What your doctor wishes you would ask about sex

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DETROIT – Dr. Renee Horowitz dubbed them the “door knob” questions.

Too many times after an obstetric-gynecologic exam, Horowitz was headed out the door when a female patient offhandedly pretended to remember to ask a question.

 

Typically, it was a question about sexual health: lack of libido. Painful sex. Vaginal dryness. No orgasms.

 

“For many years, I said the same thing that many doctors still say to women: ‘Well, you’re busy. You’re a wife. You’re a mother. It’s hard to feel sexy when the laundry needs doing,’” explained Horowitz of Royal Oak Beaumont Hospital. “I always felt I was shortchanging them.”

 

Several years ago, Horowitz, a 32-year veteran ob-gyn, decided to tackle the issues directly and boost her training in female sexual health.

 

“I started asking patients and the responses were overwhelming in terms of the problems that they were having,” said Horowitz, the founder of the Center for Sexual Wellness in Farmington Hills.

 

Despite the countless ways sex saturates our culture — from overt mentions in music and on TV to ads touting male performance boosters — talking about sex mechanically and medically can be awkward, especially for women.

 

Studies show that anywhere from 40 to 75 percent of women have a sexual health concern, regardless of age. And other studies show doctors rarely ask about the issue or delve into details to answer patients’ questions. Horowitz said she used to be one of those doctors.

 

Now, “nothing makes me gasp, nothing really rattles me when it comes to talking about sex,” Horowitz said.

 

Among the questions she hears are: “I’m having pain during sex” or “I’d rather go to bed with a book.”

 

“What’s wrong with me?” they ask.

 

If they’ve come to one of Horowitz’s past seminars, the women asking the questions know they’re not alone. Last year, Horowitz partnered with a restaurant owner for a dinner and sexual health seminar linked to the popularity of the erotic book Fifty Shades of Grey. She says she wants to stage another session when the movie of the same name is scheduled to be released early next year.

 

Elana Gottfried, a certified sex therapist and clinical social worker with the Center for Relationship and Sexual Health in Royal Oak, specializes in treating women who worry about low sexual desire, or have chronic pelvic pain associated with intercourse.

 

“Awareness about sexual health has definitely risen, but it’s still a hard topic to bring up,” said Gottfried.

 

When women seek her out, says Gottfried, the problems “have been going on for a long time, and they haven’t sought help because of embarrassment or shame or a (bad) experience with a doctor’s bedside manner.”

 

What women need to understand, said Sallie Foley, a psychotherapist and sex therapist educator at the University of Michigan, is that there is treatment and therapy available to alleviate the typical difficulties.

 

Historically, men’s sexual health issues have dominated research, said Foley, the former director of the University of Michigan Center for Sexual Health and co-author of Sex Matters for Women: A Complete Guide to Taking Care of Your Sexual Self.

 

Medical professionals “had mapped all the nerves and named them in the male reproductive system by the 1930s,” said Foley.

 

“It took until the 1990s for a similar mapping of women’s genital area,” said Foley, who credits one of her University of Michigan colleagues, ob-gyn researcher, Dr. John DeLancey, for the work.

 

Earlier this month, about 60-plus health care groups and university researchers signed an open letter to the U.S. Food and Drug Administration, urging the government agency to approve the first-ever drug to treat the most commonly reported form of female sexual dysfunction, hypoactive sexual desire disorder (HSDD) or low sexual desire.

 

There are 26 approved drugs for men’s lax libido, the signers said, and zero for women.

 

Although most women recognize male sexual disorders, such as erectile dysfunction, only a fraction of women know there’s a diagnosis for the sexual dysfunction they may have experienced, a recent survey showed.

 

Only 14 percent of more than 1,000 U.S. women between the ages of 30 and 50 knew about HSDD, according to the April survey commissioned by the nonprofit HealthyWomen and a pharmaceutical company developing a treatment for the condition.

 

Lack of sex can create tensions in romantic partnerships, shutting down intimacy and communication, and impairing women’s self-esteem as they blame themselves for the breakdown, said Foley. Many women don’t realize low sexual desire can stem from medical conditions and even common medications.

 

And the multitasking nature of women’s lives — managing jobs, children, households, volunteer work, etc. — also affects the timing and desire for intimacy.

