In case you hadn’t noticed, we’re pretty comfy talking about sexual wellness here at Poosh. But even we clam up a little when it comes to talking to the doctor about it.
“Women’s sexual wellness has not been prioritized by modern medicine, or our culture generally, in the same way it has been for men,” says Monica Molenaar, co-CEO and cofounder of Alloy Women’s Health. “Until now, women’s sexuality, outside of pregnancy, has been an afterthought at best for the medical community. This occurs even though there are safe and effective treatments for common complaints like vaginal dryness and pain (possible side effects of oral birth control and menopause), as well low libido and arousal.”
Why is it difficult for so many of us to talk to our doctor about sex?
“As a 50-year-old woman who came of age in the 90s and early 2000s, I can tell you that my generation grew up with words like ‘slut,’ ‘skank,’ and ‘ho’ being casually tossed around about girls and young women who were sexy and seemed to enjoy it,” Monica shares. “So, you had to go undercover or disengage entirely. When that is ingrained in you, how could you go to a doctor appointment expecting anything other than to be shamed for having sex?
“I had my own terrible experience the first time I went to a gynecologist after losing my virginity at 17. I was shamed by both the (male) doctor and my mother. Doctors carry their own biases, and I think that women my age, or any age, who expect judgment would prefer to avoid that at all costs,” she says. “Combine that with the shame and deprioritization of female pleasure that’s been taught, and there’s your answer.”
Why is it so important to be honest and transparent with your doctor about your sexual practices?
“At Alloy, we hear from women every day who have been dismissed or gaslighted by their medical practitioners when trying to discuss sexual wellness issues. And unfortunately, this happens even more often after breast cancer or other traumatic ailments,” Monica says. “The typical responses are along the lines of, ‘Have a glass of wine, use lube, and try to relax,’ or ‘You should just be grateful to be alive,’ as opposed to listening to women and trying to work with them to understand the root cause of their complaints and offering an appropriate treatment.”
This is … not helpful.
And it can make you feel even more reluctant to talk to your doctor about it. But, as we mentioned, it’s incredibly important because it could dramatically improve your health and quality of life, as well as potentially save your life.
Monica gives this example: “Frequently, especially for women in menopause, there is an underlying physiological issue, like the genitourinary syndrome of menopause (vaginal dryness, itching, burning, tearing due to the skin thinning from the loss of estrogen, frequent UTIs, incontinence) that leads to women’s loss of a satisfying sex life.
“But we know that these symptoms I just listed are easily treated with vaginal estrogen, which is also a life-saving treatment. Not only does it treat the symptoms, which can help bring pleasurable sex, it also greatly reduces the risk of recurrent UTIs, which can severely impact a woman’s quality of life and lead to premature death.”
This is infuriating, to say the least.
“We’ve seen too many women suffer by staying silent, and the consequences can be disastrous, from the dissolution of marriages and long-term relationships to extreme physical pain,” she says. “I spoke to a woman who had gone into premature menopause in her 30s and got to the point that she literally couldn’t walk because her vaginal pain was too extreme. For seven years, her doctor never offered her hormonal treatment or even vaginal estrogen which is when she turned to Alloy and finally got the treatment and support she needed.”
How can we be more comfortable talking with our doctor about this?
Finding the right doctor and setting goes a long way.
“Being naked in a paper gown in front of a stranger doesn’t always make for the most comfortable of settings for opening up about your sexual history, so this is an instance in which asynchronous (non-video) telehealth is really valuable and important,” Monica says. “You can seek out care that is relevant to what you are looking for and ask questions from a place where you feel comfortable, likely your home.”
Also, remember that we have absolutely nothing to be ashamed of. Our sexual health is important, and it shouldn’t be glossed over or considered an afterthought. We all deserve non-judgmental care.
“I’m so glad that the conversation is opening up and changing,” Monica says, “both for women my age and the generations behind us that will be so much more informed than we were about their bodies and their health.”
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