Sexual Health is important.
September is sexual health awareness month. This is a good time to assess our sexual health and fill in any gaps in our knowledge.
What is sex? Sex is not something that comes with a protocol or one size/ position fits all. Other than the physical aspect, there is an emotional side to it as well which needs to be taken into consideration. It is the combination of mind, body, and spirit.
What happens when two people are engaged in consensual sexual activity? The science behind this is both simpler and more complex than we can think. Powerful hormones like oxytocin are released during sexual activity. Oxytocin is also known as the cuddle hormone is a neurotransmitter and is released during contractions before birth as well as milk release. In the broad spectrum, this hormone is thought to be involved in broader social, cognition, and behavioral aspects. It is associated with pair-bonding and hence the name love or cuddle hormone. It helps with early bonding between the mother and infant as well as bonds between romantic partners.
Hormones affecting sexual desire:
Although considered as a male hormone testosterone just like estrogen is present in both men and women in different proportions. Testosterone is the most influential hormone for sexual desire. Hormones changes don’t necessarily mean there is a problem. But, if it affects your sexual desire, its good to seek help.
Factors affecting hormone level:
1.Menstrual cycle: A peak of sexual desire (libido) before and around ovulation, with a second, less intense peak during menstruation, is common. The lowest level of libido is often prior to menstruation, although there is much variation from this pattern.
2. The Pill and Other Hormonal Birth Control Methods: Some hormonal birth control methods including the pill, the patch, injectable contraceptives, and the vaginal ring, suppress the usual cyclical nature of hormones and may affect desire and sexual functioning. Some women experience vaginal dryness. The effects vary amongst women.
3. Pregnancy: During pregnancy, the estrogen and progesterone level increases and can lead to increased desire. On the flip side, however, fatigue, nausea, pain, fears, or issues with changing body size and self-image may have the opposite effect.
4. Nursing: Breastfeeding can suppress ovulation for months. During breastfeeding, there is an increase in prolactin and a reduced level of estrogen. Many women have decreased desire or no libido which usually returns when the baby is weaned.
5. Perimenopause/Menopause: During perimenopause estrogen level s fluctuate while progesterone levels decline. After menopause ( when menstrual period stops for a year)both estrogen and progesterone are steady at a low level. During these years women experience less desire and increased vaginal dryness. Using a lubricant can help (use water-based lubricant)
6. Adrenal/Ovary removal: This can result is decreased or no desire or orgasm due to a decrease in testosterone. Genital Pain and Sexual Health: Both men and women can have pain with sexual activity that can limit or completely stop sexual pleasure.
Causes of Genital Pain:
1. Sexually Transmitted Infections: Also known as a sexually transmitted disease (STD), affect nearly 20 million people in the US each year. Women are more affected than men. STD in women if left untreated can cause pelvic pain, complications in pregnancy (ectopic), infertility, organ damage, etc. Treatment includes shots and medication. It is particularly important to consult your physician if you think you have contracted sexually transmitted infections. https://www.womenshealth.gov/a-z-topics/sexually-transmitted-infections
2. Musculoskeletal Disorders: Pelvic pain can occur due the dysfunction in the muscles of the pelvic floor. The muscles of the pelvic floor help with support of the internal organs, acts as a sump pump, helps with sexual activity, and during childbirth. These muscles can get weak or tight leading to pelvic floor dysfunction.
Some musculoskeletal disorders include:
a. Vulvodynia: More than 200,000 cases in the US per year. Chronic pain or discomfort around the opening of your vagina. Pain, burning or irritation after sitting long period of times, sexual activity.
b. Vaginismus: Involuntary contraction of vaginal muscles during penetration. Pain when inserting a tampon or during penetration, pain when touched at the vaginal area.
c. Dyspareunia: Pain during sexual intercourse. It can be felt during initial penetration, deep penetration, or trust.
d. Levator ani syndrome: Chronic anal pain due to tight pelvic floor muscles. It can cause pain before, during or after intercourse in women and painful or premature ejaculation and erectile dysfunction in men.
Treatment:
More than 25% of people in US have pelvic pain. Most of the pelvic pain can be treated. Short course of treatment will help temporarily, but its important to address the root cause. Consider seeing a pelvic pain specialist or Pelvic Physical Therapist. Talk to your physician about musculoskeletal pain. If you think your pain is musculoskeletal in nature, consider talking to a pelvic physical therapist. Pelvic floor therapists are trained in assessing the muscles and nerve that play a role in sexual function and can determine if these muscles are overactive, in spasm, or weak.
