There’s no need to be shy when talking to your doctor about sexual health.

I have bad news, mamas.

1 in 3 women experience pain during intercourse at some point in their life.

Women are more likely to complain about sexual dysfunction before menopause.

And the number 1 libido killer? Kids.

That means we’re smack dab in the middle of prime sex-might-actually-suck-for-you time.

But I also have good news.

Something can actually be done about it.

I was invited to attend Let’s Talk About Sex at Virginia Women’s Center at St. Francis and as weird as it might sound, spending an evening with a bunch of people who know more about your vagina than you do and about 30 some strangers was actually a really good time. Before I get into what we talked about, here’s a little bit about who was there:

Virginia Women’s Center brought in four different experts on various aspects of women’s health for an open and mature conversation about sex, sexual health, and sexual dysfunction.

Keith P. Berkle, M.D.
Dr. Berkle diagnoses and treats disorders of the vulva including vulvar pain syndromes and has a special interest in minimally invasive surgical techniques, such as laparoscopic hysterectomies, myomectomies and single incision laparoscopic gynecologic surgeries.

Tovia M. Smith, M.D.
Dr. Smith is a urogynecologist and uses non-surgical as well as advanced technologies such as the daVinci Surgical system to reconstruct the pelvic floor for women who suffer prolapse, urinary incontinence and fecal incontinence.

Cora Huitt, PT, DPT, BCB-PMD
Practicing physical therapy for 41 years, Cora Huitt  is a certified women’s health specialist and specializes in treating women with pelvic floor dysfunction

Sara Bolden, DPT, WCS
Dr. Bolden is a licensed physical therapist and board certified women’s health specialist specializing in pelvic pain, urogynecologic disorders and pelvic floor dysfunction.  Dr. Bolden is also the author of What A Girl Wants: The Good Girl’s Guide to Great Sex.

 

So what did they talk about?
Here’s a brief overview.

The vagina… it’s complicated.
Well, not just the vagina, the pelvic floor itself has a lot of layers, so there’s a lot that could be troubling you. If you’re experiencing discomfort, head to a doctor you can trust or someone who specializes in your particular concern. When you’re there, be prepared for a loooot of questions, and don’t be shy about answering them (they really have heard it all). Sometimes it’s a simple fix, sometimes it’s a lot more than that, sometimes it’s physical, sometimes there’s a psychological factor as well. The more honestly you share, the more you’ll get out of your appointment.

Hang on, you missed a spot.
There is, perhaps, a g-spot, but as it turns out there’s also a u-spot and an a-spot. (And now I know where they are, don’t I feel special.) Don’t worry, the directions are written down for you.  Yes, further proof that though we took sex ed in high school, and even had kids of our own, but there’s a lot you might not know about your own body.

Coconut oil is a great lube and lube well, isn’t a great lube.

Popular lubricants, soaps, feminine products and other things can be drying and cause irritation. If you’re experiencing discomfort, the answer may be as simple as a product switch or dropping a bad habit or two. A couple of easy switches: Choose coconut oil or olive oil for lubricant over potentially drying store bought lubricants and when shopping for feminine products, consider switching to a more natural fiber (cotton) rather than the synthetic or scented types.

There are 26 drugs marketed for the treatment of male sexual dysfunctions.

For women? 0.
There is no FDA approved drug for the most common type of sexual dysfunction for women (hypoactive sexual desire disorder).  That doesn’t mean doctors can’t help you, they can, there are therapies that can be used to treat HSDD.  There are drugs out there, but they have yet to be approved by the FDA.  For more information visit EventheScore.org.

You don’t have to suffer in silence.

Sexual dysfunction can affect more than just your sex life. It can affect your confidence and your relationship. It is suspected that many women’s health problems are underreported due to embarrassment, but nearly half of all women suffer from sexual dysfunction at some point in their lives such as pain during intercourse, trouble reaching orgasm or decreased desire. And, it’s not just sexual health that may concern you, 50% of postpartum women experience urinary incontinence, and while something can done about it but only 60% of women seek help.
If it bothers you, it’s worth seeing a professional.

