WHAT ARE WOMEN ASKING?
One of the biggest questions I’m asked is: ‘Am I normal because it hurts a little when I have sex, and can we do something about it?’ It’s no longer considered a shameful subject.
■ They’re worried about their bleeding habits. They want to know if it’s normal that their bleeding is heavier, that they’re skipping periods, or bleeding between periods.
■ They’re concerned about hot flashes, night sweats and menopause symptoms affecting their ability to function day to day, and sleep well at night. I cover these subjects with my patients day in and day out.
■ We also have to bring up contraception, which is important for perimenopausal women. When you lose your period for one whole year, you’ve entered menopause.
■ About six women a day think they have some sort of infection because they’re itching or in pain, have discharge or odor. You name it. They don’t understand
what’s going on, whether it’s normal, and what can we do to treat it.
PLEASE ADDRESS THE RELATIONSHIP BETWEEN SEX AND HEALTH
Sex is important for general health, not just so you can be a sexual dynamo. Women who have regular sex have less depression, cancer, high blood pressure, heart disease. And those with poorer health have less sex. They clearly are intertwined.
Sexual health is a broad, but important subject, about which I’ll go into very big detail with my patients. Libido, orgasm and pain issues are the three biggest patient complaints.
Libido is complicated for women, and many issues can affect it, including a poor or strained relationship. Menopause and the hormone changes associated with menopause will physiologically change things for women; they’ll develop dry vaginas and sleep poorly, so they’re exhausted and their sex drive decreases. They may be stressed to the max. Diabetes, cancer, and certain chronic diseases also can affect libido. Diabetes can cause poor blood flow everywhere, including the genital area. Left untreated, it can cause loss of feeling in the vaginal area. Hypoactive sexual desire, which is a neurotransmitter imbalance with the brain, also affects libido.
From a physical standpoint, certain (feel good) chemicals are released during sex, and the intimate contact during partner sex affects your well being. Neurotransmitters, such as oxytocin (the cuddling hormone) dopamine, and serotonin (the feel-good hormone), are chemicals that are delicately balanced in the brain and increase with sexual activity. What’s more, sex brings more blood flow to the vaginal area and vulvar, which helps keep the tissues pliable and moisturized.
Sex satisfies our overall physical, mental and spiritual health.