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4 Common Female Sexual Health Issues: How to Detect Them, and What to Do Next

April 23, 2024 | By: Anne Scott, M.D.

Sometimes, it isn’t a headache.

When it comes to desiring sex, it’s likely that other health issues – urinary conditions in particular – are preventing women from enjoying it. An estimated four in 10 women experience sexual problems at some point in their lives. The causes can range from hormone changes to infections.

And the onset of symptoms can be alarmingly fast. Some women might suddenly notice a drop in their ability to be aroused. Many may experiencing sharp, physical pain.

Often, these events are 100% natural. They also can be treated.

Non-Sexual Health Issues Can Hinder Sex

The act of sex itself has health benefits, research shows. Because it is a form of exercise, sexual activity can lower blood pressure and reduce stress, leading to better sleep. Women who have satisfying sex lives are less likely to have heart attacks, studies suggest.

Addressing changes in sexual desire and experience can therefore improve your overall wellness, including your urinary health. Among the most common urinary issues that interfere with a women’s sexual wellness:

Vaginal pain and discomfort 

Many people associate painful intercourse with a lack of lubrication, but it also can be caused by an infection, an inflamed pelvis, or a lack of estrogen due to menopause. Topical or oral medications and injectable lubricants can help. If the pain is caused by vaginal dryness and atrophy (a byproduct of menopause), topical vaginal estrogen therapy can help. There’s also an outpatient laser therapy called MonaLisa Touch could provide rapid relief in just a few treatments. 

Pelvic prolapse 

Nearly half of all women at some point in their lives develop pelvic organ prolapse, when an organ such as the uterus or upper portion of the vagina drops from position and into the vaginal canal. Sexual symptoms include numbness, a feeling of heaviness or pressure in the pelvis, and even a visual sign of a bulge coming from the vagina. Prolapse can be treated non-surgically through estrogen replacement therapy, pelvic-muscle exercises (Kegels), or a small device called a pessary inserted into the vagina to support the vagina, bladder or uterus. Surgical procedures involve pulling the vagina into position with the support of stitches or mesh.

Interstitial cystitis (IC)

Also called painful bladder syndrome, IC occurs when the protective lining of the bladder breaks down and urinary chemicals leak out. The pain from these chemicals can feel similar to that of a urinary tract infection. Women are 10 times more likely than men to develop IC (although it may be underdiagnosed in men), generally between the ages of 20 and 40. Several therapies can help, including Kegels, oral medications, and Botox injections.

Urinary incontinence

Women who experience involuntary urine leaks might avoid intimacy for fear of having an accident. This in turn can diminish desire and make it difficult to reach orgasm, research has shown. Understanding the type you have – stress incontinence (urine leaks during pressure-related activities) or urge (a strong urge to urinate, which then causes leakage) – can help determine a treatment course. However, women can have both types. Fortunately, there are plenty of treatments, from the conservative (Kegel exercises and pessaries) or placement of a pessary, to a surgery that places a sling-like support beneath the urethra. Also, bulking medications such as Bulkamid®, injected into the urethra, can thicken and strengthen it.

Certain medications 

While not necessarily a urinary-related issue, some drugs can trigger sexual problems soon after starting or stopping them, including those that treat overactive bladder. Other medications that can interfere with sex include those that treat high blood pressure, asthma, hormone imbalances, and depression. 

Sexual Problems are Not in Your Head

Perhaps the worse side effect of sexual problems is the feeling of isolation. Many women who struggle with sexual pain or diminished sex drive blame themselves, or feel inadequate. And they’re less likely to talk about it.

As doctors, we encourage women to talk about it – with their partners, friends, and their healthcare providers. 

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