Let’s Talk About Sex was hosted by

Virginia Women’s Center 

and Women’s Health Physical Therapy
at St. Francis Medical Center.

This article was sponsored by Virginia Women’s Center and Women’s Health Physical Therapy.

Vaginal bleeding: For the first three days after delivery, you may experience a bloody discharge of leftover blood, mucus and tissue from your uterus. This discharge, called lochia, is generally as heavy or heavier than a menstrual period and may contain several clots. The discharge will turn pink, then brown and finally a yellowish-white as it decreases in quantity. The bright red flow may resume when you are breastfeeding or during periods of increased activity. Normally, this will stop completely within four to six weeks.

Things to help: Sanitary pads

What to watch for: Saturating more than one pad an hour for more than a few hours or discharge that has a bad odor

Abdominal cramps (afterbirth pains): Abdominal cramps, or “afterbirth pains,” are caused by contractions of the uterus as it returns to normal. They may be more obvious while you are nursing and will gradually subside within a week.

Things to help: Change positions, empty your bladder, take Tylenol® or Motrin® (Ibuprofen)

What to watch for: Severe abdominal pain, nausea/vomiting

Perineal discomfort: The stretching and bruising of the perineum during delivery can cause discomfort, pain and numbness. If your perineum was torn or if you had an episiotomy, you will have stitches. In most cases, this area will be very tender and sore for three to four days following delivery. Your stitches will dissolve in about 15 days, but tenderness may last several weeks.

Things to help: Warm sitz baths, witch hazel soaked in gauze pads or Tucks®, local anesthetic spray, Tylenol®

What to watch for: Increasing pain, swelling or discharge

Cesarean incisional pain: If you delivered by cesarean birth, your wound will be painful and you may experience numbness or a tingling sensation when the anesthesia wears off. Medication to relieve your pain will generally be ordered by your physician. Avoid lifting anything other than your baby, and try to keep stair climbing to a minimum.

What to watch for: Fever, increasing pain or drainage from your incision site

Constipation: Your first bowel movement after childbirth may be difficult.

Things to help: Fiber (whole grains, fresh and dried fruit), drinking water, Colace®, Milk of Magnesia® or Dulcolax® tablets

Hemorrhoids: If you have hemorrhoids, they can become swollen and painful and protrude after delivery.

Things to help: Laxatives, Anusol® or Preparation H®

Infant feeding: If you are bottle-feeding, remember to wear a well-fitting bra and avoid breast stimulation. Breast engorgement will generally improve two to four days following delivery.

If you are breastfeeding, you may not produce milk for three to four days after delivery. When your baby nurses, he or she will receive a clear liquid, called colostrum. This fluid contains important antibodies. When your milk finally begins to come in, your breasts may become enlarged, tender or unusually firm.

Things to help: Nurse your baby more frequently, apply warm compresses to your breasts or take a warm shower.

What to watch for: Body aches, chills and a fever of 101⁰ or 102⁰ as these can be signs of a breast infection called mastitis. With mastitis, one breast may become extremely firm, red hot and tender.

As always, you are welcome to call our office at 804.288.4084 with any questions or concerns you may have. If you experience any of the following symptoms, please call us immediately.

• Elevated fever over 100.4
• Nausea and vomiting
• Painful urination, burning and urgency
• Heavy vaginal bleeding
• Pain, swelling and tenderness in the legs
• Chest pain or cough
• Hot, tender breasts
• Persistent pain in the perineum with increasing tenderness
• Vaginal discharge with a bad odor
• Feelings of hopelessness that last more than 10 days after the delivery

Additional Resources:

• Postpartum mental health
• Safe medications while breastfeeding
• Returning to normal activities

About Virginia Women’s Center
Our care team – comprised of OB-GYNs, high-risk pregnancy specialists, nurse practitioners, ultrasound technologists, psychologists and a genetic counselor – are experienced in all aspects of pregnancy and welcome the opportunity to provide care that revolves around you. We have added all of these services and specialists to our practice not only for your convenience, but also because we believe that you will benefit from a coordinated and comprehensive approach to your pregnancy care. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that supports a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum. Weakened pelvic muscles or tears in the connective tissue can occur when excessive strain is put on the pelvis through childbirth, repeated strenuous activity or pelvic surgery. Other factors that can increase the risk of pelvic floor disorders include repetitive heavy lifting, menopause, chronic disease, tobacco use and family history.

