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    Sexual Health is Important

    by Ngozi Osuagwu, MD | February 11th, 2024

    Sexual Health is Important

    Once in a while, I look back to see what I have written in the past to see if it is relevant today. With Valentine’s Day around the corner, sexual health is as relevant today as it was when I first wrote this blog many years ago. What is interesting is since that time, we have three drugs that may help with hypoactive sexual desire disorder. These drugs include U.S. Food and Drug Administration (FDA)approved Flibanserin (Addyi), Bremelanotide (Vyleesi), and off-label testosterone. Flibanserin and Bremelanotide are approved for premenopausal women. Testosterone is for women who have undergone natural or surgical menopause. Sexual health is very important, and when there are problems, it can affect the quality of life.

    Usually, sexual health issues start with a questionnaire. The first is the Brief Sexual Symptom Checklist for Women, taken from the Journal of Sexual Medicine in 2010.

    Please answer the following questions about your overall sexual function:

    1. Are you satisfied with your sexual function? Yes or No

    If not, please continue.

    1. How long have you been dissatisfied with your sexual function?
    2. The problem(s) with your sexual function is: (circle one or more)
      1. Problem with little or no interest in sex
      2. Problem with decreased genital sensation (feeling)
      3. Problem with decreased vaginal lubrication (dryness)
      4. Problem reaching orgasm
      5. Problem with pain during sex
      6. Other:___________________________
    3. Which of the problems above is most bothersome (circle)
    4. Would you like to talk about it with your doctor?

    Problems with sexual health typically fall into four categories:

    Problem with desire- just not in the mood to have sex

    Problem with arousal – once in the mood, unable to be lubricated

    Problem with orgasm – not able to achieve an orgasm

    Problem with pain – You have pain during sexual activity that makes it difficult for you to have sex

    Sexual dysfunction becomes a significant problem when it affects the quality of your life. When it gets to that point, you should seek help.

    I want to leave you with the following:

    1. When it comes to sex, there is no such thing as normal. What is normal for one woman might not be normal for another. It is quite okay to make a decision that you do not want to have sex, and it is okay to want sex every day. Do not compare yourself with others.
    2. What happens in the bedroom is your business. We have vaginal sex, anal sex, oral sex, fingering, or digital sex, and we have dildo sex. You can have sex with a partner or derive pleasure on your own. If you are with a partner, communication is key.
    3. As I mentioned in my book Letters to My Sisters, a woman’s body is a dynamic entity with changing requirements and responses. What made you happy in your 20s may not make you happy in your 40s.
    4. Be frank and open with your physician. Use the answers to the questionnaire to help start a conversation with your doctor. If your doctor cannot help you, ask for a referral.
    5. You deserve to be happy at any age. Sexual health is essential for all ages.

    Although your healthcare provider may ask about your sexual health during your annual exam, they may not be able to treat sexual health problems at that visit. This visit takes time and may require a separate visit.

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    The second half of the book briefly discusses the most common gynecological conditions and also provides an overview of sexually transmitted infections. A list of annotated websites dealing with the different topics in the book is provided for the reader who wants to pursue each subject in depth.

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