Your Best Sexual Health at Every Age
September 2020 Issue - Pink Prescriptions
Your Best Sexual Health at Every Age
Really? Do I still need the sex talk?
Of course you do! Sex isn’t a one-and-done when it comes to talking and learning about your sexual needs, desires and health. Our bodies change as the decades go by, which impacts your sexual health with new issues always arising. To achieve your best sexual health—and keep your intimacy in shape—be sure to talk to your doctor regularly about any concerns, strange sensations, or noticeable changes you may be experiencing. Don’t be afraid to ask any question, even if you find it embarrassing. Remember, sex is a science that your doctor has studied for years. One last thing: Tell all! You have to be 100 percent honest and detailed with your physician if you want the best solution. Rest assured, doctors really have heard it all!
I’m recently divorced, postmenopausal and haven’t dated for years. I’m nervous about dating again. What do I need to know about safe sex and new intimacy?
by Deana Harmon, D.O., FACOOG
How exciting to be getting back into the dating scene! Know that many products, over the counter and prescription, are now available to help menopausal women with vaginal dryness and discomfort. Just as important is safe sex practice. Although pregnancy is not a concern, protecting yourself with a condom is key in preventing sexually transmitted infections.
My husband’s interest in sex has decreased a lot as we have gotten older. Mine has not. What can I do?
Your husband may be affected by a low testosterone level. Also, is he experiencing issues with erectile dysfunction? He should first speak candidly with his healthcare provider to ensure there are no underlying medical issues affecting his libido. A healthy lifestyle, including diet and exercise, is also so very important in maintaining a healthy sex life.
I have a difficult time having an orgasm during intercourse. It just seems to be so different for women. Any suggestions?
I like to counsel my patients (if they are comfortable) to explore on their own which area stimulated leads to orgasm. Most women need clitoral stimulation to achieve orgasm. If you can target this area during intercourse, your chance of achieving orgasm will be much higher with your partner.
Deana Harmon, D.O., FACOOG – Obstetrician/Gynecologist recently relocated with her husband, Jacob and her son, Gabriel, to the Lowcountry after 13 years of practice in Tennessee. She joined Riverside Women’s Care, an affiliate of Hilton Head Regional Physician Network.
I’m middle-age and experiencing pain during intercourse. What is causing this and what can I do about it?
by Katherine Coley, M.D.
There are many reasons for pain with intercourse. You should see your gynecologist to rule out infection, prolapse, cysts, fibroids and endometriosis. If these are not the issues, generally it will be hormone related. As women reach middle-age their estrogen levels start to decrease. This can happen even before menopause during peri-menopause. Healthy vaginal tissue is lubricated and has folds, or rugae, which allow for stretching without discomfort. As estrogen levels decrease, vaginal tissue thins out, becomes dry and loses these natural folds, making the tissue less elastic. This can cause symptoms such as dryness, pain, cracking and bleeding when stretched during sex. Using something to stimulate the vaginal tissue will help these symptoms. There are many options, including different forms of estrogen. In addition, there are alternatives, such as oral medications without estrogen, vaginal suppositories using DHEA and vaginal rejuvenation, which uses either CO2 laser or radio frequency energy to repair and stimulate the vaginal tissue. This will bring back the lubrication and elasticity, making sex more comfortable and enjoyable.
I’ve always enjoyed sex, and I’m worried that my vagina will change after pregnancy. What changes should I expect?
The size of the baby, the mode of delivery (vaginal vs. cesarean), the shape of the pelvis and any trauma, such as lacerations or episiotomy, all play factors in vaginal changes after pregnancy. Additionally there can be trauma to the muscles of the pelvic floor, which can change the shape and the “tightness” of the vagina. This does not necessarily mean that sex will be less enjoyable, but sometimes interventions are required, such as Kegel exercises, pelvic floor physical therapy, or even surgery to “lift” the bladder, or support the rectum after childbirth. There are now also options using electromagnetic stimulation to aid in strengthening the muscles of the pelvic floor and the core muscles of the abdomen, which can return the tone to the supporting musculature. The same vaginal rejuvenation treatments used in menopause can also help with postpartum changes and can help support the bladder and rectum after childbirth.
Dr. Katherine Coley is a Board Certified Ob/GYN at Advanced Women’s Care with 13 years of experience. She graduated residency from New York Presbyterian hospital/Weill-Cornell program. Call for more information: 843-341-9700.
Can long-term use of birth control cause problems getting pregnant when I’m ready? What are other possible side effects from long-term use?
by Dr. Tiffany Bersani
The good news is that long-term use of birth control pills should not impact your ability to get pregnant. The hormones in the pill only stay in your body a short time, which is why you need to take one every day for the pill to be effective. Once you stop taking birth control, your normal cycle should return, as well as, your ability to get pregnant within a few months.
It’s important to point out that while the pill does not impact fertility, age does. So if you stop taking the pill after several years, and find it difficult to get pregnant, it may be more likely related to your age and not your years of contraceptive use.
Other risks of long-term usage are minimal, but you should see your health care provider on a regular basis to monitor any possible side effects. Some birth control pills may increase the risk of stroke, blood clots and heart attack in women who are already at risk. There is also evidence that pill usage may increase the risk for breast and cervical cancer, but on the other hand, reduce the risk of ovarian, colorectal and endometrial cancers.
On the plus side, you may find that both your PMS and acne improve and your periods are lighter and less painful.
Dr. Tiffany Bersani is an OB-GYN with Beaufort Memorial Obstetrics & Gynecology Specialists. She sees patients in both Bluffton and Beaufort and can be reached at 843-522-7820.
Having a young child is exhausting and taking a toll on our sex life. How do we keep our sexual relationship healthy?
by Dr. Eve Ashby
Many couples find that after having children the important things that were shared as a couple now take a back seat to the daily concerns of parenting and trying to continually adjust to new routines. Additionally, using hormonal birth control can sometimes blunt the effects of your normal hormonal “urges,” and your sex drive may not feel the same as it did before giving birth.
Many women experience low sex drive or libido. Libido is usually 50 percent in your hormones and 50 percent in how you think. The “hormone” part can be checked with bloodwork and may be affected by some medications, or the body adjusting after delivery and to breastfeeding.
The “think” part is how you feel about yourself, your partner, being a parent, as well as the stresses at home and work. So it’s important to take care of yourself the same way you did before you were pregnant. Make sure to do those things that help you feel confident, attractive and well-rested. For some, it will be a facial or working out, for others, it may be a new haircut, makeup routine, or outfit.
My best advice is to move your partner to the front seat! The main thing is to realize you each have needs, and even though you don’t feel like doing something, it’s still important to show them you love them and they are worth the effort. Often times it’s the little things, like dividing up daily responsibilities, hiring a babysitter for “date night,” or just asking each other how your day’s been, that can make big differences. Uniterrupted conversation is easy, inexpensive and allows for the other to vent, brag, or just say, “OK.”
Mutual respect and adoration are the best aphrodisiacs when it comes to strong relationships, and there’s no reason why that needs to change with children.
Eve A. Ashby, DO, FACOOG, is a board-certified gynecologist at Beaufort Memorial Lowcountry Medical Group. She is also an Assistant Professor and Regional Director of Medical Education for A.T. Still University School of Osteopathic Medicine.