Sexual Changes

Sexuality plays a tremendously important role in women’s lives.   It brings women an ever-evolving source of pleasure, intimacy, personal expression, interpersonal connectedness, and of course, reproduction.  It can be a wonderful part of a healthy relationship, but sometimes it can become a source of frustration, pain, or even become tedious and unfulfilling under certain circumstances.

Changes in women’s sexuality can occur at any point during their adult life.   Many things can impact a woman’s sexuality. I would like to take a little time to discuss some of these and hopefully provide some insight into what may be causes or contributing factors to these changes, and offer some treatment options.

One way to organize the various factors that affect women’s sexuality is by age, but that becomes problematic since most of these can occur at any age.   The following is a list of some of the factors that can have a negative impact on sexual health.

Pain during intercourse can be caused by many things.

Sexually transmitted infections:  can occur at any age, and while some cause no symptoms, most cause pain, sometimes chronic pain that can make sex difficult.

Endometriosis (which is more fully discussed in another “Girl Talk” episode that is archived) is very often a cause of pain during intercourse, especially causing pain in the lower pelvis during intercourse.

Vaginismus is a condition where the muscles at the opening of the vagina can go into spasms and tighten painfully with attempts at penetration.  Sometimes a ‘triggering’ event (something that caused the symptoms to start occurring) can be identified, but sometimes it can begin to happen without any obvious cause.

Interstitial cystitis is a condition of inflammation of the bladder that causes pain during intercourse.

Ovarian cysts, scar tissue “adhesions” from infections or previous surgeries can cause pain; the latter being a very difficult to diagnose and treat.  Uterine fibroids can cause pain in some cases (fortunately, a lot of they time they are small, and don’t cause any symptoms).

Vaginal dryness is a problem that can occur at any time during a woman’s life, but is most often seen during the menopause, when the loss of estrogen causes changes in the vaginal skin that make the skin very dry, and sensitive.  The loss of estrogen causes the vaginal skin to lose it’s ability to lubricate normally and to stretch – which can cause tearing of the skin and burning pain with attempts at intercourse.  Vaginal dryness can occur at younger ages sometimes due to dermatological skin conditions like lichen sclerosus, psoriasis or eczema.  Sometimes vaginal dryness from lack of lubrication or decreased arousal due to the use of oral contraceptive pills, or other hormonal contraceptives.

A history of physical or sexual abuse or trauma, or even emotional abuse can cause problems with pelvic pain, and/or pain during intercourse.

Changes in libido can affect women at any age.

Libido is the desire to have intercourse.  While excessive libido is an uncommon problem, it can occur, and can cause problems for the sufferer, particularly if the woman becomes excessively promiscuous, which can put her at risk for exposure to STDs or cause relationship problems of social stigma.  Decreased libido is a much more commonly encountered problem for women.  One of the biggest concerns can be due to a difference in libido in couples, with one couple wanting sex more often than the other.

Libido is a ‘multi-factorial’ condition, meaning that many things affect a woman’s libido.  While hormones contribute significantly and can often be a cause of decreased or absent libido, they are not the only factor.  Social factors affect women’s libidos as well.  Stress, fatigue, and family responsibilities as well as depression and other health conditions can have a huge effect on a woman’s sex drive.  For most women, being very stressed, or over-tired from working inside or outside of the home (or both) can leave them both emotionally and physically drained and have a negative impact on their libido.  Marital discord almost always has a negative impact on a woman’s sex drive.  Often women don’t desire to have a physical connection with their partner if the emotional connection is strained.  Many medications can have a negative impact on a woman’s libido, including birth control pills, anti-depressants, some blood pressure medications, even some anti-histamines can have a decreasing effect on libido.    Psychological factors are tremendously important in a woman’s sex drive.  A history of sexual abuse, or physical trauma can cause sexual dysfunction involving both libido and pain symptoms for victims.  Poor self-esteem, or body image disorders can leave women feeling undesirable and prevent them from having satisfying sexual interactions.