What conditions can a urogynecologist treat?

• Pelvic organ prolapse: One or more of the organs in the pelvis drops down causing a sense of pressure or a bulge in the vagina. It may also cause urinary incontinence, pain or constipation.
• Stress urinary incontinence: Leakage of urine with coughing, sneezing, laughing or any other activity that increases the pressure on the bladder and/or the supporting tissue.
• Overactive bladder syndrome: Frequency, urgency (a sudden and strong desire to urinate that is bothersome) and nocturia (waking up more than once at night to void) with or without urge incontinence (accidental urine loss associated with a sudden and strong desire to urinate).
• Anal and fecal incontinence: Involuntary leakage of gas and/or stool.
• Fistulas: An abnormal connection between two organs (i.e. bladder and vagina or vagina and rectum)
• Complications from third and fourth degree tears following vaginal childbirth

What treatment options are available?

There are a variety of non-surgical approaches as well as surgical options that can help relieve the symptoms associated with pelvic floor disorders. After consultation, you and your physician will work together to find the solution that works best for you, your lifestyle and your overall health.

Why should I see a urogynecologist?

While many of the symptoms and conditions listed above are very common, it is important to know that these are not a normal part of aging or something that women need to put up with. Consulting with a urogynecologist will provide you with specialized expertise to help determine the best way to relieve your symptoms and restore your quality of life.

At Virginia Women’s Center, we are excited to welcome our first urogynecologist, Dr. Tovia Smith. Dr. Smith will work with female urologist Dr. Lonny Green and gynecologists Dr. Elizabeth Roberts and Dr. Louis Thompson to care for women whose qualities of life are being affected by bladder and pelvic health issues.

About Virginia Women’s Center
Since 2006, Virginia Women’s Center has been dedicated to helping women with urinary incontinence and other bladder problems find solutions to restore their quality of life. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

The loss of a child through miscarriage can be a difficult and emotional experience. Even in the early weeks of pregnancy, many women develop a strong bond with their unborn child and feel a deep sense of loss when miscarriage occurs.

Common responses include shock or denial, disappointment or anger, helplessness or perceived loss of control, sense of failure, feelings of inadequacy, guilt or self-blame, sadness or fear. Everyone responds in a different way to the grief process. There are no “shoulds” or “right” ways to feel. Keep in mind that whatever your feelings, it is important to be gentle with yourself. Although there are many ways to lessen the pain, the only thing that truly diminishes grief is time. Some women will move through this loss freely, while for others, it will take far longer.

During your recovery, it is important to eat properly, get plenty of rest, exercise – and most importantly, do not be afraid to ask for what you need.  Reach out to others and request help; allow friends to make meals, watch other children or help with household duties.

When you feel ready, talk about your experience. You may be surprised how many other women can offer their love and support because they have been down this road too. Although it does not ease your grief, miscarriage occurs in 10 to 20 percent of pregnancies making it a very difficult common experience. However, be prepared that when you talk about your experience, you may also encounter some misunderstanding. Many people who have not experienced a miscarriage consider it the end of a pregnancy rather than the loss of a child. They may question your grief or suggest that you keep busy and forget about your loss. Be assured that your grief is real and allow your tears to flow. In time, with love and support, your pain will subside, but the loss will always be a part of your life.

It is likely that you will not want to be around other pregnant women or that you will be unable to attend a friend or relative’s baby shower. This is a very natural reaction and does not indicate jealousy or selfishness on your part. It is important to honor these feelings and to be honest with others about them; they will understand.

