learn how to satisfy each other. Open and honest conversations are necessary to make the sexual experience optimal for both of you, whether you have multiple partners or self-esteem to spare. 

Hypoactive sexual desire disorder, the most common female sexual dysfunction, is characterized by a complete absence of sexual desire. For the 40 million women who suffer from this disorder, the factors involved may vary since sexual desire in women is much more complicated than it is for men. Unlike men, women’s sexual desire, excitement and energy tend to begin in that great organ above the shoulders, rather than the one below the waist. It’s not a myth after all that women are more complicated than men.

Health benefits of sex

There are very few things better in life for your heart, body and soul, literally, then consensual sex. Emotionally, sex is comforting, calming, relieves stress, reduces anxiety and boosts your confidence and overall sense of well-being. It’s also thought that regular sex allows women and men to look younger and live longer. There are many physical benefits. For starters, the act of sexual intimacy can be a great workout and count as such for many as their daily exercise regimen. If women incorporate Kegel exercises during sex, this helps strengthen the pelvic floor, improves bladder control and heightens both your and your partner’s orgasms. Other medical benefits of regular sex is it makes for a stronger immune system, fighting off common illnesses such as colds and having fewer sick days from work. Regular sex helps lower your blood pressure and lowers your risk of heart attacks. Sex stimulates the vagina’s natural secretions and increases blood flow. The natural lubrication created by the vagina keeps the integrity of the tissue healthy and strong.

In addition to life stressors, women also experience hormonally driven cycles in their lifetime that drastically affect and interfere with their sexual health. Examples of the most disruptive hormonal cycles that affect our sexual health include pregnancy, postpartum, perimenopause, menopause, and what I refer to as maturity.

Sex in pregnancy is completely safe for low risk women. There are misconceptions that sex can cause a miscarriage, so pregnant women and their partners are often afraid to have sex during pregnancy. Men are often terrified to have sex with their pregnant partners for fear of hurting the baby. Many believe women are more sexual during their pregnancy, but in truth this doesn’t seem to be the case. Women often lack an interest in sex and prefer to be held, cuddled and kissed during pregnant. Extra weight gain makes pregnant women feel depressed and less sexy. Breast enlargement is loved by husbands and partners but typically not by the pregnant woman. Women worry that an orgasm can lead to a miscarriage, preterm labor or premature rupture of membranes. Each trimester brings a whole new set of circumstances that sets the stage for sex and intimacy obstacles.

Postpartum is the least talked about time during the pregnancy cycle. From the moment the baby is delivered until the body completely recovers is the postpartum period. At the six-week postpartum visit you see your obstetrician for an exam, Pap smear and birth control and now are given permission to have sex and get back into the bathtub again. For the majority of women, the bathtub sounds great while the thought of having sex again is the last thing on their mind. If you had a vaginal birth, your vagina is finally healing from the trauma of the delivery. If you are breastfeeding, you are still in “postpartum menopause” meaning you have no libido and your vagina is dry. It’s probably been at least six weeks since you last had any sexual intercourse so the vagina, even though it has a great memory, will take some time to get back on track. Sex is usually the last thing that you are interested in doing but with patience, time and KY, it will feel enjoyable again. 

Perimenopause is the time period your body transitions, hormonally, physically and emotionally into menopause. Every woman’s experience is different and can last up to 10 years before getting into full blown menopause. If you are aware that you might have irregular and heavy periods, emotional ups and downs, night sweats and insomnia, you won’t be so surprised that you are also not that interested in sex. When you enter the next chapter of life, called menopause, your estrogen and testosterone levels both drop, affecting your desire to be sexually intimate. Over 60 percent of women will report losing their libido. You are being bombarded with physical and emotional symptoms that directly affect your mood in the bedroom. Many women would rather be doing the laundry than having sex with their partner. This can create a lot of disruption in a relationship since over 30 percent of women stop having sex all together. The birth control pill, hormone replacement therapy, self-awareness and education can ease this hormonal cycle.

Menopause typically occurs around the age of 51. When you transition into menopause and decide not to be on hormone replacement therapy, the vagina suffers dramatically. Often, the hot flashes will improve over time but vulva-vaginal atrophy only worsens. In the vagina specifically, estrogen increases blood flow to the tissue, thickens the vaginal walls and helps with overall lubrication. With menopause and the loss of estrogen stimulation in the vagina, the tissue becomes dry and pale. The medical term for this is vulva-vaginal atrophy (VVA). As a result, intercourse and other forms of vaginal contact become painful and often impossible. There are many treatment options including HRT, vaginal laser and lubricants that can help with VVA.

Maturity is the hormonal cycle in a woman’s life beyond the first 10 to 15 years of having a menopause diagnosis. For those women taking HRT, sexual desire, intimacy and orgasm potential is easier than those women who are not taking HRT. For women who are not taking HRT, the physical side effects of aging including VVA can make sexual contact painful and less enjoyable. The labia of the vagina can become fused, and the vagina and clitoris shrink. VVA is damaging to intimacy, often making intercourse impossible, and has a harmful effect on emotional and physical health. For many women, sexual desire and excitement is still going strong. During these years of peaked maturity and confidence, you may be at your full pleasure potential with sexual satisfaction and exploration.

Women’s sexual health has to be made a priority in life. Despite life’s expected obstacles and hormonal challenges, a sexual and intimate life reminds you that your body deserves to be celebrated for healthy aging and longevity.

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Categories: Women's Health
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