Sexual Health and Wellness
Sexual health is an important part of our well-being. There are many aspects to Sexual health including physical, emotional, social, and psychological components that make up our beliefs, thoughts, and attitudes related to sex and sexuality. Our mission at OC Pelvic Wellness is to recognize and respect your attitudes toward sex and sexual health in order to create an education and treatment plan that is tailored to your individual needs.
More than 40% of women complain of sexual dysfunction including low sexual desire or drive and/or problems with orgasm and arousal. Although it is a very common issue, many women don’t talk about it openly with friends and they don’t often seek treatment until it’s been a problem for way too long. Sexual dysfunction can impact self-esteem, relationships, and quality of life.
H Hypoactive Sexual Desire Disorder (low sex drive) is defined by the lack of (or reduced) sexual interest, sexual thoughts, or reduced sexual initiation as well as being unreceptive to a partner’s attempts to initiate sex.
Female Arousal Disorder or problems with orgasming and genital sensation is defined by absent or reduced sexual excitement/pleasure during 75-100% of sexual encounters including internal or external sexual erotic cues (written, verbal, visual).
Risk factors for sexual dysfunction:
- Aging and menopause: reduced testosterone, low vaginal estrogen
- Chronic medical conditions: diabetes mellitus, hypertension, depression, heart disease
- Pelvic surgery and pelvic disorders: pelvic floor muscle spasm
- Neurological disorders: multiple sclerosis, epilepsy, paralysis
- Endocrine disorders: Addison’s disease (hyperthyroidism), Hashimoto’s thyroiditis (hypothyroidism)
- Medications: birth control pills, anti-depressants, anti-anxiety medications, antihypertensives, steroids, statins
- Infection: sexually transmitted disease, genital warts
T The evaluation for low sex drive and/or arousal disorder involves a complete history of medications, surgeries, and sexual experiences, ability to use tampons, musculoskeletal injuries and relationship status and wellbeing. A complete examination is done, observing the health of the vulva, hymen and vagina, performing a vaginal culture, and palpating the vulvar and vaginal muscles, as well as the pelvic organs.
Treatments for sexual dysfunction
- Education about current modifiable risk factors (perhaps changes in medication)
- Sexual response and anatomy, foreplay and sexual positions, and use of sexual aides.
- Lubricants can be helpful for ease of sexual penetration. Zestra oil is wonderful for local stimulation.
- Medications that address hormonal imbalance and/or arousal through serotonin levels. Hormone replacement with estradiol, testosterone, and/or progesterone will improve sexual thoughts and interest, arousal and response. Vaginal estradiol cream can be applied to the vulva 3x a week to maintain health.
- Flibanserin (Addyi®) is the newest drug that is FDA approved for premenopausal hypoactive sexual desire.
- Pelvic floor physical therapy can treat the tight muscles of the pelvic floor and local massage with vibrators/dilators or wands can help improve relaxation and blood flow to the area.
- ThermiVa is a non-hormonal and non-surgical treatment that uses radiofrequency to gently heat the tissue to cause improved blood flow and elasticity, improved orgasm and lubrication.
- Psychological therapy, including couples’ therapy, is important help women address barriers to sexual wellness and for partners to have similar sexual goals.