 

“There’s this idea that women want to be magically carried off into the bedroom” to spark arousal, explained Foley. But even when women don’t initially feel in the mood, said Foley, they may want to make time and effort for sexual intimacy.

 

“Don’t expect it to look like Madonna in one of her musical videos singing ‘I want it. I want it,’” said Foley, referring to a lyric in the Michigan-bred pop star’s 1989 song “Hanky Panky.”

 

“Instead, think that once I start being touched and touch my partner,” said Foley, “my body will remind me of how much I want it.”

 

And their partners, said Foley, need to realize that mutual seduction and satisfaction starts in places other than the bedroom.

 

“I always say to couples that foreplay involves everything, including emptying dishwashers,” said Foley. “It’s about your partner respecting you, helping you, connecting with you.

 

“People change their rules in permanent partnerships, and they have to talk to each other about resentments and the work that relationships take.”

 

“It’s work to have a good sex life,” said Foley, “but it’s good work to do.”

 

 

Categories: female sexual, intimacy nbsp, ob gyn, royal oak, sex therapist, sexual desire, sexual dysfunction, sexual health, women nbsp

70% Of Women Say Low Libido Affects Their Relationship. So Why Aren"t They Seeking Help?

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The BDSM bestseller, 50 Shades of Grey, titillated the interest and expanded the sexual imaginations of millions of American women. Yet the results of a new sex survey reveal that many of those very women, in their own lives, in their own beds, are saying no: “Not tonight.” “I’ve got a headache.” “I’m just too f-ing tired.”

 

According to the 450-women survey, 27% of premenopausal women and 34% of postmenopausal women are very dissatisfied with their current level of sexual desire. And while more than 70% of those women say their relationships have suffered as a result, very few have sought help for it.

 

“The women in the survey didn’t even know [low desire] was an actual thing,” says Sheryl A. Kingsberg, PhD, professor of both reproductive biology and psychiatry at Case Western Reserve University School of Medicine in Cleveland and author of an upcoming Journal of Women’s Health article on the survey. “They didn’t realize that low sexual desire is a medically recognized condition with a name—Female Sexual Interest and Arousal Disorder—and that there are places to go for treatment.”

 

It is and there are, stresses Kingsberg—sort of.

 

Yes, Female Sexual Interest and Arousal Disorder is in the latest edition of the diagnostician’s Bible—the Diagnostic and Statistical Manual, or DSM for short—and by all indications, it’s alarmingly prevalent. And while psychotherapy can be very helpful for women for whom flagging desire is psychological in origin, there are no FDA-approved drug treatments for low female sexual desire that’s biologically driven—no pink Viagras. And Kingsberg says, that makes many family docs loathe even to bring up sexual health during a routine exam. “They don’t have anything to offer patients, so the attitude is, ‘Why talk about it?’ ” she says. “Often, they don’t.”

 

Which means it’s up to you to bring it up.

 

“Low sexual desire truly is a silent epidemic among women,” says Louann Brizendine, MD, founder and director of the Women’s Mood and Hormone Clinic at the University of California, San Francisco and author of The Female Brain. “Women feel they will be rejected by their partners and even judged by their friends if they tell the truth. They live in deep, deep shame.” The only answer for them personally, says Brizendine, and for women’s health in general is to break the silence. “Talk to your doctor, talk to your friends,” she says. “The problem deserves the attention—and you do, too.”

 

Brizendine recalls when Viagra hit the market 15 years ago: “Droves of men went to their GPs—doctors whom they had been seeing for 20 years or more—asking them for Viagra. The GPs had no idea their patients were having erectile dysfunction, because they had never asked and the guys had never volunteered the information—the fact that there was a solution broke their silence.” Brizendine says we need to break our silence now so that the FDA knows there’s demand for a solution.

 

Your first step: Stop by eventhescore.org—a website created by numerous women’s-sexual-health-concerned nonprofits to alert the FDA to the fact that there are now 26 drugs on the market to address male sexual dysfunction and not a single one for women. Your second: pop in to see your own doctor, and, if you need to, raise the issue. This is not something you need to suffer in silence.

 

In the meantime, these 20 just-for-women tips can help you start to want sex again.

