HERmd

As a women’s sexual healthcare physician who has been practicing for nearly 20 years, I have seen many women who suffer from some type of sexual dysfunction. Many women think they are alone, but it is estimated that nearly 40% of all women suffer from some type of sexual dysfunction.

Many women come to me with the same types of questions. There has been such a lack of information available to women with respect to their sexual health. HERmd is on a mission to educate women, advocate for their healthcare, and empower them to take control of their sexual health.

What are the most common complaints about female sexual health?

1. Pain during intercourse. Many women suffer from painful sex. There are treatment options out there, from medication, to laser treatment, physical therapy, surgery, dilators, hormones, and creams. There are many options! Why don’t women know? Because we are not talking about it.

2. HSDD (Hypoactive Sexual Desire Disorder) or lack of desire. How many of you know what Erectile Dysfunction (ED) is? My guess is that most, if not all of you, have heard of ED and Viagra. And yes, men’s sexual health is important as are their treatment options, but women’s sexual health is too, and many of my patients who have suffered from HSDD did not even know that it existed as a diagnosable condition. Medication, hormone therapy, and counseling are all treatments for HSDD

3. Lack of arousal. Many of my patients have come to me with a lack of arousal or desire and thought it was all their fault. The inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity is in fact categorized as Female Sexual Arousal Disorder (FSAD). Not to be confused with orgasm dysfunction (anorgasmia) or hypoactive sexual desire disorder (HSDD)  – which is the lack of sexual desire, FSAD also refers to the lack of normal lubrication during sexual activities. Treatments include testosterone, and FDA approved addyi.

4. Orgasm dysfunction. For some women reaching an orgasm may take longer than usual. For others, orgasms may not be satisfying. And for others yet, reaching climax at all is difficult – even with proper stimulation. This can happen – it’s called “orgasm dysfunction”, also known as anorgasmia or female orgasmic disorder, and there’s something we can do about it. Let’s talk about what physical (age, chronic illness, hysterectomy, etc.) and / or emotional issues (past sexual abuse, religious/cultural views, relationship issues, depression, etc.) may be a root cause of the orgasm dysfunction and then let’s work to fix it. Certain symptoms may be treated with hormone therapy, prescription medications, physical therapy, or compounded medicines.

 Why do I have no sex drive?

This is one of the most commonly asked questions I get from patients. There is no single answer and it differs for everyone. No sex drive can be attributed to a multitude of factors for women including hormones, self esteem,  other medications, overall health, your relationship, lifestyle and neurotransmitters in the brain.

Why do I have pain with sex?

There are a multitude of reasons, atrophy from lack of hormones, side effect from medicines like birth control, anatomic problems like an ovarian cyst or uterine fibroid, infections, or chronic problems like endometriosis.

I cannot insert anything in the vagina is something wrong with me?

Sometimes there is an anatomic reason, like an imperforate hymen or a vaginal septum.  Other times it is a condition called vaginismus- involuntary contractions of the muscles surrounding the vaginal opening. There are a multitude of treatment options, ranging from medicine, physical therapy and believe it or not vaginal Botox- I am one of the few physicians in the country trained to do this.

Why would I want vaginal rejuvenation?

I hate the term vaginal rejuvenation because it makes it seem cosmetic rather than medical. This procedure helps with pain with intercourse, prolapse, stress incontinence and can help with laxity of the external genitalia. This procedure has been a life saver for my patients with cancer who are not candidates for hormones and want to be intimate again without pain.  IT also has been great for patients who are not quite ready for incontinence surgery as there is almost no down time and the procedure takes less than 10 minutes. We use the CO2RE intima laser in our office for this procedure, and I have performed this procedure on thousands of patients.

There are so many medications for men for sexual dysfunction, how about us women?

26 to 2. That’s right, there are 26 FDA approved medications for male sexual dysfunction and until five years ago there were 0 for women. Now, WE can finally say yes. WE have medications for women.

We have two.

addyi, which was FDA approved for HSDD in 2015, and just last year, vyleesi came onto the market.

We have a lot of work to do to close the gender gap in healthcare and have more medical treatment options for women. Where does that start? With education, advocacy, and empowerment. My goal is to educate women on their sexual health and treatment options, to advocate for them with clinical research, and empowering them to start the conversation and take control of their sexual health.

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