Changes in a woman’s production of hormones (specifically testosterone and or estrogen) can be a significant contributor to loss of libido.  These hormonal declines (in testosterone production) or imbalances are more commonly experienced as women age, especially from their mid-30’s and often more pronounced in their 40s and beyond.  Once a woman goes through menopause, her body’s own production of sex steroid hormones is very minimal (whether menopause occurred naturally, or due to having her ovaries surgically removed at a younger age) and low testosterone may be a significant contributor to decreased libido.  Before menopause (during something called ‘perimenopause’) many hormone changes occur in women that can have many effects on their lives; decreased libido being just one of those effects.  After giving birth is another time in womens’ lives that testosterone production has been shown to decline.  In the immediate post-partum period for breast-feeding women, their bodies produce minimal hormones, and they are in a period of temporarily suppressed hormones (almost like a ‘mini-menopause’) until they stop breastfeeding and their hormones return to more normal levels.   Even if women don’t breastfeed, having a child can result in lower than previously produced testosterone levels that can impact libido.  Although the exhaustion of having a  newborn (and small children, and, come to that, teenagers) – are also things that can negatively impact a woman’s sexual desire.

Orgasmic dysfunction.

Exact numbers vary by study, but it is estimated that only 25% of women are regularly able to have orgasms during vaginal intercourse.  Up to 10% of women never have orgasms.   It is important for women to know that it is ‘normal’ for them to not have orgasms with penile-vaginal intercourse alone.   For women who have never had an orgasm (or aren’t sure if they have) there are resources available to help them learn how to achieve orgasm.  Sometimes women can lose this ability, due to certain medications (anti-depressants being the most common cause of this), medical conditions, nerve injuries, or even due to hormonal declines.  A careful history by their gynecologist should be able to uncover possible causes and direct treatments.

Source : This Article Originally Appeared on https://www.ifwh.org/en/sexual-changes/

What is Urogynecology?

Urogynecology (official name: Female Pelvic Medicine and Reconstructive Surgery) is a subspecialty within Obstetrics and Gynecology. It is dedicated to the evaluation and treatment of disorders of the pelvic floor in women.

Urogynecologists have completed medical school and a residency in Obstetrics and Gynecology. They become specialists with additional training and experience in the study and treatment of conditions that affect the female pelvic organs. Many have completed formal accredited fellowships (additional training after residency) that focused on the surgical and non-surgical treatment of pelvic floor disorders. We encourage you to feel comfortable asking about the training and expertise (and Board Certification in Female Pelvic Medicine and Reconstructive Surgery) of any doctor caring for you.

So what are the pelvic floor disorders (“PFDs”)? The pelvic floor is a set of muscles, ligaments and connective tissue that provides support for a woman’s pelvic organs (bladder, uterus, vagina, and rectum). The pelvic floor is important in keeping these organs in their proper place as well as in making them function properly.

Women with a weakened pelvic muscles or ligaments may have trouble controlling their bladder and bowels. They can experience leakage of urine, bowel gas or stool, difficulty emptying their bladder or having a bowel movement or overactive bladder. Some women can also feel or see tissue coming out of the opening of their vagina. This can be a prolapsing uterus or vagina (pelvic organ prolapse). It is also possible to experience several of these problems at the same time.

While primary care physicians, general gynecologists and general urologists can start the evaluation and initial treatment of PFDs, if the diagnosis is not clear, if you experience several pelvic floor problems at the same time, if the initial approach has not helped or if a surgery is considered as treatment, we recommend that you are evaluated by a Fellowship-trained Urogynecologist, with Board Certification in Female Pelvic Medicine and Reconstructive Surgery.

Source : This Article Originally Appeared on https://www.ifwh.org/en/what-is-urogynecology/

The Importance of Girlfriends

How many friends can you call right now and ask them to accompany you to the doctor? If you can count more than five, you have a much higher chance of being healthier than most women. Often times we mistake friendship with how many Facebook friends, Twitter followers, or Reddit reposts we have. We loose track of how to build real, meaningful, and long-lasting friendships. Since we are celebrating “National Girlfriends Day”, we want to point out the importance of having girlfriends in our lives.

Having girlfriends not only allows us to live a fuller and happier life, it can actually lower blood pressure, reduce the risk of depression, and create a sense of well-being. Friends are those people that look out for us, they are always there to support us, make us laugh, and push us to be healthier and better. They are the ones that know who we truly are and therefore expect us to live life to our fullest potential. You can expect them to always be by our side throughout all the ups and downs of life, this is why we should always invest time and effort in our friendships.