 

 

Categories: arousal disorder, desire, female sexual, nbsp, sexual, sexual desire, sexual health, silence, Women

What to Do When Sex Becomes a Painful Ordeal

When sexual pleasure becomes painful, it is known as female sexual arousal disorder. This affects the wellness and wellbeing of thousands of women every year. Female sexual arousal disorder (FSAD) is defined as the recurrent or persistent inability to enjoy sexual activity and a lack of lubrication and swelling response to sexual excitement.

 

This condition is both a physical one, which may come alongside other physical issues associated with sexual dysfunction, and a psychological issue. There are a few different types of FSAD.

 

Genital sexual arousal disorder is when the genitals fail to become aroused, even although other areas of the body may be aroused and the sufferer may be mentally aroused.

 

Subjective arousal disorder occurs when there are diminished feelings of sexual arousal, even when sexual stimuli is present.

 

Combined genital and subjective arousal disorder is when both of the above conditions occur at the same time – feelings of sexual arousal and a physical response to sexual stimuli are both absent at the same time. It can be present on its own or at the same time as other sexual or physical disorders.

 

The causes of female sexual arousal disorder are varied and it can have many different causes. It may be due to problems with the bladder or bowel, as a result of arthritis or following on from previous surgery on the pelvis. Sometimes it occurs alongside neurological problems, fatigue or headaches. Irregular hormone levels can be to blame in some cases, as can untreated depression or anxiety, or even severe stress.

 

In some cases the cause is far more subtle, as it can be something like a negative body image or a problem with self esteem that causes the woman to fail to feel aroused. Others are responding to religious or cultural issues surrounding sex, and in this case counselling may be the most appropriate treatment.

Categories: arousal, arousal disorder, Disorder, female sexual, nbsp, ordeal, painful, Sex, sexual, sexual arousal, sexual stimuli, subjective arousal

What Everyone Ought to Know About Sexual Dysfunction

Male and female sexual dysfunction can be a really serious problem, affecting the wellness and wellbeing of otherwise perfectly healthy people. In men, it can include things like impotence or erectile dysfunction (being unable to get or maintain an erection) or something like premature ejaculation, where a man ejaculates far more quickly than would normally be expected. It usually means that he comes/ejaculates within two minutes of penetration and can be linked to being very aroused but can also be a problem when it becomes a regular thing.

 

Male sexual dysfunction can be caused by various things, including diabetes, drugs and alcohol, raised cholesterol, psychological problems around sex and low testosterone. Men who are worried about sexual dysfunction should see their GP asap or go to a sexual health clinic to undergo testing for underlying causes. If there are no physical causes found, they may need to seek some form of sexual counselling.

 

Female sexual dysfunction is just as common in women and generally includes things like a loss of sexual desire, lack of orgasm during sex, pain during sex or a loss of arousal during sex. Problems get worse as women get older, and can also be linked to excessive drug and alcohol use. In addition, women can have sexual problems as a result of depression, problems within the relationship, heart disease, disorders of the hormones, traumatic previous sexual experiences or a natural drop in testosterone levels.

 

Women who are experiencing sexual dysfunction should also visit their GP or a sexual health clinic, where they can undergo testing to find out if there are any underlying medical conditions that are causing the problems.

 

Treatment can involve hormone replacement therapy, the treatment of other conditions (such as depression, heart disease or diabetes) and also sex therapy, if the problem is not a physical one.

Categories: Dysfunction, female sexual, health clinic, heart disease, problems, Sex, sexual, sexual dysfunction, sexual health, undergo testing

What Everyone Ought to Know About Female Sexual Desire

In a busy, modern world, with many people juggling fast-paced careers, turbulent lifestyles, families, friends and many more besides, the thing to suffer is often your sexual health. You may find that you simply have no time for sex, and it seems like the last thing on your priority list.

 

In these modern times, however, when sexuality, sexual wellness and wellbeing and all associated issues are discussed more openly, it is surprising to find that sex is so low down the priority list for so many women.

 

The main causes of lack of desire are generally tiredness, lack of intimacy in the relationship, lack of communication, getting older, changes in lifestyle, physical or hormonal changes associated with childbirth or the menopause, or even the effects of contraception.

 

Many researchers have attempted to make sense of female sexual desire in order to better explain why fewer and fewer women are enjoying a good, healthy libido. Some say that it is because the physiological changes in the body causes a mental lack of desire to have sex, and some say it is the other way around. Whatever way you look at it, however, it represents a serious problem.

