What No One Wants to Talk About with their Provider

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Wednesday, February 6, 2019

Sexual health is something most patients and providers don’t openly discuss during appointments. But, it’s an important part of overall health and wellbeing.

Studies show that approximately 43% of women and 31% of men experience sexual dysfunction at some point throughout their life. Most assume that sexual health issues like low libido, impotence, painful intercourse, or difficulty having an orgasm are only related to the function of your sex organs, but in reality, there are a number of factors that can impact your sexual health.

A woman’s sexuality is a complex balance of physical and emotional responses that impact how she feels about herself. When a woman has a sexual problem, it can impact many other areas of her life like self-esteem, relationships, confidence, and more. It’s also very common for a woman’s feelings about sexuality to change over time depending on circumstances of stages of life. Like everything in life, sexual function can ebb and flow over time.

Early research on sexual response suggests a traditional linear cycle: desire, arousal, orgasm, resolution. More recent research shows us that a woman’s sexual response is much more complex. A woman’s sexual response is more connected to a relationship and intimacy than a physical need. It’s more connected to an emotional response than previously thought.

Along with a number of factors that impact your emotional health, sexual dysfunction also impacts your physical health. Sexual dysfunction can be related to a lifelong issue or something acquired depending on circumstances or your partner. The most common sexual issue for women is lack of sexual desire or low libido. There are a number of other common sexual dysfunctions women experience as well.

-Dyspareunia Disorder

Frequent pain during or after intercourse. Nearly two out of three women experience Dyspareunia at some point throughout their life. The most common cause is a lack of vaginal lubrication which can be caused by hormonal issues, medications or lack of arousal.

- Female Orgasmic Disorder

Delay of orgasm after sufficient stimulation and arousal. According to the Association of Reproductive Health Professionals, 24% - 37% of women have troubles reaching orgasm.

-Hypoactive Sexual Desire Disorder

This refers to a reduced desire for sexual activity that causes distress or relationship challenges. It’s estimated this occurs in 20% of women.

-Sexual Arousal Disorder

The inability to reach or sustain lubrication during the arousal phase of sexual response. This is the second most common sexual health issue for women, especially for postmenopausal women. Low estrogen levels can reduce blood flow to your genitals. Arousal may take longer and vaginal sensitivity may decline.

-Sexual Aversion Disorder

Avoiding nearly all genital sexual contact with a partner causing distress or relationship challenges. This may affect someone who has experienced sexual abuse, grew up in an atmosphere where sex was not discussed or someone who suffers from a panic disorder.


An involuntary spasm of the muscles near the opening of your vagina, causing pain. This can be caused by medical or psychological factors.


Pain anywhere in the vulva. This can include pain inside or outside of the vulva, itching or burning.

There are many causes of sexual dysfunction for women and men. Psychological, physical, emotional, interpersonal relationships and medications are just a few factors that can cause an imbalance in your system which can lead to sexual health problems. Many times women who are experiencing sexual dysfunction are also experiencing some of these health concerns as well.

Chronic Health Conditions

Chronic health conditions like diabetes, kidney disease or heart disease can cause sexual health issues. A diagnosis can lead to physical or emotional stress and fatigue. Treatments and medications that people with chronic health conditions commonly use can cause a number of symptoms including low energy and low libido.


It’s said that your brain is your biggest sex organ. Stress is one of the most common causes of sexual dysfunction. Stress can not only impact your libido but also your hormones and your mood. Chronic stress can cause your body to produce cortisol, which can lower your libido and make it more difficult to orgasm. Stress can also lead to depression and anxiety which can have negative impacts on your sexual response.

Hormonal Changes

Hormonal changes like perimenopause, menopause, or pregnancy also play major roles in sexual health.  Women over 40 experience a drop in estrogen levels from menopause. This cause vaginal dryness and painful intercourse. Pregnancy also causes a major change in your hormones which can cause low libido, or dryness (especially for women breastfeeding).


Medications or over the counter drugs are also linked to sexual dysfunction. If you are taking multiple medications, the risk of sexual health side effects is even greater. Blood pressure medication, antidepressants, hormones, anti-anxiety medication, statins and fibrates to treat high cholesterol, antipsychotics, and other common medications have been known to interfere with sexual function.

The good news is, nearly all sexual health issues can be treated, most without invasive treatment or medications. A holistic whole-body approach is most effective. In most situations, sexual dysfunction is a side effect or symptom of an imbalance in your body somewhere else. I frequently treat patients suffering from sexual dysfunction with acupuncture and traditional Chinese medicine with great results. There are also a number of other therapies that can be helpful. Physical therapy, pelvic floor exercises, meditation, yoga, psychological support, and supplements can make big changes in sexual health and overall health. It’s also important to make sure you are communicating with your partner, getting enough sleep, eating a healthy diet, reducing stress, and practicing a healthy lifestyle.

Most importantly don’t be afraid to discuss your sexual health with a trusted care provider. Sexual dysfunction is very common, and there is no need to suffer in silence anymore. Sexual health is an important part of overall health. It can impact your health and happiness for years to come.


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