Here are some reasons why having girlfriends can have a positive impact on your health and life:

You push each other to be better.

When you are in a rut, friends are the ones that always find ways to get you back on your feet. They can help you find motivation to exercise and eat right. Research shows that those that pact to make healthy lifestyle changes together are more likely to do so. It is also important to push each other to constantly take control of your own health. Ask your friends if they’ve had their annual exam done or if they need help letting go of an unhealthy habit.

Girlfriends are your best support group.

From a hard day at work to getting through cancer, friends will always be there to support you no matter what. They always know just what to do, what to say, and how to help. If they are not equipped to help you, they will find someone that can. Remember to always be a good friend and take interest in your friends’ health. Motivate them to schedule regular visits to their general and OB/GYN physicians.

Your girlfriends know what it is to be a woman.

Your girlfriends will ALWAYS understand your menstrual mood swings, your health concerns, your pregnancy fears, and your menopausal hot flashes. It’s great to always have someone that knows exactly what you are going through. You don’t have to be shy or embarrassed with your friends. You can ask them intimate questions about being a woman without any repercussions. You are all on the same boat.

So grab your phone and call up your girlfriends! Celebrate this “National Girlfriends Day” with your closest friends and remember to always look out for each other. Happy Girlfriends Day!

For More Information about it Visit https://www.ifwh.org/gn

Source : This Article Originally Appeared on https://www.ifwh.org/en/the-importance-of-girlfriends/

Solutions to Common Breastfeeding Challenges

Even though breastfeeding is one of the most beautiful things a woman can do, it often comes with its challenges. One important thing to note is that every woman’s body is different, therefore some might face breastfeeding challenges while others might not. The important thing is to always be prepared and know how to solve problems that may arise. Before you start breastfeeding, it is very important to ask your doctor everything you need to know about it.

Here are some common breastfeeding challenges and tips on how to manage them:

Running Low on Milk?

Sometimes it is difficult to know if your baby is getting enough milk and if you will be able to produce the milk your baby needs. It is normal for your breasts to feel less full after a couple of months. Let your doctor know if you are concerned. Remember to always check your baby’s weight and growth to see if she/he is getting enough milk. Here are some things you can do if you are concerned about your milk supply:

• Limit the use of the pacifier.
• The more you nurse, the more you supply. Remember to always follow your baby’s lead- he will let you know when he is done.
• Use both your breasts when feeding. Start with one breast and if he is still sucking and swallowing offer him your second breast.
• Your baby does not need solid foods until he is 6 months old. Try to only breastfeed him and avoid offering him formula or solid foods. The less interest the baby has in your breast milk, the less you will supply.

Supplying Excess Milk?
While some mothers worry about the low milk supply, other mothers worry about oversupplying milk. This can be very uncomfortable for both the mother and the baby. Here are some things you can do if you are an over supplier.

• Try to gradually increase the length of time you breastfeed on each side.
• When your breast feels extremely full and it’s not time to breastfeed yet, hand express it for a couple of minutes or use a cold washcloth to reduce swelling.
• Try to prevent aggressive sucking and feed your baby before he or she becomes very hungry.
• Positions like “side lying” and “football hold” may help with milk ejection.

What to do if you have a rush of milk:

• Carefully and gently hold your nipple with your forefinger and middle finger to lightly compress milk ducts and reduce the milk ejection force.
• Let excess milk spray into a towel if you feel your baby is choking.

Are Your Nipples Sore?

It is normal for breasts to be sore, especially if you just started breastfeeding. Once you find a comfortable position and your baby has a good latch everything should be easier and feel better. Here are some things you can do if your nipples are sore.

• Changing positions can ease the pain and help you find a good comfortable latch.
• If your baby is not getting a good latch and only sucking on your nipple, carefully break your baby’s suction by placing your finger in the corner of your baby’s mouth and try again.
• Heal your nipples with your milk. Once you are done breastfeeding gently rub a few drops of milk on your nipples and let your nipples air-dry.
• Try to stay away from bras and clothes that can put a lot of pressure on your nipples.
• If you can’t deal with the pain or can’t seem to get a good latch don’t hesitate to get help from your doctor or a lactation consultant.

Nursing Strike:

If your baby refuses your breast all of a sudden, your baby is going into a “nursing strike”. This usually means that your baby wants you to know that something might not be quite right. Here are some of the major causes of nursing strikes.