 

In women – more so than in men – there is a strong link between the body and the mind. If women don’t feel physically attractive then it doesn’t matter what the reality is. Similarly, if women feel confident and sexy, it doesn’t matter whether that is in reality the case. It’s all about how they feel, and therefore it’s impossible to cure sexual desire with some kind of female equivalent of Viagra, to ‘pep’ a physical part of them up again. Lack of sexual desire has to be treated on all levels – mental, emotional, psychological and physical, to really get to the root of the problem, in order to solve it.

Categories: desire, female sexual, lack, libido, nbsp, priority list, Sex, sexual, sexual desire, Women

Could the Debate Over Female Sexual Dysfunction Affect You?

When there’s an issue with your sexual health, as a woman, you face a long history of sexist stereotypes, as well as a fierce current debate as to how these stereotypes can be undone. Though you’d expect your doctor to be up-to-date with contemporary opinion, there still remains a problem with uneven diagnosis and treatment. Wellness experts and frustrated patients assert that while a man with a sexual dysfunction will most likely be taken seriously and given treatment by his doctor, as a woman, you’re more likely to be told to “relax,” and the problem is probably “all in your head.” Let’s take a look at the female sexual dysfunction debate; does it exist? And how does it affect your wellbeing?

 

In 1999, the Journal of the American Medical Association published a study in which 43% of all women (and 31% of men) surveyed reported experiencing an episode of a sexual problem (meaning lack of interest in sex, difficulties with orgasm or erection, or finding sex painful). In this widely cited study, the researchers termed these troubles as “sexual dysfunction,” noting that these episodes were “significant public health concern” and needed new treatments—especially for women. But if it’s happening to almost half of women, doesn’t that make sexual problems “normal”, rather than dysfunction?

 

According to Irwin Goldstein, MD, director of San Diego Sexual Medicine and the editor in chief of The Journal of Sexual Medicine, “We can’t as physicians tell people what is normal.” Yet still we have a burgeoning industry of sexual health medications and centres which tell a different story; your sex drive and/or sexual response falls short of that nonexistent “normal” – but we have the solution for you. However, psychologist Joy Davidson, PhD, who’s on the board of directors of the American Association of Sexuality Educators, Counsellors and Therapists, asserts “If you say for two weeks out of the past year you had no interest in sex … Well, maybe you were stressed out at work, maybe you were pissed off at your husband. Maybe you had the flu! You can be a very sexually healthy, sexually vital person, but there may be times when your sex drive is low. That’s not a dysfunction; that’s life!”

 

Experienced sexologist Leonore Tiefer, PhD, a psychiatry professor at NYU School of Medicine, has taken this belief one step further and spear-headed a campaign against the “disease-mongering” actions of labelling problems with desire and arousal as female sexual dysfunction. Tiefer explains, “Sexuality is much more a cultural matter than it is a biological matter.” Biology she reserves for dysfunctions in terms of sexual pain, which she acknowledges can be a medical issue. Sexual problems with desire and arousal, then, may occur for non-medical reasons, so does that mean you have to grin and bear it?

 

Andrew Goldstein, MD, an associate professor at George Washington University, argues, “Hurricanes, AIDS, and earthquakes are all natural, but not desirable,” questioning how a doctor can dare to deny your wish to get back your sexual pleasure? In fact, during one of Dr. Tiefer’s lectures about the naturalness of losing libido after menopause, a woman in the audience reportedly protested “But I liked sex!” Aside from the sheer fun of it, sex is important in many wellness areas, be it for starting a family, connecting and growing as a couple or boosting your self-esteem.

 

So whether your sex problems are psychosocial or biological, who cares? “I think both issues are real,” says Marjorie Green, MD, director of the Mount Auburn Female Sexual Medicine Centre, and a clinical instructor at Harvard Medical School. Biology and psychology overlap in the study of sex drive and sexual function more so than in most other areas of human health, and Dr. Green claims she prescribes therapy as often as she prescribes drugs. The important thing to note is that help is available, in whatever treatment it comes, so don’t let your sexual wellness suffer unnecessarily just because your problems are “normal”.

Categories: biological, female sexual, Female Sexual Dysfunction, goldstein md, md director, psychological, Sex Drive, sexual, sexual dysfunction, sexual health, sexual medicine, sexual problems