Women's Sexual Health Archive


When sex hurts

Three-quarters of women experience painful sex at some point, and up to six in 10 report painful sex during the transition to menopause and beyond. Childbirth, menopause, and a condition called hypertonic pelvic floor contribute play a role in many cases of painful sex, though other health problems and treatments can contribute as well. Treatment options include lubricants, vaginal moisturizers, vaginal estrogen, and pelvic floor physical therapy.

How do I approach a new partner about STI testing?

Discussing sexually transmitted infections (STIs) at the start of a new relationship can protect both partners' health. Many STIs don't cause symptoms. Couples can test for STIs together or separately and share results before becoming intimate.

Should I use vaginal probiotics?

Vaginal probiotics contain live microorganisms and come in oral and suppository forms. Some ads claim these products can prevent or treat infections. But the vagina regulates its own bacterial mix, so vaginal probiotics aren't necessary.

What symptoms should I report to my gynecologist?

Women with unusual pelvic or vaginal symptoms should report them to their gynecologist. These symptoms include vaginal odor, itching, or burning; menstrual changes; pelvic pain or discomfort; or new bleeding.

Laser therapy can counter vaginal symptoms of menopause

The results of a small trial published online in July 2021 by the journal Menopause found that both vaginal estrogen and fractional CO2 laser therapy are effective for postmenopausal symptoms related to skin problems of the vulva and vagina.

Understanding and treating pelvic organ prolapse

This common problem is often ignored or misunderstood.

Roughly half of women over age 50 have pelvic organ prolapse, a condition in which the uterus, bladder, small intestine, or rectum bulges into the vaginal wall or drops down through the vagina. But unlike with other common health conditions, many women don't talk about it — even with their doctors. For some, this may stem from embarrassment, but in other instances, it's because they think it's just something they need to deal with as they age.

"Women will say to me, 'I thought this was normal because I had kids.' But it's not normal. Not everyone who has had a vaginal delivery or is over 65 has urinary incontinence or pelvic organ prolapse," says Dr. Emily Von Bargen, a Harvard Medical School instructor in Obstetrics, Gynecology, and Reproductive Biology. Pelvic organ prolapse is treatable, and it's not something women have to live with, says Von Bargen.

Affairs of the heart

Cardiovascular problems can conspire to put a damper on sexual enjoyment. Talking to your doctor and your partner can help.

A physical connection with your romantic partner is often an important part of a fulfilling relationship. But when it comes to matters of the heart, the health of your heart matters.

"A satisfying sex life depends on physical health, psychological well-being, and the quality of the relationship," says Dr. Jan Shifren, who directs the Massachusetts General Hospital Midlife Women's Health Center. Heart disease and related conditions can influence all three of those factors in both men and women. Here's a look at the range of those effects and some possible solutions.

Probiotic may help prevent recurrences of bacterial vaginosis

Research we're watching

If you've ever experienced a bout of bacterial vaginosis, a vaginal infection that affects anywhere from 15% to 50% of reproductive-age women, a study published May 14, 2020, in The New England Journal of Medicine may be of interest. It found that women who inserted a type of probiotic called Lactobacillus crispatus (Lactin-V) in their vagina twice per week were less likely to have a recurrence of bacterial vaginosis than women who did not. Experts don't fully understand what causes bacterial vaginosis, but it is associated with an overgrowth of some microorganisms (such as Gardnerella vaginalis or Prevotella), which outnumber healthier types of vaginal bacteria, including a common one called Lactobacillus. In many cases, the condition will recur after treatment. All of the 228 women in the study were initially treated for bacterial vaginosis with the standard topical antibiotic metronidazole (MetroGel Vaginal). But after that treatment, 152 of the women were assigned to use Lactin-V for an additional 11 weeks. The remainder of the group got a placebo treatment. Researchers found that only 30% of the Lactin-V group had a recurrence of bacterial vaginosis by week 12, compared with 45% of the placebo group.

Image: © spukkato/Getty Images

Can certain exercises worsen my pelvic organ prolapse?

Ask the doctors

Q. I have pelvic organ prolapse and I want to start working out. Are there exercises I should avoid?

A. Pelvic organ prolapse is a common problem, caused by a weakening of the bowl-shaped group of muscles and tissues that supports your pelvic organs. As this support fails, one or more of these organs — such as the uterus, bladder, or rectum — can shift out of place, typically pushing into (and sometimes protruding out of) the vagina.

Sexual and gender minorities face unique health risks

Memory problems and confusion are just the newest in a list of health problems that appear to disproportionately affect LGBT individuals.

Past research has shown that sexual and gender minority groups may be at higher risk for certain health conditions, including cardiovascular disease and mental health disorders such as anxiety and depression. A new study suggests that another condition — dementia — may also be on that list. Findings presented at the 2019 Alzheimer's Association International Conference showed that people who identified as a sexual or gender minority were more likely than other people to report worsening memory or increased confusion over the past year.

It's possible that some of the same underlying factors that affect risk of other diseases are playing a role in these reported cognitive changes as well, says Dr. Ole-Petter R. Hamnvik, an assistant professor of medicine at Harvard Medical School. "Almost any health outcome that you look at, you can find disparities in these groups. It's not just dementia," he says.

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