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Sexual Problems? Asking for Help Is the First Step

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WebMD Health News

June 9, 2000 -- You walk into your doctor's office for a routine checkup. He or she asks if anything has been bothering you. You decide to bite the bullet and mention that you are having some difficulty in the bedroom. Congratulations. Telling your doctor is the first step toward achieving a better sex life, experts tell WebMD.

There's no need to be shy or feel alone in this dilemma. A recent survey looking at women ages 18 to 59 showed that 43% of women have sexual function complaints. "The most important issue in evaluating sexual dysfunction in women is finding out the cause or causes," women's health expert Donnica Moore, MD, president of Sapphire Women's Health Group in Neshanic Station, N.J., tells WebMD. "It is more complicated for women than it is for men because our sexuality is not dependent on a small piece of real estate," she quips.

The primary care doctor's first job is to listen and ask questions, Moore adds. "Sometimes, the basis of the sexual dysfunction can be determined by these two processes," she says. "Clearly, communication with the doctor is important. Communication with your sexual partner is usually the other half of the solution," she says.

"The primary care doctor can help you identify whether the problem is predominately physical, biological, emotional, psychological, of some combination of the above," Moore says.

Here's how:

He or she may ask what medications you are taking. Many prescription drugs -- such as a class of antidepressants that includes Prozac and Zoloft, high blood pressure medications, and even some over-the-counter cold medicines -- may lead to a lack of sexual desire.

"Sometimes, the solution is as simple as changing the dose or switching to another medication in the same family," she says. For example, a newer antidepressant called Effexor apparently has fewer sexual side effects than Prozac and the rest, even though it's in the same class.

Alcohol may also be a culprit, she says. Remember, "alcohol is a great social lubricant ... It may help you get into bed, but it won't help you once you are there," she says.

Your primary care doctor will also know when to refer you to a specialist, she says.

"If your doctor decides that your problem is related to sexual abuse in your teen years, then he or she may refer you to a psychiatrist, but if he or she feels it is related to a vaginal infection that is within their range of treatment expertise, he or she will treat it," Moore says. But if it is related to a complicated physical problem or has to do with changing hormone levels, he or she may refer you to a gynecologist, she adds. Sometimes, says Moore, a urologist may be called in for further examination of the urinary tract. And in some difficult cases, a pelvic or vaginal ultrasound may provide clues to the cause, she says.

Pam White, RN, of a practice called OB/GYN South in Birmingham, Ala., says she sees a lot of patients who are referred from their primary care doctor due to pelvic pain that impedes a satisfying sex life.

"The first thing we have patients do is fill out a lengthy questionnaire on the pain; then a doctor will do a thorough physical exam to check out the pelvic muscles and take it from there," she tells WebMD. "There can be various problems causing the pain." Medication and/or surgery can be used to treat most problems, and many women will see an improved sex life after treatment, she says.

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