By: Padmashree Dr Alka Kriplani, Director & Head – Centre for Minimally Invasive Gynaecology, Obstetrics & ART, Paras Hospitals, Gurgaon
The lack of clear approach to sexual health and reproductive concepts have caused many problems in this part of the country for a long time now. However, the general lack of awareness about sexual health in girls who have attained puberty is more telling as sex is still a taboo subject in conservative societies. The cost of it is severe as these girls are dependent on unverified sources of information, mainly hearsay, and experience of older girls and women. Sex is presented as a means to fulfill an end as not as an experience. As a result, anyone who is exposed to it outside the approved pattern is filled with guilt. They are not likely to come out and seek help. This guilt and shame around sexual health increases the risk of these girls and women increasing their risk of sexual health problems.
Common sexual health problems
Female sexual dysfunction (FSD) is a fact of life and many women face it at some or the other point of their lives. Some of the common sexual health problem women encounter include:
- Pain during sex: This is one of the most well-known sexual health concerns among women. Pain during sex, known as dyspareunia, can be the result of vaginismus. Vaginismus is a condition when the vagina suddenly tightens up just as something is inserted into it. The condition can be caused by a vaginal trauma, such as an episiotomy during childbirth, the guilt of having sex being a ‘wrong’ doing, fear of pregnancy or relationship problems, and can be treated.
- Low libido: Stress is a major reason for low sex drive. Besides, diabetes – both type 1 and type 2 diabetes; hormone disorders such as that of thyroid gland; depression; tiredness; and mental or physical trauma, among others can cause low sex drive. Women after menopause may experience a drop in sexual drive due to lower levels of estrogen.
- Orgasm issues: A woman may have never experienced orgasm or has had an orgasm in the past, but not any longer. One may have this due to fear or lack of knowledge about sex; not enough stimulation before sex; feeling depressed or stressed; relationship problems; or previous traumatic sexual experience.
- Trauma and sexually transmitted infections: Women who have undergone the trauma of female genital mutilation (FGM), as practiced in some communities, can find it painful to have sex. The process deliberately cuts or changes female genitals. Lack of sexual knowledge increases the risk of sexually-transmitted infections such as chlamydia or gonorrhoea or more serious HIV (human immunodeficiency virus) causing AIDS (acquired immune deficiency syndrome).
Knowledge is important
Sexual health problems can be addressed with knowledge and awareness. The most important is knowledge of contraception that will prevent both STI and unwanted pregnancy. Psychosexual therapy aims to help the woman to understand and change feelings about her body and sex. Physical contractions during sex can be addressed with relaxation techniques such as mindfulness and breathing while gentle touching exercises will help learn the vaginal muscles to relax. One can also do pelvic floor exercises to gain control of these muscles. Sensate focus exercises can help one relax during sex and increase sex drive.