12 Things Most Doctors Don't Tell You About Sexual Health

Every year, millions of women give up or drastically compromise their expectations of having enjoyable, fun, satisfying sex ever again.

Even if these women are among the majority who actually dare to discuss sexual issues with their doctors, they are often left without productive answers about their lack of libido, lack of orgasms, and lack of pleasure.

The truth is, even otherwise fabulous doctors are not experts on the physical, hormonal and medical aspects of maintaining peak sexual health ... and pleasure! All women who are experiencing physical and/or hormonal issues related to sexual function — menopause, incontinence, chronic lack of sleep — as well as those with medical conditions including heart disease, diabetes, cancer, and more, still can elevate their sexual awareness and health.

And, the good news is you don’t even need to don those attractive paper gowns or put your heels into stirrups.

Here are 12 examples of important facts about sexual health that your doctor has probably not mentioned:

1. A headache during an orgasm may indicate a serious problem.

You probably mentioned your bad headache to your doc. But did you neglect to mention that, oh, by the way, that headache happened simultaneous with an orgasm? If so, that’s something you want to check out sooner rather than later. Patients with a sub-arachnoid hemorrhage report that a severe headache at the time of climax was their first indication of a serious problem.

2. Diabetes may affect your ability to have an orgasm.

Your doctor asked about numbness in your feet, but not in your clitoris. According to a recent study, there is a likely correlation between diabetes and sexual dysfunction in women; this might have to do with decreased sensation in the clitoris from common vascular or neurologic changes.

3. Your birth control pills can cause vaginal dryness.

Menopause may be years away, but lately, even when you’re totally in the mood, your vagina is more like the Sahara desert than the waterfall it used to be. While not typically the case, some women experience this distressing side effect from hormonal contraception.

4. Your vibrator won’t mess with your pacemaker:

No way do you want to tell your cardiologist that you are terrified that sex with your regular partner, “Bob” (AKA your “Battery Operated Boyfriend”) will cause a pacemaker malfunction. Rest assured, vulvar or vaginal vibration will not “unpace” your pacemaker.

5. Using vaseline as lubricant can cause recurrent vaginal infections.

Vaseline makes your chapped lips feel so much better, so it stands to reason that it would be the perfect product to keep your other lips moist as well. But unfortunately, petroleum jelly has been shown to double the chance of bacterial vaginosis, the most common cause of odor and irritating vaginal discharge. Instead reach for a silicone lubricant like Replens Silky Smooth when the time comes.

6. Infertility treatments don’t have to ruin your sex life.

You are not imagining it. Sex with a purpose, takes the sexy out. A 2012 study out of the Indiana University School of Public Health confirmed what most couples have already figured out — assisted reproductive techniques, especially IVF, cause problems with sexual desire, interest, and satisfaction. As expected, “mood-type symptoms” that could be attributed to the stress of going through fertility treatments, like sadness and anxiety, were huge, but the study also found that women had physical issues such as vaginal pain and dryness.

7. Taking estrogen is not equivalent to taking poison.

According to a recent global survey, estrogen could be your ticket back to a slippery, slidey sex life. But, for those who can’t or prefer not to take estrogen, plenty of alternatives are readily available at the local drugstore, so menopause can actually be the start of a better-than-ever sex life.

8. A clitoral vibrator might be the prescription your doctor should've given you at your last visit.

If the only thing you own that vibrates is your cell phone, it’s time to go shopping. Many older women (and younger women, too, for that matter) require additional intensity to achieve an orgasm. This is particularly the case if there is compromised blood flow from a medical condition, or just from normal changes that accompany aging. Not sure what to buy? Just ask me.

9. The female condom is underrated.

The female condom (FC2) not only prevents pregnancy and STDs, but also actually makes for sex better. The ring on the outside provides clitoral stimulation and the lubrication coats the vaginal walls.

10. Women with incontinence may also have painful sex or the inability to have an orgasm.

Not to mention the fear of peeing accidentally during sex.The culprit is weak, and/or sometimes painful pelvic floor muscles. And, yes, there are solutions that don’t involve surgery or diapers. (Kegels are a great place to start, for instance.)

11. Cancer survivors may need help salvaging their sex lives.

It’s the exceptional oncologist who gives you real solutions to deal with the physical AND emotional aftermath of chemotherapy, radiation, and early menopause. Self-esteem may be shaky, and reclaiming one's body after trauma is a simultaneously emotional and physical journey.

On a physiological level, I'll start by saying that it is safe to use vaginal estrogen even if you’ve had cancer; that said, some are uncomfortable using hormonal solutions for these changes in sex drive. In this case, there are equally good non-hormonal solutions available, so ask your doctor.

12. That funky smell coming from your vagina may just be a pH balance.

A number of triggers, including menstruation, intercourse or medications, can upset the vaginal ecosystem and elevate pH, causing an odor, an increase or change in vaginal discharge, or a bacterial infection. An effective remedy to these triggers is an over-the-counter vaginal pH-balancing gel (I recommend RepHresh) which can help you maintain a healthy vaginal pH for three days and can eliminate feminine odor.

Of course, there are toys, lubes, and devices that can take things to a whole new level, but it isn’t just about making sex pleasurable, it’s about how to make it possible. Every woman, regardless of age, should be able to enjoy fulfilling, exciting sex and overcome pain, lack of desire and lack of lubrication as a result her body's unique challenges.

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