Talking about sex and sexual health isn’t always easy. In fact, it can be confusing, embarrassing and often frustrating. But if there’s something you’re unsure about, asking a professional for advice is your best option.
Not sure what to ask? We put together a list of some of the most common (and important) things to discuss with your gynecologist.
We asked Dr. Renee Horowitz, a board certified obstetrician and gynecologist for 27 years and founder of the Center for Sexual Wellness, for her advice on some of the most common topics your gynecologist can help you out with.
STDs and safe sex — what do I need to know?
One of the most important things to be clear about when it comes to sex is safety. “When you meet someone new and the sparks fly, just remember you don’t know where they have been and they don’t know where you have been,” Horowitz says, adding that the best protection is condoms. “Use them faithfully and responsibly and you will greatly diminish your chances of getting an STD.” She advises getting tested prior to a new partner, using condoms for six months, retesting, and if you are both still negative (and you have both been monogamous), you can stop using condoms.
Anatomy — what’s normal?
Many women are unaware of their female anatomy so it can be tough to figure out what’s normal and what isn’t. If you are unsure if something is normal or your partner points something out, make an appointment to talk to your gynecologist. “Just like our faces all look different, there is also great variation in our genital structures,” Horowitz explains. There has been a boom in cosmetic genital surgery, but The College of Obstetricians and Gynecologists strongly discourages this surgery and does not recognize this as a specialty, she warns. Your best bet if you do think something looks different than it should, is to talk to your gynecologist.
Orgasms — why can’t I have a vaginal orgasm?
That is a frequent question that Horowitz is asked and the answer is very reassuring. “Most women do not have vaginal orgasms but have orgasms that originate from direct clitoral stimulation,” she explains. That’s not to say that you can’t have an orgasm while you are in the act of intercourse but the key is to figure out what works best for you. “Think about being on top. Be creative with positions, toys, etc.,” she says.
Pregnancy and birth control — when should I go off the pill?
A common question to talk to your gynecologist about is when you should stop your birth control pills if you want to get pregnant. “My advice to patients is to have one natural period off the pill and then go for it,” Horowitz says. “There was a study that showed an increased risk of miscarriage with conception immediately after stopping the pill. So why take the risk and the heartache? You have waited this long, so wait one more month.”
Discharge — what’s normal?
Vaginal discharge can certainly indicate an infection but it may also be normal. “The vagina, depending on your hormonal status, age and your menstrual cycle will normally secrete discharge,” Horowitz explains. “If you have irritation on the vulva, irritation of the vagina with or after intercourse, burning, itching or odor with or without discharge, you may have an infection. It is best if you go see your gynecologist and determine if the discharge is normal or infectious.” Avoid self-treating unless you are absolutely sure what the problem is and try not to use medication the night before you see your doctor as it may make the infection hard to diagnose, she advises.
Pain during sex — what should I do?
Sex should be pleasurable, not painful. If you are having pain during sex, then you need to see your gynecologist. Try to note when the pain occurs so you can better explain it to your doctor. “Is it during initial penetration, is it positional or is it only with thrusting? Do not ignore it. Figure it out with your doctor,” Horowitz advises.
How can I improve my sex life?
We all get into ruts and when we do, no matter what it is — the same food, clothes, activities or sex, it gets boring. The remedy: Change things up. “Mix it up, surprise your partner with a new place, position, toy, atmosphere,” says Horowitz. “It will boost your brain chemicals which respond to novelty and increase your desire and arousal.”
Libido — what if my partner wants to have sex more than I do?
This is a complicated issue and there are no easy answers, but understanding that male and female sexual needs and cycles are different may help, Horowitz tells us. “Women have more responsive desire. In other words, they become aroused first, then experience desire whereas men generally have desire first, followed by arousal,” she explains. “Knowing that you will become desirous after you get started may help you get going.” Although there may be times you don’t want to have sex, being in a relationship means it’s important to compromise but communication is the key. Talk to your partner about the best times to initiate sex and when you are most likely to be in the mood.