Sexual Health: 10 Things Doctors Want You to Know
When it comes to sexual health information, it goes beyond the simple matter of intercourse. Sexual health also involves sexually transmitted diseases, reproductive health, LGBT health, sexual dysfunction, and more. To fully and adequately address the various aspects of sexual health, it’s important to find a doctor well-versed in this specialty. Doctors want patients to know sexual health is not a simple matter, and patients should not be afraid to address it.
1. “It is critical to find a specialist in the field of sexual medicine.”
When experiencing issues related to sexual health, it is important to find a specialist in sexual medicine, particularly for women and members of the LGBT community. While men can readily be treated by a primary care physician, female sexual dysfunctions should be evaluated by a physician experienced in the area, says Dr. Harin Padma-Nathan, developer of Viagra and chief medical officer of MANNA Molecular Science in Mansfield, Mass. For women, this often is their gynecologists. “Such experts will be comfortable with asking the appropriate questions in a sensitive manner and communicate your options for diagnosis and treatment.” Likewise, LGBT patients should seek out physicians knowledgeable about issues and social factors unique to LGBT health, he says.
2. “The prevalence of sexual dysfunctions is as high in women as in men.”
Although it doesn’t attract as much attention as male sexual dysfunction, many women also suffer from sexual dysfunction. “Approximately 43% of American women report experiencing sexual problems with 12% considering this problem to be so bothersome that it leads to personal distress,” Dr. Padma-Nathan. “The prevalence of female sexual distress increases through middle age, from approximately 10% among women ages 18 to 44 years to a peak of 15% among women ages 45 to 64 years.” If you experience sexual problems, from pain to displeasure, talk with your doctor about getting an accurate diagnosis and exploring treatment options.
3. “Treatment of erectile dysfunction should start with identifying the cause.”
There is no shortage of treatments available for erectile dysfunction, but the first step should be addressing the cause, says Dr. Paul Gittens, MD, FACS, founder of Centers for Sexual Medicine and Wellness in Philadelphia and New York City. “That would be to lower weight, stop smoking, control sugar levels for diabetics, exercise and diet,” he says. “This may reverse ED or at least slow the progression of ED so it may be easier to treat. In terms of treatment, there are oral pills, urethral suppositories, injection therapies and penile implant. They are all effective, and they have their role, depending on how severe a man’s ED is.”
4. “Erectile dysfunction may appear beyond intercourse.”
While erectile dysfunction may appear during intercourse when the man cannot initiate or maintain an erection, signs of ED may appear outside of intercourse. “For some men, one of the first signs can be their loss of morning and nighttime erections or loss of spontaneous erections throughout the day,” Dr. Gittens says. “Morning and nighttime erections are important because they provide the penis with needed oxygenated blood to help nourish the muscle and tissues in the penis. Thus, morning and nighttime erections help to provide a healthy environment for intentional erections for intercourse.”
5. “Erectile dysfunction could indicate medical problems elsewhere in the body.”
While it’s a main factor in measuring sexual health, erectile dysfunction can be a barometer of what could be occurring in the rest of the body. “We know ED can be associated with depression, high cholesterol, diabetes, cardiovascular disease, hormonal problems and smoking, to name a few,” Dr. Gittens says. “Thus, the better we take care of our body, the better and longer throughout life men will be able to rely on their erections. In multiple studies time and time again, it has been proven that diet and exercise are two key components to better erectile function.”
6. “STDs are the ‘silent killers’ of fertility.”
Sexually transmitted diseases often are seen as inconveniences, but the effects can be much worse. “STDs are usually caused by the bacteria gonorrhea or chlamydia and are the ‘silent killers’ of fertility because most of these infections are without symptoms,” says Mark P. Trolice, MD, director of Fertility CARE: The IVF Center in Winter Park, Fla. “The initial symptoms of STDs are mild: vaginal discharge with odor and burning on urination. In addition to the immediate consequences of an STD, such as fever, abdominal and/or pelvic pain, and painful urination, the more extensive complications of STDs are pelvic scarring, blocked fallopian tubes, and possibly hospitalization for pelvic inflammatory disease.”
7. “Suppressive therapy for herpes can decrease the risk of transmission.”
In many cases, physicians offer treatment that addresses herpes during an active outbreak, but ongoing treatment could be more beneficial. “Suppressive therapy (an antiviral therapy taken daily) for herpes can decrease the risk of transmission to partners by 50%,” says Kristy Goodman, MS, MPH, PA-C, co-founder and CEO of PreConception Inc. in Los Angeles. “With 1 in 6 women in the U.S. suffering from genital herpes, this is important for patients and their partners to know.” With daily therapy, patients tend to experience few to no outbreaks, plus there are few risks to taking the medication on a daily basis, Goodman adds.
8. “Unprotected sex can lead to vaginal discomfort and odor.”
While intercourse is a natural bodily function, it sometimes can still result in vaginal discomfort for the woman. “The introduction of semen into the vagina can throw off vaginal pH,” says Maria Sophocles, MD, Ob/Gyn and founder of Women’s Healthcare of Princeton in Princeton, N.J. “Imbalanced pH can lead to discomfort, profuse discharge, and socially embarrassing odor.” Treatments can include medicines that balance pH. “If the odor persists, you should see a clinical provider to check for bacterial vaginosis or an infection,” Dr. Sophocles adds.
9. “UTIs are very common among sexually active women.”
Unfortunately, for many sexually active women, urinary tract infections can recur often. “When diagnosed with a UTI, your healthcare provider will prescribe an antibiotic that will deplete your body of both its good and bad bacteria,” Dr. Sophocles says. “This can sometimes have an adverse effect, with the imbalance causing yet another infection.” In these cases, treatment may include a vaginal probiotic that balances yeast and bacteria every day to normalize the delicate vagina flora, she adds.
10. “That yeast infection may not be, in fact, a yeast infection.”
In many cases, women who think they have a yeast infection actually suffer from bacterial vaginosis, a proliferation of “bad” bacteria, often caused by an unbalanced vaginal pH, says Dr. Lakeisha Richardson, Ob/Gyn at Delta Medical Group Women’s Healthcare Clinic in Greenville, Miss. “If you aren’t sure whether your symptoms indicate BV or a yeast infection, see your doctor before you apply any over-the-counter treatment,” she says. “Once BV is diagnosed, a course of antibiotics is required to eliminate the symptoms. Recurrence rates are very high. The best way to prevent recurrent BV is to maintain a normal vaginal pH and keep yeast and bacteria balanced every day.”