Sex and sexual health often have a stigma of being awkward or inappropriate, even though they’re important and natural conversations to have. We asked our viewers if they had any sexual health questions that they would like answered, and you did! Dr. Marjorie Dixon shares her answers, plus some solutions to problems you may be experiencing.

Question #1:

Dear Marjorie,

Since hitting my mid-forties, I’ve lost the desire to have sex, and when I do, it’s more difficult to achieve orgasm.  What could be the cause? Do I need some kind of treatment? I feel like I’m too young for my sex life to be over.

Marjorie’s Answer:

Orgasm enhancing treatments! As blood flow to the vagina decreases with age, this can impact clitoral arousal. Like men have had little blue pills to help with blood flow, women now have treatments like Cliovana, that use a series of non-invasive ultrasound sessions to stimulate blood flow to the area.

Question #2

Dear Dr. Dixon,

My partner and I have been trying to conceive for almost 6 months with no success.  I have always had irregular periods, so we have been having sex as often as possible. I hear you’re supposed to wait for 1 year before seeking medical help but now that sex has just become another chore and we’re exhausted, this is starting to put a strain on our relationship.

Can you offer any advice?

Marjorie’s Answer:

Many people don’t know that for a “healthy” woman in her early 30s or younger, the chance of conceiving on any given menstrual cycle is 20-25%, so its natural for it to take  a few cycles. The one year milestone is a guideline, but not a hard requirement to be seen by a fertility specialist – especially if there are other underlying concerns such as irregular periods.

Sex should not be a chore, and the strain or anxiety this couple is facing is important to address. We see it often in clinic, and we always encourage our community to speak with a fertility counsellor to address some of the emotional aspects of their fertility journey.

Question #3

Hi Marjorie,

Since going through menopause, I’ve found that vaginal dryness has become an issue for me.  Now, that my kids no longer live at home, I would like sex to be more spontaneous. Is there a safe therapy for women so that my partner and I don’t always have to use lubricant?

Marjorie’s Answer:

Vaginal dryness is a common complaint in my office, and I wish women spoke about it more. Think of it this way, how often do you moisturize your hands? The same logic can and should be applied to a dry vagina. There are vaginal moisturizers to be applied on a regular basis, so that when the moment arrives – things might go more smoothly. However, that doesn’t replace the need for other forms of lubrication, no matter your age.

Question #4

Dear Marjorie,

I’m 41 years old and over the past couple of months, I have been finding it painful to have sex. On top of everything else going on in the world right now, I can’t even enjoy sex in my own home. How can this be happening to me?

Signed,

“Worried”

Marjorie’s Answer:

There are a lot of reasons why sex can be painful. Sometimes there is a medical reason which we refer to in the field as “organic pathology“. Someone can have a diagnosis of endometriosis or adenomyosis- which can manifest itself as painful sexual relations. Sometimes, it’s due to low oestrogen states where someone has had ovarian failure at a younger age or is on medications that block oestrogen for example in the treatment of breast cancer. This results in a dry vagina and difficult intercourse.

As women age the amount of blood flow to the pelvic floor region and the vulva is less, Which intern, can manifest itself as decreased vaginal lubrication and thus difficult intercourse.  Even the stress of life including taking care of children and ageing parents can impact our ability for pleasurable sex. This is where a consultation with a medical professional is indicated, who can tease through the different possibilities and explanations and create a reasonable management plan for you that is tailored to your needs.

Resources to help point you in the right direction:

Sexual Health Ontario 

The facts on menopause from Canada’s experts 

Fertility service in Ontario 

Find out if you can receive government funded fertility treatments in Ontario and how to get started here.