Can You Bring Up Sexual Health With Your OBGYN?
Yes, and it belongs in the visit as much as any other symptom. Low libido, pain during intimacy, dryness, and difficulty with arousal are common, frequently have identifiable causes, and are often treatable.
Dr. Joseph Leveno addresses sexual dysfunction as a routine part of care at his Medical City Plano practice, seeing patients from Richardson and nearby communities.
What Falls Under This Topic?
Patients often assume the category is narrower than it is, and stay quiet about something that would have been straightforward to raise.
Concerns that belong in this conversation include:
- Reduced interest in sex, or a noticeable change from your baseline
- Pain or discomfort during or after intimacy
- Dryness that persists regardless of circumstance
- Difficulty with arousal or with reaching orgasm
None of these are too minor to mention, and none of them require a particular relationship status to be worth addressing.
Why Is It So Hard to Bring Up?
Most patients cite some mix of embarrassment, a worry about being judged, and a quiet assumption that this is simply how things are going to be from now on.
Many also expect to be told it is normal for their age and sent on their way. That expectation keeps a lot of treatable problems unspoken for years.
Practically speaking, the discomfort tends to last about thirty seconds. What follows is a fairly ordinary clinical conversation about symptoms, history, and possible causes.
Is This Only a Menopause Conversation?
Not at all. Sexual health concerns come up at every stage of adult life, and the underlying causes differ accordingly.
Postpartum changes, breastfeeding, contraceptive method, medications including antidepressants, thyroid function, stress, and relationship factors can all play a role. Menopause is one contributor among many rather than the whole explanation.
Assuming a symptom is age-related often means the actual cause goes unexamined for years. Younger patients in particular tend to assume this conversation is not meant for them.
What Does an Evaluation Involve?
Mostly conversation. The history is what points toward the likely cause, and any testing follows from there if and when it is actually warranted.
Depending on what you describe, an evaluation might include a physical exam, a review of your medications, hormone testing, or a discussion of factors outside the clinical picture entirely.
You are not obligated to discuss anything you would rather not, and you can stop the conversation at any point without needing to explain why.
What Do Treatment Options Look Like?
Treatment depends entirely on the cause, which is exactly why the evaluation comes first.
Approaches that may be considered:
- Local or systemic hormone treatment, where appropriate
- Adjusting a medication that may be contributing
- Treating an underlying condition causing pain
- Referral to pelvic floor therapy or counseling
Results vary from patient to patient, and some situations need more than one approach tried in sequence before something works well.
Improvement is often gradual rather than immediate, which is worth knowing at the outset so that a slow start does not read as failure.
Normalizing a Conversation That Matters
You do not need a special appointment for this. It can be raised at a routine visit, and it does not have to be the last thing mentioned on the way out the door.
If it helps, write it down beforehand and simply hand over the note. Plenty of patients do exactly that, and it works perfectly well.
"Nobody has ever surprised me with this topic," says Dr. Leveno. "The only thing that surprises me is how long people wait to bring it up."
Frequently Asked Questions
Is low libido always related to hormones?
No. Hormones are one possible contributor, but medications, stress, sleep quality, thyroid function, pain, and relationship factors all influence libido as well. A proper evaluation looks at the whole picture rather than assuming a single cause and treating only that.
Can pain during intimacy be treated?
Often yes, once the cause is identified. Pain can stem from dryness, pelvic floor muscle tension, an underlying gynecologic condition, or several of these together. Treatment is directed at the specific cause rather than applied generically.
Do I need a separate appointment to talk about this?
Not usually. It can be raised during a routine well-woman visit, and mentioning it early in the appointment leaves more time to discuss it properly. If a longer conversation is needed, a follow-up can be scheduled.
If something in this area has been bothering you, contact our Plano office and bring it up at your next visit.