The Common Issue Women are Often Afraid to Talk About

Author: Leslie Toldo

When someone says “menopause”, what is the first thing that comes to mind?  Hot flashes?

You will often hear women talking about the misery of hot flashes that come on during menopause.  Sleep issues, night sweats, weight gain, hair loss, and dry skin are also frequently discussed symptoms.  But there is an equally common issue that women talk about far less- sexual dysfunction.  An estimated 40 percent of American women of all ages suffer one or more of these forms of sexual dysfunction:

  • Lack of sexual desire.
  • Impaired arousal.
  • Inability to achieve orgasm.
  • Pain during sex.

“There is embarrassment related to sexual health issues preventing a lot of people from discussing them,” said Cindy Fulton, MSN, CNM, WHNP-BC, RNC-OB, C-EFM at McLaren Flint Women’s Health.  

Fulton is a certified nurse midwife. It is a common misconception that midwives only work with women when they are pregnant or going through childbirth.  They actually see patients in every phase of life.

“The definition of a midwife is “with women”.  We strive to ensure that our patients understand that we are here for all care across the lifespan.  Midwives spend additional time with patients at each visit to ensure that the whole woman is cared for,” Fulton said.

Sexual issues are something women can experience during any phase of their lives.  Lisa Cavett, MSN, CNM, another certified nurse midwife at McLaren Flint Women’s Health, stresses talking about intimacy issues with a health provider to find out what is causing them.

“Have a thorough evaluation and counseling to determine whether it is a structural issue, hormone imbalance, medication side effects, psychological concerns, relationship issues, or something else,” said Cavett.

Even some of the other symptoms women can suffer during menopause, pregnancy, post-partum, and beyond can contribute to intimacy struggles.

Things like weight gain, hot flashes, mood changes, body image issues, lifestyle changes, stress, relationship difficulties,” Cavett said. “That is why it is so important for a woman to seek medical care if they are experiencing any issues.”

 Because there are so many potential causes of intimacy issues, there is also a variety of treatment options.

“Once we have identified what is causing the issue, we discuss with the patient what their individual goals are and then build a treatment plan using a shared decision-making model of care,” said Fulton.

That could mean medications like hormone replacement therapy. Pelvic floor therapy is something a provider may recommend before trying drugs. McLaren Flint has physical therapists who specialize in pelvic floor treatment options. In some cases, a woman may be referred to a physician who specializes in female sexual dysfunction.

“Healthcare providers need to build a trusting relationship with their patients to ensure that these difficult conversations can occur in a safe environment,” Fulton said. “Once a patient feels safe, they are more likely to open up and discuss these most intimate topics. “

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