A satisfying sex life can be a source of comfort and joy. When it's neither comfortable nor joyful, however, don't automatically blame your mate. Maybe your body is trying to tell you something.
"Sex and health do reflect each other," says research scientist Debby Herbenick, associate director at the Center for Sexual Health Promotion at the University of Indiana and author of Because It Feels Good: A Woman's Guide toSexual Pleasure and Satisfaction. "But because sex is still often seen as taboo, as something we don't talk openly about, people often separate the two in their lives."
Here are seven physical problems that can tiptoe into a woman's bed -- affecting the quality and quantity of sexual relations. (Of course, it takes two: Sexual clues can also reveal what your sex life says about his health.)
Sex scene #1:
You've been avoiding sex because, well, it hurts.
It might be: Vulvodynia (pain syndrome)
In 2010, in the largest nationally representative survey of American sex lives in 20 years, Indiana University’s Center for Sexual Health Promotion found that 30 percent of women reported mild to moderate pain during their most recent sexual encounter. "That's a striking number -- we didn't expect it would be that big," notes Herbenick.
Fleeting causes of painful sex can include insufficient foreplay and the penis striking the cervix. But for many women, the pain is more generalized, often described as burning, stinging, or knife-like and showing up even when they're not having sex -- hallmarks of a mysterious pain syndrome known as vulvodynia. Almost one in five women experiences vulvodynia at some point, according to the National Vulvodynia Association, and six million women have it.
What to do: See a gynecologist. The cause of vulvodynia is unknown, but a thorough medical workup can rule out other possible causes, such as skin diseases or infections. (Top theories include nerve stimulation or inflammation.) Be persistent if you don't get help: One Harvard University study found that women with vulvodynia see an average of three doctors in seeking diagnosis, after which 40 percent still remain undiagnosed. Try looking for a doctor with a vulvovaginal specialty. Treatment includes a range of therapies, including drug therapy to block pain signals, physical therapy, and biofeedback.
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Sex scene #2:
You take forever to climax, if at all.
It might be: Diabetes
Many things can contribute to difficulty achieving orgasm, including pain or medication side effects. But one fast-growing factor is complications from diabetes. In a 2010 study of 2,000 adults ages 57 to 85, University of Chicago researchers found that both women and men with diabetes reported difficulty attaining orgasm, even though male erectile dysfunction gets most of the attention.
Diabetes can damage nerves and small blood vessels, including autonomic nerves, the kind the brain uses to send unconscious signals for involuntary responses, such as sexual stimulation. The reduced blood flow caused by damage to blood vessels contributes to the problem.
What to do: If you've never been diagnosed with diabetes but you're also having other possible signs of diabetes, have a medical check-up and mention all worrisome symptoms. If you're a known diabetic, don't be shy about mentioning this sexual effect to your doctor. Only 19 percent of the women in the Chicago study discussed sexual problems with a doctor, compared to 47 percent of the men. Better glucose control can improve responsiveness, and your doctor may refer you to a gynecologist to help pinpoint and control other contributing factors.
Sex scene #3:
You don't lubricate much when aroused -- and you're not even menopausal.
It might be: A sign of an unhealthy heart
Most women have heard that vaginal dryness is a common side effect of the shifting hormones at perimenopause and after menopause. But if you're under 45 and affected by dryness, one possible cause is your heart health.
"Lubrication comes from hormones but also from fluid in your bloodstream," Herbenick says. "If there's impaired blood flow for any reason, it could reflect early signs of a cardiovascular issue." Men experience this surprising signof an unhealthy heart more noticeably in the form of erectile dysfunction.
Interestingly, longtime smokers can also develop vaginal dryness. In lab studies, women who chewed nicotine gum experienced less blood flow to the genitals than those chewing a placebo gum, Herbenick says.
What to do: Consider whether you have other signs of heart trouble, which can include fatigue, shortness of breath, or heartburn. Get a thorough checkup if you haven't had one lately. There are other causes of vaginal dryness, of course, including early menopause (in women under ages 40 to 45), perimenopause (which can begin at 40), and medication side effects.
Meanwhile, over-the-counter vaginal lubricants can replace what nature isn't producing. Water-based lubricants were shown in a 2010 University of Indiana study to reduce discomfort better than silicone-based types.
