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Healthy Sex for Women

Overview

Key points

  1. Regular testing can reduce the long-term consequences of a sexually transmitted infection.
  2. Severe pain during your period or during sex is usually a sign of a health problem.
  3. Pap smears can detect early signs of cervical cancer.

Sexual health has multiple aspects, including protection from sexually transmitted infections (STIs), birth control and family planning, and sex drive and fulfilling sexual relationships. For women, sexual health significantly impacts overall health.

Practicing safe sex, using contraception properly, and getting screened regularly for STIs can keep your sexual health in good shape.

Understanding sexually transmitted diseases and infections

If you are a sexually active woman, you are at risk of contracting an STD, which are now more commonly known as STIs. Risk increases with the more sexual partners you have. However, it’s possible to contract an STI the first time you have sex. Vaginal, anal, and oral sex all put you at risk for sexually transmitted infections, so it’s important to know how to protect yourself.

Practice safe sex

Safe sex, using a barrier method like a condom or dental dam, is very effective at preventing STIs that spread through secretions, such as HIV, gonorrhea, chlamydia, and hepatitis. It’s less effective at preventing STIs that are transmitted through skin-to-skin contact, like syphilis, HPV (human papilloma virus), and HSV (herpes). But it can still reduce your risk.

Try to use latex or polyurethane condoms and dental dams every time you have any kind of sexual contact or penetration. There is always an advantage to using protection. Consistent use of barriers can reduce the transmission of STIs during:

  • oral sex
  • vaginal sex
  • anal sex

A number of STIs can be transmitted during oral sex. These include:

  • syphilis
  • HPV
  • herpes
  • gonorrhea
  • chlamydia

Most mouth and throat cancers are now known to be due to HPV, typically from unprotected oral sex.

Preventive vaccines

Currently there are vaccines for three STIs: human papillomavirus (HPV), hepatitis B, and hepatitis A.

Three HPV vaccines are currently approved by the FDA:

  • Cervarix protects against the two strains of HPV that cause most cases of cervical cancer.
  • Gardasil protects against those two strains, as well as the two strains that cause the majority of genital warts.
  • Gardasil 9 covers the same four strains of HPV as Gardasil but includes an additional five “high-risk” strains (nine strains in all).

These vaccines are most effective when given before a person starts having sex. It’s typically recommended to begin vaccinations for both young women and men, starting at age 11. You can still get vaccinated up through your late 20s.

A vaccine is also available for hepatitis B. It’s normally given during infancy. Hepatitis B causes liver disease. It can be transmitted through sexual activity as well as through infected blood or blood products.

A vaccine for hepatitis A is available as well. Hepatitis A is not usually spread during sex, but it can be transmitted during oral-anal contact. The vaccine is recommended for all children at age 1.

Get screened for STIs

Regular STI testing can reduce the long-term consequences of an infection. Left untreated, bacterial diseases such as gonorrhea and chlamydia can have serious health consequences, including infertility. Screening can help to prevent such complications.

Screening can also reduce your risk of contracting an STI. Make a date to get tested with a new partner before starting a sexual relationship. That way, you will each know if you are putting the other at risk, and treatment can be given if appropriate.

STI screening is a good idea for anyone who is sexually active. STIs can affect individuals of any age or relationship status.

Get regular Pap smears

Pap smears are a routine part of women’s healthcare and start at age 21. This test detects early signs of cervical changes that could lead to cervical cancer if left untreated. Precancerous changes can be followed up and treated before they become serious.

Nearly all cases of cervical cancer are caused by HPV. Therefore, practicing safe sex can reduce your risk of cervical cancer. HPV vaccination can reduce your risk as well. There are many strains of cancer-causing HPV. Vaccination, practicing safe sex, and regular Pap smears are all necessary.

Invasive cervical cancer, and its treatment, can have negative effects on your sex life and fertility. It’s better to catch cervical changes early than wait for them to cause damage.