• Distraction while breastfeeding.
• Overuse of pacifier or reduced milk supply.
• Reaction to overstimulation, stress, constant late breastfeeding, and a mother’s strong reaction to a baby’s bite.
• Loud noises or discussions while breastfeeding.
• Major change in routine.
• Breastfeeding positions might cause pain or soreness.
• Teething pain, fungal infection, ear infection, or a cold sore.

These are just some of the most common breastfeeding challenges. If you are confronted with pain, infections, or other breastfeeding problems, please contact your doctor as soon as possible.

Click Here For More Information

Source : This Article Originally Appeared on https://www.ifwh.org/en/solutions-to-common-breastfeeding-challenges/

Everything You Need to Know About the HPV Vaccine

August is Immunization Awareness Month and it’s a great time to talk to your daughter, son, friends, or family members about getting the HPV vaccine – or even getting it yourself. This vaccine protects against Human Papillomavirus (HPV) –the most common sexually transmitted disease in the United States – that can lead to cervical cancers, vulvar cancers, vaginal cancers, anal cancers, oropharyngeal cancers, and genital warts.

To maximize the vaccine’s effectiveness, girls and boys should receive it BEFORE they are sexually active. The recommended age is between 11 and 12 years of age. Although women can receive the vaccine until the age of 26 and men until the age of 21, it will not protect them against HPV infections they have already been exposed to. Many people think that this vaccine is only for girls, but it can also prevent anal cancers, mouth and throat cancers, and genital warts in men.

There are two types of vaccines – Cervarix and Gardasil – that protect against HPV-16 and HPV-18 strains, which account for over 70% of cervical cancers and an even greater percentage of HPV-associated cancers. The Gardasil vaccine also helps protect against anal cancers and genital warts. They are all given in a series of three shots over a period of six months. Those that have missed a dose or never finished getting all the shots should visit their doctor to complete the series. More than likely, they will not be required to start the whole series again.

So how does the HPV vaccine protect against these cancers? The vaccine contains proteins that are almost identical to the real HPV. When these proteins are injected, the body creates antibodies to clear this protein from the body. When people that have received the vaccine are exposed to HPV, their body already knows how to defend itself and keep it from entering its cells and creating an infection. The real or live virus is not used in the vaccine so there is zero risk of being infected from it.

One of the most common questions that I hear from my patients is: “Is the vaccine safe?” The response is that clinical studies have shown that it is safe and the Food and Drug Administration (FDA) has also declared it safe after extensive investigation. It is important to keep in mind that just like with any other vaccine, there might be some short-term side effects that can include bruising, itching, swelling, and tenderness at the injection site. Very rarely, individuals have reported dizziness, nausea, and vomiting, but it is important to emphasize that this is extremely uncommon. Doctors and health authorities recommend the HPV vaccine because they know that the benefits heavily outweigh the risks.

For more information about HPV Vaccine Click Here.

Source : This Article Originally Appeared on https://www.ifwh.org/en/everything-you-need-to-know-about-the-hpv-vaccine/

Discussing Women’s Health With Your Teen Daughter

As your daughter enters her teenage years, it’s important for her to understand how and why her body is changing. It is also time for her to start seeing an OB/GYN. Parents often feel nervous and embarrassed to bring up the subject. Here are some ways to make talking about women’s health with your teenage daughter easier for both of you:

Start Early

Establishing open and honest communication with your daughter early on will make it much easier for you to talk about sex, puberty, birth control, STDs, and other difficult topics. Don’t start talking to your daughter about her period when she begins to menstruate for the first time and don’t wait to talk about sex when her friends are already doing it. Start approaching these topics early so your daughter feels comfortable coming to you for information. Putting off these conversations may lead her to seek information from the wrong sources.

Don’t Have “The Talk”- Have Many Talks

Trying to teach your daughter everything she needs to know about women’s health in one sitting can be a daunting task. Make it easier for both of you by casually bringing up the subject when the opportunity arises. For example, if a menstrual pad commercial comes up on television, use the opportunity to explain to your daughter what these pads are used for and how she will be using them in the future. Look for “teachable moments” every day to casually bring up the subject.

