There are many sexual health problems that can affect your wellbeing, but so often we sweep them under the rug. Research scientist Debby Herbenick, author of Because It Feels Good: A Woman’s Guide to Sexual Pleasure and Satisfaction, explains, ‘Sex and health do reflect each other, but because sex is still often seen as taboo, as something we don’t talk openly about, people often separate the two in their lives.’ So let’s take a look at you sexual wellness, and what these problems are telling you.
1. You’re avoiding sex because it hurts.
According to a 2010 survey by Indiana University’s Centre for Sexual Health Promotion, 30% of women had experienced mild to moderate pain during their most recent sexual encounter. Herbenick notes, ‘That’s a striking number – we didn’t expect it would be that big.’ This pain may be because of insufficient foreplay or the penis striking your cervix, but if it’s a more general pain, like burning, stinging or even knife-like, this could be vulvodynia (pain syndrome). Six million women are affected by this syndrome, and the causes are unknown, but a vulvovaginal specialist can help you find the right treatment.
2. You have trouble climaxing.
If you take forever to climax, if at all, you might have diabetes. This disease can damage your nerves – including the ones your brain uses to send unconscious signals for involuntary responses, such as sexual stimulation – and small blood vessels, which restricts blood flood to your sexual organs. Whether you’ve been diagnosed with diabetes or not, go to your doctor and mention all your worrying symptoms, as he or she can help your glucose control (which can improve you responsiveness) or refer you to a gynaecologist.
3. You’re not menopausal, but you still don’t lubricate much when aroused.
Vaginal dryness is a common side effect just before menopause and afterwards, due to shifting hormones, but if you’ve been affected by dryness before the age of 45, your heart health may be to blame. Herbenick notes, ‘Lubrication comes from hormones but also from fluid in your bloodstream. If there’s impaired blood flow for any reason, it could reflect early signs of a cardiovascular issue.’ If you have other signs of heart trouble – such as fatigue, shortness of breath and heartburn – go for a check-up. While you’re there, ask about other causes of vaginal dryness, like early menopause, perimenopause and medication side effects. You can also buy vaginal lubricants over the counter in the meantime.
4. You’re never in the mood for sex.
If sex is hardly ever on the menu, you might be short on testosterone. This hormone is linked to desire in both men and women, and your levels decline dramatically in the years between you 20s and 40s. Elizabeth G. Stewart, a vulvovaginal specialist in Boston and co-author of The V Book, advises supplemental testosterone if the problem is mainly hormonal, but tread carefully, as the long-term consequences of testosterone-replacement therapies aren’t yet well studied. Stress, fatigue, boredom, and relationship woes can all contribute to your low sex drive, so working on those other factors can also help.
5. Urine leaks out when you have sex.
You might wet yourself a little when you orgasm, but this isn’t just part of the excitement run amok. Herbenick urges, ‘Peeing at any point during sex, whether foreplay, intercourse, or climax, is not normal.’ Leaking during sex is a form of stress incontinence, which is the most common form of incontinence in women. However, there are many ways to prevent this from happening. Avoid liquids for the hours leading up to sex and experiment with different positions; rear or side entry, for example, take pressure off your bladder and urethra. You can also consult a urologist who specialises in incontinence, as he or she will be able to provide pelvic floor exercises, medications, or even a surgical fix.