Menstruation and reproductive health

Women often assume that pelvic pain, like cramping, is normal. They have been told that menstruation is supposed to hurt. Therefore, they may not discuss their discomfort with their doctor.

Women should not have to live with serious pelvic pain or abdominal cramps. Often severe pain during your period is a sign of a health problem. It may be related to fertility or pain during sex.

Endometriosis

Endometriosis is growth of the lining of the uterus, outside of the uterus. This lining is called the endometrium. It’s the source of blood and tissue during menstruation. It’s also needed to nourish a growing fetus.

When a woman has endometriosis, the endometrium deposits onto organs and tissues throughout the abdomen and pelvis. This can be extremely painful. Symptoms of endometriosis include:

  • severe menstrual pain
  • pain during sex
  • pain during bowel movements
  • heavy bleeding
  • bleeding between periods

Pain from endometriosis can often be treated. Treatment depends on whether you want to have children. Options include:

  • anti-inflammatory medications
  • hormone therapy
  • surgery to remove the excess tissue
  • hysterectomy (removal of the uterus)

Fibroids

Fibroids are noncancerous tumors of the uterus. Research shows that up to 77 percent of women have fibroids. However, most women will never need treatment. Fibroids are not necessarily painful or problematic. They do not increase your risk of cancer. Large fibroids may affect your ability to have children.

Fibroids can affect your sex life if they cause:

  • pelvic pain
  • pain during sex
  • problems with heavy or painful menstrual bleeding.

If treatment is necessary, several options are available. Your doctor can help you decide which method is best for you.

Birth control

If you are a woman who has sex with men, it’s important to know your options for birth control. Trying to get pregnant or worrying about an unwanted pregnancy takes a toll on many women’s sex lives.

Birth control options range from the affordable, use-when-needed condom to an intrauterine device (IUD), which can last for up to 12 years. Some methods require a prescription or a minor procedure in the doctor’s office, and some do not.

Contraceptive options include:

  • male or female condom
  • IUD
  • birth control pills
  • contraceptive sponge
  • cervical cap
  • diaphragm
  • hormonal patches or rings
  • birth control shot
  • under the skin implant
  • sterilization

Talk to your doctor about which option is right for you. The effectiveness varies greatly. So does the ease of use. Sterilization for both women and men is considered the most effective, but it’s permanent.

Sexual relationships and libido

Some sexual health issues affect sexual activity and libido.

Lack of interest in sex

There are many reasons why a woman may have a reduced interest in sex. According to Mayo Clinic, possible causes for decreased libido in women include:

  • new medication
  • chronic medical conditions
  • fatigue
  • menopause
  • pregnancy, after delivery period, and breast-feeding
  • anxiety or depression
  • stress

If you have experienced a sudden lack of interest in sex, talk to your doctor. There may be an identifiable cause. Your doctor can treat many conditions, as well as refer you to a sex therapist or other therapist for counseling. Couples therapy may be beneficial, too. If you are bothered by a decreased sex drive, there are a variety of methods and treatments that can help.

Painful sex

Sexual intercourse shouldn’t be painful. If you are having pain during sex, talk to your doctor. There are several potential causes of sexual pain. These include:

  • infection
  • endometriosis
  • fibroids
  • vaginismus
  • vulvodynia
  • vaginal dryness

Painful sex can be treated in a variety of ways, depending on the cause. When you talk to your doctor about your problem, be prepared to discuss if you have pain:

  • and any discharge or vaginal symptoms
  • during penetration
  • when touched on the outside of your vulva
  • after sex
  • during deep penetration

The details are important. They can help your doctor diagnose underlying problems that may be causing your pain.

Problems with orgasm

There is a common misconception that all women should be able to orgasm from vaginal intercourse. However, many women need direct clitoral stimulation to climax.

If you have difficulty reaching orgasm, practice on your own to see what feels good for you. During a shower or bath is a good time for self-exploration. It’s also important to keep communication open between you and your sexual partner(s). For a better understanding of your sexual health, a sex therapist can be a useful resource.

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