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Everything You Wanted to Know About Sex, but were Afraid to Ask

Sexual dysfunction or sexual difficulties are a very common problem presenting to our office. Both men and women can experience sexual dysfunction. It is much more common in women according to all surveys. It is important that you feel comfortable to ask your physician about these issues. We are asked this virtually on a daily basis. You should not feel that you are alone with your concerns, nor should you be embarrassed. We are all very comfortable in helping you with these issues, or referring you to a specialist if necessary.

A thorough history and physical examination is an important evaluation of sexual difficulties. We are often asked what a normal frequency of sex is. Studies show that for men it is seven times per month and for women six times per month on average.

Having normal sexual function requires a normal sexual response. There are four stages to sexual response. The initial one is desire. The second stage is arousal. The third stage is orgasm. The fourth stage is resolution. Both men and women normally experience these with healthy sexual function.

Sexual function can be broken down into multiple categories. Lack of desire is a common concern. Often times this involves interpersonal relationships. Lack of arousal is another common problem. Both of these are areas that can often be helped with treatment. Lack of orgasm is a common concern expressed by patients. Statically over 90
percent of women are unable to experience orgasm with intercourse alone. Once again this is an area that is often treated successfully. Dyspareunia and vaginismus specifically refers to a spasm of the muscles that make penetration very painful. Fortunately, this is an area that responds well to treatment. The last area involving sexual dysfunction is relationship and psychological factors. This is the area that often encompasses the most difficult to treat because of the time involved. This usually requires more extensive therapy.

An area of particular concern is medications. There are many medicines that affect sexual function in both men and women. There are a number of medications such as anti-depressants that affect a women’s ability to achieve orgasm and a man’s ability to have an erection. Please make sure you review all your medications with your physician in detail so that these can be addressed.

All of the above noted areas can be successfully treated. Sometimes medications are used, as well as counseling.

Some of the factors that affect sexual function: Pregnancy, menopause, cancer, pelvic surgery, and chronic medical illnesses. Each of these have some impact upon sexual behavior.

There are a number of male factors involved in sexual dysfunction as well. The most common is erectile dysfunction. Fortunately, there are a number of treatments for this, both surgical and medical. Additionally, psychological effects can have a major impact upon male sexual function.

In summary, if you are having sexual difficulties, please do not feel uncomfortable with discussing this with your physician. You are certainly not alone. This is a very common discussion in OB/GYN offices. There are many treatments now available to help in this area of concern. If you do feel uncomfortable discussing this, writing the questions down and giving them to your physician is a way to open up the dialogue. Some women also choose to bring their partners in to discuss this together. This is an excellent option and often results in successful treatment.