Trends In Sexual Health

By Rhonda Mann Beth Israel Deaconess Medical Center Staff

Women are talking more about sex in the doctor's office-- and it’s mostly due to the internet.

"Instead of talking with their friends or spouses about sexual problems, they've researched them on line," says Dr. Jennifer Potter, Director of Women's Health at Beth Israel Deaconess Medical Center. "They're coming to their appointments with that information, and it opens the door to a discussion about potential solutions."

Dr. Potter says a growing number of women are realizing that sex is part of healthy living. Benefits of regular sexual activity include overall wellbeing, tension relief, better sleep and mood. Still, some 43 percent of women will experience sexual problems in their lifetime, according to a survey of 391 respondents earlier this year by the Women's Sexual Health Foundation. Dr. Potter says depending on age, those problems may involve one or more of four areas: desire, arousal, orgasm and pain/discomfort.

"There are many myths about female sexual function. For instance, most women do not achieve orgasm through vaginal penetration alone: clitoral stimulation is also necessary. In addition, contrary to popular belief, younger, rather than older women experience more pain during sexual activity-- usually due to conditions such as vulvodynia or vaginismus.”

For older women, the concern is often around decreased sex drive, Dr. Potter explains. While some drop in libido may be the result of changing hormones, there are often other culprits, like vaginal dryness or relationship changes. The problem is that this shift in sex drive often happens at the same time their male partners are discovering erectile dysfunction medications like Viagra and Cialis. “The men in their lives are chasing them around the house looking for sex at a time when they were content with the status,” explains Dr. Potter.

While there are no proven formulas that will magically increase desire or heighten the sexual experience for most women, Dr. Potter notes that taking a good sexual history can unlock important clues to problems. For example, sometimes female sexual dysfunction can be caused by depression, hypertension or urinary incontinence. In addition, vaginal dryness can cause discomfort during both intercourse and "outercourse", but there are treatments that can provide lubrication and restore pleasure.

In addition to looking for solutions to problems, she says, women simply want to know if what they're experiencing is normal. Television programs like Sex In The City and Desperate Housewives, for instance, may leave the impression that all women want to make love every day. Many surveys suggest most women and men have sex much less frequently and are happy with their sex lives. One study done at the University of Chicago in 2002 found that married couples say they have sex slightly more than once per week. Working women seem to have sex as often as women who stay at home, and those who are married have almost 7 more sexual encounters per year than those who have never tied the knot.

According to Dr. Potter, "each woman and each relationship is unique, and there is no clear definition of what is the norm.” Instead, she says, there is enormous variability in degree of sexual desire, frequency of sexual activity, preferred types of stimulation, and the intensity and duration of stimulation an individual woman needs to achieve orgasm. “For a healthy and satisfying sexual life, the key is for each woman to get to know her body and what pleases her, and to learn to communicate this effectively to her partner," Dr. Potter notes.

While more women are reaching out to their clinicians for information on sexual health, research suggests health care providers need to be more in-tune with the issue. A survey of 391 respondents earlier this year by the Women's Sexual Health Foundation found that less than 9 percent of adult women were asked by their doctor if they re having sexual difficulties during their regular check ups.

"Clinicians are much more likely to ask men than women about sexual health--it's part of the perception that it matters much more to men," says Dr. Potter. "However, studies show that sexual satisfaction is every bit as important to women. In order to achieve greatest success, it's important for both providers and the women they care for to learn to address sexual issues in an open and comprehensive manner."

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