Some women find it helpful to honor the existence of their baby by giving their baby a name and participating in a funeral or ritual to mark the loss. In addition, prepare yourself for future dates, such as your unborn baby’s due date and subsequent anniversaries. These dates will likely have a place in your heart for years to come.

One issue that exacerbates this loss is that there are not always explanations for miscarriage. While it is important to ask your health care provider if there is an explanation, understand that often there is no specific medical problem.

Given the many hormonal changes, you may experience mood swings, fatigue, irritability, heart palpitations, poor appetite and a desire to withdraw from social activities. All of these symptoms are normal and will gradually diminish. However, if you find these symptoms to be persistent or severe, call your health care provider immediately.

Physical Healing After a Miscarriage

Physically, it may take several weeks or months for your body to return to normal. In the beginning, you may notice spotting or light vaginal bleeding, mild cramping, nausea and fullness in your abdomen and breasts.

To help prevent infection, use sanitary napkins instead of tampons and avoid sexual intercourse until your bleeding stops. Call your health care provider immediately if:

• You have a fever of 100 degrees or more
• Bleeding increases significantly or lasts more than several weeks
• Bleeding changes color to bright red
• You experience pelvic pain or unusual cramping
• Your vaginal discharge appears yellow, green or has a bad odor

Planning for the Future

If you are considering becoming pregnant in the future, discuss your risks and options with your health care provider. Every situation is unique, but in most cases, the chances of suffering another loss are not significantly increased unless you have had three or more miscarriages. Whatever you decide, remember to give yourself ample time to recover physically and emotionally from your miscarriage before making the decision to get pregnant.

Subsequent pregnancies may create a number of psychological issues, including anxiety about possible recurrent miscarriages and the fear of not being able to have children. Anxiety will be greatest up until the time that the first miscarriage occurred. It is understandable that you would experience this type of response. In order to cope, stay in the here-and-now and focus on being pregnant again and not what could possibly happen.

Additional Resources

If you want more structured, formal help, you may wish to pursue counseling at Virginia Women’s Center with one of our two psychologists: Dr. Lisa Cuseo-Ott or Dr. Mary Polce-Lynch. There are also many support organizations and groups in the Greater Richmond area that you may find helpful, including:

• Compassionate Friends
  • www.compassionatefriends.org or 804.254.0588
• Family Extended
  • www.familyextended.org
• Full Circle Grief Center
  • www.fullcirclegriefcenter.org or 804.357.5924
• M.I.S.S. Foundation
  • www.missfoundation.org or 800.726.4322
• Bliley’s Internment of Angels
  • Bliley Funeral Home offers monthly funeral services for families who have experienced a miscarriage or stillbirth. The services are at no cost to you and close family and friends are welcome to attend. To learn more, call Bliley’s at 804.355.3800.

About Virginia Women’s Center

At Virginia Women’s Center, we value the complete health of women. As researchers continue to identify the significant relationship between physical and mental health, Virginia Women’s Center has emerged as a leader in innovative health care for women by providing psychological counseling services to our patients since 2005. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

Virginia Women’s Center is a sponsor of Richmondmom.com

 

Learn more about the risk factors and symptoms of postpartum mental health disorders:http://www.virginiawomenscenter.com/services-psychology-postpartum-mental-health.html

Women suffering from stress incontinence experience the leakage of urine when they cough, sneeze, laugh or engage in any activity that increases the pressure on the bladder and/or the supporting tissue. There are many non-invasive treatment options that women experiencing stress incontinence can try first. However, for some individuals, non-invasive therapies may not completely eliminate the symptoms of incontinence. These individuals may be good candidates for minimally invasive surgeries that take as little as a few minutes to perform.

The most common surgical procedure to remedy stress incontinence uses a synthetic sling, which acts like a hammock to support the urethra, the tube that carries urine from the bladder. Synthetic sling procedures are often done under anesthesia in an outpatient setting. For most women, the complete recovery period is approximately four weeks, but many are able to return to work and other non-strenuous activities after a couple of days.

