The Wellness Conversation: Sexual Health - Changes, Comfort & Connection

For many women, sexual health changes throughout life, but conversations about those changes don’t always happen openly.

“Sexual health is such a large part of women’s overall health,” said Cassandra Gray, MD, OhioHealth OBGYN on The Wellness Conversation. “But it’s not always something people feel comfortable talking about.”

Sexual health involves more than physical intimacy. It includes emotional wellbeing, healthy relationships, safe sex practices and feeling comfortable enough to recognize when something feels different or concerning.

Throughout different stages of life, from a woman’s 20s and 30s to pregnancy, perimenopause and menopause, sexual health needs and experiences can change. Hormonal shifts, particularly during perimenopause and menopause when estrogen levels naturally decline, can affect libido, comfort, body image and emotional connection.

“The most common thing I hear from patients in their perimenopausal and menopausal years is dryness,” Dr. Gray said. “And many women don’t realize there are treatment options that can help.”

One misconception Dr. Gray hopes to change is the belief that pain or discomfort during intimacy is something women simply have to accept.

Pain during intimacy can have several causes, including hormonal changes, pelvic floor disorders, infections, ovarian cysts or fibroids. Depending on the underlying issue, treatment options may include lubricants, prescription estrogen therapies or pelvic floor rehabilitation.

Dr. Gray encourages women to bring up concerns during annual wellness visits or schedule appointments specifically focused on sexual health.

“I love when patients ask me those questions,” she said. “It helps me understand where they’re coming from and what they’re worried about.”

Mental and emotional health can also play a significant role in intimacy and libido. Stress, anxiety, depression, poor sleep, body image concerns and the demands of everyday life can all contribute to changes in sexual health. Some medications used to treat mental health conditions may also affect libido.

“Having a healthy relationship with yourself and feeling comfortable in your own body is important too,” Dr. Gray said.

Dr. Gray also cautioned women to be careful about sexual health advice on social media. She said many patients come to appointments with questions about trending treatments they’ve seen online.

While some information may be helpful, many products marketed toward women can be expensive and lack strong scientific evidence. Dr. Gray recommends talking with a trusted healthcare provider before starting supplements, hormone treatments or other sexual health products.

To listen to the full episode, click here.