A systematic approach to care is key to improving your sexual health and desire

by Paul Joslyn, MD, FACOG

At one time or another, many of my patients have experienced problems with decreased libido, painful intercourse or other problems related to intimacy. If you are having problems with sexual desire or response, you are certainly not alone.

And here’s the good news: many solutions are available.

Research reveals that about 40% of women report sexual problems, with about one in nine saying that their sexual health issues interfere with their quality of life. This includes 10% of women under 45 and 15% of women ages 45-65. 

Many factors – mental as well as physiological – can interfere with women’s sexuality, including anxiety, depression, menopause, high blood pressure, diabetes, medications, relationship discord, substance abuse, self-esteem, trauma, and breastfeeding. 

Sorting out the often-complex underlying causes of sexual problems and devising a successful treatment plan requires a systematic approach. This begins with an office visit that includes an in-depth history, a physical exam, possibly some labs, and – if pain is an issue – perhaps an ultrasound.

Because there are many causes for decreased libido or sexual dysfunction, there is not a single medication or treatment that will work for everyone. But by carefully considering all the possible explanations, the providers at Premier Women’s Care of Southwest Florida can help you narrow down the cause of the problems you are experiencing and find a resolution.

Sometimes that might involve looking at alternatives to the medications you are taking for other issues. Some anti-depressants and psychotropic medications directly affect sexual function. Likewise, blood pressure medicines can have side effects that reduce desire. Hormonal medications for breast cancer treatment and endometriosis can also be a problem. 

The solution could also involve changing habits or addressing issues that are separate but related to sexual health. Overall health and fitness can have a huge effect on well-being and libido. Exercise, weight control, and stress management all play a part. Depression and anxiety can be treated with the proper medications. Sometimes, curbing habits such ask heavy drinking, smoking or narcotics is the answer. If the problem is with the relationship, then counselling could be key.

Hormone decreases with menopause can affect desire, and decreased estrogen levels can cause pain and dryness. Estrogen supplementation with creams or tablets can help relieve discomfort and increase libido, often leading to a quick improvement. In some instances, a testosterone cream can help.

Several new medicines or treatments can help in specific cases. Flibanserin (Addyi), Intrarosa, and Vyleesi are a few of the newer treatments available. Addyi is a tablet taken at night that can increase desire, while Intrarosa is a vaginal insert for vaginal pain, and Vyleesi is a shot you use on an as-needed basis.

And in cases where post-menopausal vaginal atrophy is the cause of painful intercourse, Premier Women’s Care of Southwest Florida offers a treatment called MonaLisa Touch®, which uses focused laser energy to restore and rejuvenate vaginal  tissues, resolving the pain and helping restore the production of natural lubricants.

As you can see, the issue of women’s sexual health is complex, and the solutions are many. I hope this quick overview has been helpful. Just remember that the problem is more common than you think, and with a methodical approach to pinpointing the cause or causes, the chance for improvement is excellent.

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