As a physician who has treated many women over the years, I am very comfortable talking about sex. I talk about it with women every day, but my first impression when I ask people about their sexuality is how uncomfortable they become. They are embarrassed to use the words necessary to tell me about their sex lives.
One of the things I stress to women is that sexuality is a very important part of your life, your whole life. If you’re in a relationship, it helps you maintain intimacy and closeness.
For women, sexuality is complicated. For men, it tends to be pretty straightforward. It’s easier for men to get aroused. They have sexual thoughts much more frequently than women do — particularly women who have been through childbirth or are going into menopause.
As a woman, if you don’t talk about your sexuality, you may very well be suffering needlessly with questions or concerns that actually have pretty easy answers. You may have difficulties, disappointments or bad experiences. If you talk about it, I might have several suggestions and solutions to help you to have a happier, healthier, more enjoyable sex life.
One thing in particular all doctors need to ask women about is the medications they are taking. Antidepressants, high-blood pressure medication and others can cause sexual dysfunction or have sexual side effects. This is especially true for antidepressants. 30% of women taking common antidepressants like Zoloft, Prozac or Lexapro may experience a decrease in sex drive, or, if they do get aroused and engage in sex, their ability to have an orgasm is diminished.
That’s one of the first things I talk about when treating a new patient because depression can also decrease your sex drive. But if the treatment for depression prevents you from being able to have enjoyable sex, that’s not OK. It’s not OK to spend years having sex because your husband or partner wants to, but you aren’t getting any enjoyment out of it. If medications are causing side effects, there are solutions that can help.
Unfortunately, most patients aren’t going to volunteer information about their sexuality or admit they are having problems. It’s up to physicians to ask the right questions, approaching the topic calmly and matter-of-factly. I can’t think of anything anyone has said to me that I haven’t heard many times before.
When taking a woman’s history, every physician should ask the following:
- Are you having regular sex?
- Is it satisfactory for both you and your partner?
- What is the frequency? Is this satisfactory for both you and your partner?
- Do you have pain with intercourse? Does your partner have trouble maintaining an erection?
- Are you in a relationship? Do you feel safe in this relationship?
For most women, the relationship is a key component to a satisfactory sex life. It’s important for men too, but women in particular need to feel safe and that they can trust their partner. They need to feel loved and cared for in order to feel vulnerable enough to enjoy sex. If the relationship is broken or not working, or if there is resentment or anger, women don’t enjoy sex or don’t want to have sex. These things need to be addressed.
If you would like to learn more, I will be discussing this topic during an upcoming free seminar at Texas Children’s Pavilion for Women. There will also be other brief, targeted presentations by my colleagues from Baylor OB/GYN and The Women’s Specialists of Houston about the emotional and physical changes that impact women’s sexuality, common complaints including lack of libido and urinary incontinence and what you can do to improve your sexuality.
Your Sexuality: After Childbirth and Beyond
Thursday, Feb 21, 2013 – 6:30 p.m. to 8:00 p.m.
Texas Children’s Pavilion for Women
6651 Main Street, Houston, TX 77030
4th Floor, Conference Education Center
Reserve your seat now! Limited seating is available.
I hope to see you there!