Spend Quality One-on-One Time With Your Daughter

It’s important for your daughter to have plenty of opportunities in which she can ask questions or talk about the changes that she’s going through. Plan activities where both of you can chat without having siblings or other family members around. Allow your daughter to share what’s going on in her life. Keep an open mind and avoid getting angry at the information that she shares.

Find an OB/GYN Your Daughter Feels Comfortable With

As your daughter enters womanhood, she will need to start seeing an OB/GYN and getting her annual exams. The thought of visiting a gynecologist for the first time can be very scary for her. She’ll probably ask: What will they do to me? Will it hurt? What will they think about my body? Ease your daughter’s fears by letting her participate in the process of selecting an OB/GYN and share some of your own experiences with her. Ask her if she would like for you to stay in the same room during the visit or if she prefers that you wait outside.

For More Information about San Antonio OBGYN visit https://www.ifwh.org/en/

Source : This Article Originally Appeared on https://www.ifwh.org/en/discussing-womens-health-with-your-teen-daughter/

Is it Just the Baby Blues?

Having a baby should be the happiest time of your life, right? So why are you feeling sad and out of yourself the first few days after giving birth to your baby?

If you’re feeling irritable, sad, and find yourself crying often the first week or two after giving birth, you’re not alone. Up to 80 percent of new mothers experience weepiness, irritability, frustration, mood swings, vulnerability, forgetfulness, exhaustion, and stress for the first two weeks after delivering. This condition, known as the Baby Blues, will peak itself around five days after delivery and should resolve on its own in around ten days.

The problem is that during this time, new mothers are also at risk of developing Postpartum Depression (PPD), which according to the American Psychological Association affects between 9-16 percent of postpartum women. Unlike the Baby Blues, PPD is a serious condition that requires treatment. It’s important to know the difference so that you can get timely care if needed.

How can I distinguish PPD from the Baby Blues?

The number one differentiating factor is that PPD impairs your normal functioning, explains clinical psychologist, Shoshana Bennett in her Psychology Today article. Although you experience ups and downs with the Baby Blues, you should feel happy most of the time. On the other hand, women suffering from PPD have symptoms like loss of appetite, difficulty sleeping, hopelessness, anger, low self-esteem, and deep sadness that keep them from being able to perform their daily activities.

Another big differentiating factor is time frame. Symptoms of the Baby Blues should only last for a few days and a maximum of two weeks. After that, it is considered Postpartum Depression. However, if symptoms are keeping a new mother from being able to perform her daily activities it is probably PPD even if it hasn’t been two weeks. Women with both conditions report feeling tired and overwhelmed but the major difference is that with the Baby Blues these feelings go away with rest or support from loved ones.

What should I do if I’m experiencing the Baby Blues?

Remind yourself that what you are feeling is normal and that it doesn’t make you a bad or unfit mother. Make sure you get plenty of rest and ask your partner or loved ones to provide support during this time. Talking to other new mothers who are going through the same thing can also help you feel better. It is important to talk about your experience with a trusted doctor, such as yourOB/GYN, who can reassure you that these feelings are normal and can let you know if it’s time to seek additional help.

What should I do if I’m experiencing Postpartum Depression?

If you suspect that you are suffering from PPD, seek professional help from a licensed counselor or psychologist. He or she can provide you with treatment options that will help you go back to your regular functioning and let you enjoy your new baby. Your OB/GYN can evaluate your symptoms and help you take the next steps toward recovery.

Keep in mind that there is a dangerous condition known as Postpartum Psychosis in which new mothers experience hallucinations, paranoia, confusion, and suicidal thoughts. Call the National Suicide Prevention Hotline at 1-800-273-TALK or chat online athttp://www.suicidepreventionlifeline.org (available 24/7) if you ever have thoughts of hurting yourself.

Gonima, Camilo A., MD
The Institute for Women’s Health

Source : This Article Originally Appeared on https://www.ifwh.org/en/is-it-just-the-baby-blues/

References:

New York State Department of Health:https://www.health.ny.gov/community/pregnancy/health_care/perinatal/maternal_factsheet.htm

Psychology Today: https://www.psychologytoday.com/blog/mommy-mental-health/200902/baby-blues-or-postpartum-depression

American Psychological Association: http://www.apa.org/pi/women/programs/depression/postpartum.aspx