From birth control choices to menopause treatments, women’s sexual health can be complex. What’s more, you may feel uncomfortable discussing intimate issues with your friends or partner.
But sharing questions and experiences is one of the best choices you can make, says Stephanie Tarracciano, D.O., an obstetrician/gynecologist at Piedmont. When you understand your body and needs, you can make better health choices.
“I think women too often judge their sexual health based on what they see in the media,” Dr. Tarracciano says. “They think they should have multiple orgasms, should want to have sex multiple times a week and that it is never uncomfortable. The reality is women’s bodies and the female sex drive are much more complicated.”
Here are eight things she says women should know about their sexual health:
Birth control won’t significantly raise your cancer risk
Oral contraceptive use for five years has been shown to decrease the risk of ovarian cancer, Dr. Tarracciano says, and doctors use intrauterine devices to treat some early forms of uterine cancer.
“There may be some cross-reactivity with certain kinds of hormone receptor-positive breast cancers,” she says, “but that theoretical risk is not easily quantifiable.”
Most birth controls aren’t linked to weight gain
Modern formulations have very low hormone doses, Dr. Tarracciano explains. Most pills aren’t associated with weight gain at all.
Depo Provera (a contraceptive injection) has been shown to cause gains of about 2 to 3 pounds a year, she says, but birth control often isn’t the culprit behind more significant weight gain.
“I’m fond of telling patients, ‘Maybe we can blame XYZ method of contraception for your weight gain, but you know what will really make you gain weight? Pregnancy,’” Dr. Tarracciano says.
Many women can’t orgasm based on vaginal penetration alone
Don’t feel bad if the orgasms your male partner achieves seem to elude you. Many women need assistance from manual or oral stimulation in order to reach orgasm, Dr. Tarracciano explains, and some may need extra lubrication to make sex enjoyable.
“You have to know what you need and ask for it,” she says.
You need STD testing even if you’re in a monogamous relationship
No matter how much you trust your partner, it’s smart to get tested for sexually transmitted diseases. Dr. Tarracciano points out that some STDs have no symptoms, especially for males, so they can be easy to pass unknowingly.
Older women may need extra lubrication for sex
As women age, they lose their main source of estrogen, and that can make sex uncomfortable.
“Estrogen helps keep vaginal tissue healthy and able to withstand the trauma that happens naturally with intercourse—think friction—and it also provides lubrication,” Dr. Tarracciano says.
If maintaining an active sex life is important in your relationship, she adds, you may want to consider extra lubrication or vaginal estrogen.
If you experience discomfort during sex, you may need to change positions
Some sex positions may cause your partner to bump against your cervix, which can feel unpleasant, Dr. Tarracciano says. Inadequate lubrication is another common cause of pain.
However, severe or frequent pain is not normal. Talk to your doctor to rule out more serious issues like fibroids, endometriosis and other conditions.
There’s no right answer for how often you should have sex
Too much sex? Too little sex? There’s no such thing as either—it’s all about what feels right for you.
“For women, libido is often multifactorial,” Dr. Tarracciano says. “There’s no one simple answer.”
If you and your partner aren’t having sex but feel happy and intimate, then there’s no reason to worry, she says.
Don’t be scared to talk to your doctor
“Every woman and every relationship is different,” Dr. Tarracciano says. Your doctor is a trained health professional who understands that women’s sex lives can vary greatly.
“Please don’t be embarrassed to come in and talk about this,” she says.
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