Learn more about incontinence and read patient testimonials here: http://www.virginiawomenscenter.com/services-urogynecology.html

• If you are under 35 and have not become pregnant after one year of having regular sexual intercourse without birth control
• If you are over 35 and have not become pregnant after six months of having regular sexual intercourse without birth control
• If your periods are not regular
• If you or your partner has a known fertility problem

Learn more about infertility here: http://www.virginiawomenscenter.com/blog/obstetrics/infertility-causes-and-when-to-see-your-ob-gyn/

Did you know that heart disease kills more women than all cancers combined? While it is important to spread awareness, it is also important to help educate our friends, families and loved ones. Here are some tips for living heart healthy:

–          Eat a diet rich in fruits and veggies, whole-grain and high-fiber foods

–          Try to limit your sodium intake to 1500 mg/day

–          Avoid trans-fatty acids

–          Eat very little saturated fat (such as fat from meat, cheese and butter)

–          Eat less than 150 mg of cholesterol per day

–          Drink no more than one alcoholic beverage a day

–          Stop smoking cigarettes. It is important for many things, including heart health

–          Get 150 minutes of moderate intensity exercise a week, such as brisk walking

Check out this infographic to learn how much Calcium women need throughout the different stages of their lives as well as some good sources of Calcium at this link.

Weekly Health Tips provided by Virginia Women’s Center

How do you know if you need to take vitamins? And, if you do, which one(s) should you choose?

A good place to start is to take a look at your eating habits. It’s important to remember that vitamins cannot replace balanced meals and healthy snacks. If you eat a well-balanced diet, you may not need a multivitamin.

Are you hoping to take vitamins to prevent a chronic disease? If so, eating a nutritious diet, exercising regularly, quitting smoking and getting recommended health screenings are likely better solutions.

Prenatal Vitamins

There are certain times where vitamins are essential. If you are planning pregnancy, currently pregnant or breastfeeding, prenatal vitamins are recommended. An adequate intake of folic acid has been shown to prevent birth defects. Prenatal vitamins are essentials for moms-to-be and their babies because they provide folic acid, iron and calcium. They can help fill in any gaps in vitamins and minerals, but they are not meant to substitute the need to eat a healthy diet. Learn more about prenatal vitamins here.

Calcium and Vitamin D for Bone Health

If you are perimenopausal or postmenopausal, you may need to increase your intake of Calcium and Vitamin D. Calcium and Vitamin D work hand-in-hand to slow the rate of bone loss and prevent Osteoporosis.  Vitamin D is necessary to ensure that Calcium is adequately absorbed and incorporated into your bones. Without Vitamin D, Calcium would be sent out of the body as waste.

Ideally, you should obtain Calcium by eating foods that are rich in Calcium. Some good sources include low-fat dairy products, dark green vegetables and fish.  If necessary, you may also need to take a Calcium supplement.

You can increase the amount of Vitamin D you get by choosing milks, yogurts, cheeses and cereals that are fortified with Vitamin D. In addition, tuna and salmon are good sources. Spend time outside each day as exposure to sunlight converts a chemical in the skin to Vitamin D. Vitamin D supplements and/or therapy might be recommended for individuals who are not getting an adequate amount.

Talking with your Health Care Provider

There are other situations where vitamins might be recommended. For example, if you are vegan or vegetarian, you may need to supplement your diet in order to maintain a balanced supply of nutrients. Similarly, vitamins might be recommended if you have certain medical conditions or allergies that affect how your body absorbs or uses nutrients.

It is always important to talk with your health care provider to weigh the potential benefits and risks of any vitamin/supplement before starting. Vitamins can be beneficial to some individuals, but they are not right for all people. There are side effects, medications and health conditions that need to be considered.

About Virginia Women’s Center

Virginia Women’s Center is a full-service women’s health care provider specializing in obstetrics, gynecology, urology, high-risk obstetrics, obstetrical genetic counseling, ultrasound, in-office procedures, mammography, bone health, psychology, nutrition and clinical research. The practice sees patients in four locations in the Richmond area and has additional offices in Kilmarnock and Tappahannock. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.