Sexual function is important for good health. It promotes a better mood and better sleep, as well as a healthy heart and immune system. And it deserves the same priority as any essential bodily function. So don’t be shy if the sex doesn’t work out the way you want it to.
Talk to your doctor, who is there to help you understand the big picture of health, not just one or two bodies.
rooms. “You come for all of you. This includes everything related to sex. If it’s not discussed, it won’t be discussed, ”says Dr. Nichole Butler, an obstetrician-gynecologist at the Women’s Health Center at Weiss Memorial Hospital in Chicago.
Here are six common sexual problems and ways to deal with them.
Erectile dysfunction (ED)
In order to have an erection, two things must happen. “Enough blood must flow into the penis for it to be full and erect, and a series of valves must close to hold the blood,” says Dr. Petar Bajic, urologist at the Center for Men’s Health at Glickman. Cleveland Clinic Kidney and Urology Institute.
When the small arteries that supply the penis narrow, erectile dysfunction can result. Bajic says cardiovascular disease is to blame 90% of the time, fueled by an unhealthy lifestyle, high cholesterol, or high blood pressure.
About 10% of the time, says Bajic, ED is due to:
Reversing erectile dysfunction involves improving blood circulation. This requires treating the underlying conditions, swapping out medications that cause side effects, and leading a healthy lifestyle (eating healthy, exercising daily, getting enough sleep, and managing stress). Other options include drugs that increase blood flow to the penis, such as sildenafil (Viagra) or tadalafil (Cialis) or testosterone replacement (if levels are low).
“There are many other options, such as vacuum devices, injectable drugs, even implants that can be curative for erectile dysfunction,” says Bajic. “There is always a way to restore function. “
In this condition, a person with a penis experiences an orgasm earlier than desired. “It’s most often associated with erectile dysfunction,” Bajic points out. “People who start having erectile dysfunction early on may subconsciously learn to reach orgasm faster, before erections go away.”
If premature ejaculation is bothersome, two treatments can help:
- A numbing agent such as benzocaine or lidocaine. “This is applied to the penis to reduce sensitivity,” says Bajic. Anesthetic agents are available as sprays, “wipes” and very thick condoms that contain drugs.
- Certain antidepressants, such as selective serotonin reuptake inhibitors or SSRIs. “These can be used as needed or on a daily basis. We take advantage of the side effect of SSRIs (which are antidepressants), which makes orgasm more difficult. The goal is to make it harder to reach an orgasm, ”says Bajic.
Dysfunction of arousal, libido or orgasm
Anyone can experience certain types of sexual dysfunction. The three common types include:
- Low libido or “libido”. You might not be interested in having sex.
- Difficulty waking up. You might be interested in having sex, but have a hard time being “turned on”.
- Difficulty having an orgasm. You might not be able to reach an orgasm during foreplay or sex, or it might be delayed.
These problems can be caused by a combination of health factors such as:
- Chronic stress. A chronic “fight or flight” response affects hormones, brain chemistry, concentration, and bodily function. It can zap libido and arousal. “The first necessary building block of sex is arousal, which occurs in the brain. If something interferes, the subsequent response may be diminished, ”says Bajic.
- Low hormone levels. As we age, we notice a decrease in the levels of hormones that affect sexual health. For a person with a penis, the main hormone is testosterone. For a person with ovaries and a vagina, the main hormone is estrogen, which not only decreases with age, but decreases sharply with menopause (when the ovaries stop producing). “With the loss of estrogen, the clitoris and vulva atrophy (shrink). It takes longer to get aroused. You have hot flashes, you don’t sleep well and you become more anxious, ”says Butler.
- Underlying conditions. Many health problems can affect libido, arousal, and the ability to orgasm, such as endometriosis, infections, cancer, neurological disorders, diabetes, or even sleep apnea – breathing pauses during sleep that prevent you from getting restful sleep (and increase blood pressure). “Testosterone is produced during sleep,” Bajic notes.
- Side effects of drugs. Certain medications, such as antidepressants, anticonvulsants, or prescription pain relievers, may hinder interest in sex and the ability to cum.
Treatment for arousal, libido, or orgasm dysfunction begins with treating the underlying conditions, replacing medications that might affect your libido, and adopting a healthier lifestyle.
Hormone replacement therapy can help, but only if:
- The levels of specific hormones are low (like testosterone or estrogen).
- There is no history of conditions that make replacement therapy risky, such as cancer or pulmonary embolism.
A prescription drug can help people with female sex organs, who have low sexual desire without a clear cause, and who have not yet gone through menopause. Flibanserin (Addyi) can increase sexual desire by targeting chemicals in the brain.
If the inability to achieve orgasm is the problem, you may need to reframe the situation. “That doesn’t mean you can’t have satisfying sex. And sometimes it’s just educating the person on how to find the focal point and what the partner can do to help with the response, ”says Butler. Working with a sex therapist can also help.
For someone with a vagina, sex can be anything but pleasurable. This may be due to the changes that accompany menopause, such as a lack of lubrication which leads to too much friction during sex.
Other potential causes of painful sex include:
- Endometriosis (the overgrowth of tissue inside the uterus).
- Bladder infections.
- Yeast infections.
- Sexually transmitted disease.
- Vulvodynia (a condition that causes pain or burning when the vagina opens).
Don’t self-diagnose the cause of your pain. “The patient may think, ‘I have a bladder infection,’ and it turns out that she has bladder dysfunction due to a uterine tumor pressing on the bladder, causing her to painful intercourse, ”says Butler.
See your doctor for treatment, which should be carefully tailored to the cause. If this is due to low estrogen levels and a lack of lubrication, hormone replacement can help. But again, it must be tailored to the individual. “You can also administer estrogen with a low dose cream without a significant systemic response,” says Butler. “It only works on the vagina.”
Over-the-counter (water-based) vaginal lubricants and vaginal moisturizers (which promote vaginal hydration) can also help reduce pain and friction during sex.
Do not give up
Sexual dysfunction is common and it’s not your fault. Most importantly, you don’t have to go it alone. “We take a holistic view and see sexual dysfunction as a problem that affects the couple, not just the individual. We don’t just treat one partner because there may be issues that affect both, ”Bajic says.
And keep in mind that it may take time to make improvements.
“It’s a process. It takes communication, follow-up and fine-tuning treatment once you’re on the road to recovery, ”says Butler. “I’m not going to guarantee that you’ll have good sex in three to six months, but we can work on it.” And once we get started, you might not need my help anymore. You can do a lot of work without my contribution.