A libido that's MIA, discomfort during sex that keeps you from reaching orgasm, vaginal dryness you can't figure out: When problems crop up that put a dent in your sex life, chances are you turn to your friends for advice or hit up Dr. Google.
They might be able to help, sure, but you're ignoring the one person who is actually trained to solve your sex-related situation: your gynecologist. STD tests and breast exams aren't the only things she knows how to do. Her wheelhouse is female reproductive and sexual health, which gives her experience and insight when it comes to the physical or emotional issues that prevent you from steaming up the sheets.
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To give you an idea of how your gyno can lend a hand, we asked our favorite ob-gyns about the common sex issues women bring to their offices—and what they typically say and do to help their patients get back in the saddle again.
Low libido
Gynos see this one all the time, and research backs up how common a problem it is. A recent study published in the journal BMJ Open found that 34% of women reported lacking interest in sex for at least three months during the year. And half of those who lost their sex mojo said they felt stressed about it.
Changes in your sex drive can be caused by physical issues, such as normal hormonal fluctuations when you're breastfeeding, during pregnancy, or even at certain points in your cycle. Diminished testosterone levels (yep, women produce testosterone too, in small amounts) can also sink your sex drive, so your gyno might prescribe a compounded testosterone cream, says Leena Nathan, MD, ob-gyn at the Ronald Reagan UCLA Medical Center. Just know that the creams aren’t approved by the FDA and can trigger side effects like abnormal hair growth, she adds.
There's also a pill specifically FDA-approved to treat low libido in women. The so-called "female viagra," called Addyi, is an option, though it must be taken daily and patients can’t drink alcohol while they’re on it, says Dr. Nathan.
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Feeling disconnected or unattracted to your partner will also mess with whether you feel in the mood. “If it’s your relationship that’s the problem, your gynecologist can’t help you with that,” says Alyssa Dweck, ob-gyn in New York and author of The Complete A to Z for Your V. But your doctor can offer advice on how to arouse yourself so you feel more motivated to get it on.
She might also talk to you about engaging in more foreplay and solo sex. “Masturbation can help women better understand what they like and also educate their partner,” says Dr. Nathan.
Vaginal dryness
Vaginal dryness is most common during and after menopause, when a woman's natural estrogen production diminishes. But almost 20% of women ages 18 to 50 experience it too, so it's definitely something gynos address.
There are two ways to deal with dryness, says Dr. Dweck. First, she recommends artificial lubricants, which you can use in the moment when your brain wants to get it on but your body isn't cooperating. Dr. Dweck suggests both water- and silicone-based varieties to see which works better for you. Just remember not to pair oil-based lubes with condoms, since they can wear down latex, she says.
Dr. Dweck suggests asking your gyno about vaginal moisturizers that work similar to regular skin moisturizers. Over-the-counter products like Replens can be used one to two times per week to keep your lady bits from becoming Sahara-like, and you don't have to stop the action to squeeze out some lube (and possibly ruin the moment).
“Another option is an estrogen cream, pill, or ring,” says Dr. Nathan. These moisture-replenishing products can be prescribed by your gyno. They're not right for everyone, but your doctor will let you know if they're an option for you.
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Painful sex
Whether it's discomfort during penetration or a sudden jab in the middle of intercourse, feeling pain at some point during sex can be seriously worrying. If the pain happens when your partner is entering you, it could be a vaginal infection caused by an STD, and your gyno will want to run some tests to rule it out (or treat it so you get rid of the infection).
Dr. Dweck says that internal pain can be caused by uterine fibroids, which are benign growths on or inside the uterus. Fibroids don't have to be removed, but if they interfere with your sex life, it's something your doctor will talk over with you so you know your options.
Some women with endometriosis—a condition whereby the uterine lining migrates into the pelvic cavity—also experience painful sex. So if fibroids aren't the cause of the pain, your doctor might ask you about other symptoms of endometriosis, such as super painful periods or pelvic pain all month long. The only way you'll know what's up, says Dr. Dweck, is if you schedule an appointment.