Common Obgyn Issues

Gynecologic cancers, incontinence, pregnancy, sexually transmitted diseases and infections, and menopause are known to have an impact on sexual well-being. Balance providers aim to better understand why a woman is experiencing sexual dysfunction and this includes a thorough review of past medical history and, when necessary, a physical examination.

The most common sexual problems following treatments for gynecologic cancers include decreased desire, fatigue, vaginal dryness, reduced vaginal sensitivity, and a change in intensity of orgasm. Research suggests that up to 83% of women report sexual problems after having a gynecologic cancer (ex: cervical, vaginal, ovarian, vulvar) and 90% of women report sexual problems after the diagnosis and treatment of breast cancer. In addition to the physical changes related to cancer treatment, psychological and relationship difficulties may also contribute to sexual problems such as anxiety, altered body image, and difficulty communicating these changes with a partner.

Urinary incontinence is the involuntary leakage of urine. This condition can cause anxiety and diminish sexual self-confidence. Women with urine incontinence may have a difficult time relaxing during sex and rush through intercourse. Anxiety causes the body to tense which can cause pain during penetration. Additionally, many women are worried about how their partner may respond to leakage should it occur during sex.

It is common for women to have some sexual problems during pregnancy. Sexuality changes throughout a pregnancy and each trimester brings new changes in hormones and anatomy. Most couples can continue to have sexual intercourse throughout a pregnancy as long as there are no medical concerns requiring abstinence. Physical issues that can contribute to sexual dysfunction during pregnancy can include, nausea, backaches, constipation, diarrhea, and a frequent need to urinate. These symptoms can create a lack of desire for sex and leave women feeling less than “sexy.”

STDs (sometimes called sexually transmitted infections, or STIs) are very common and are passed from one person to another through intimate physical contact – such as heavy petting – and from sexual activity including vaginal, oral, and anal sex. There are dozens of STDs and some are mainly spread by sexual contact (syphilis, gonorrhea and chlamydia). If you have sex, you can lower your risk by using condoms and being in a sexual relationship with a partner who does not have an STD. It is possible to have a STD and not know it because not all STDs do not always cause symptoms. Research suggests that the diagnosis and treatment for a STI can result in sexual problems in up to 55% of women. Depression, anger, guilt, shame, and anxiety may accompany the diagnosis of a STI and decrease sexual satisfaction. Fortunately, STD’s can be treated with medicine and some can even be cured entirely.

The loss of estrogen following menopause can lead to changes in a woman’s sexual health. The emotional changes that often accompany menopause can lead to a woman’s loss of interest in sex and/or the ability to become aroused. Menopausal women may not be as easily aroused and may be less sensitive to touching. Additionally, lower levels of estrogen can cause a decrease in blood supply to the vagina which can negatively affect vaginal lubrication, causing vaginal dryness, and painful sex. Other factors that can influence a woman’s interest in sexual activity during menopause and after includes sleep disturbances, bladder control problems, medications, stress, health concerns, and relationships.