Infertility is a condition in which a couple is unable to conceive and carry a pregnancy to term after one year of consistent vaginal intercourse. It is estimated to affect 12-16% of couples worldwide, and its diagnosis and treatment are often accompanied by several emotional, physical, and relational stressors.
Menopause is a major life transition for many women, often bringing unexpected changes in sexual function. Postmenopausal women may face factors such as genitourinary syndrome of menopause (GSM), vulvovaginal atrophy (VVA), and pelvic organ prolapse (POP), which are changes associated with decreased estrogen levels and, in the case of POP, weakened pelvic floor muscles. They may also be dealing with chronic conditions that they developed later in life.
Gender dysphoria is the distress a transgender individual may experience as a result of their gender identity not matching the sex they were assigned at birth. Not all transgender people experience gender dysphoria. However, for those who do, gender-affirming care (e.g., gender-affirming hormone therapy and gender-affirming surgery) has been shown to reduce distress caused by gender incongruence.
Chemsex, or taking psychoactive substances to enhance or extend a sexual experience, is growing in popularity in many parts of the world. Often, the substances used for this purpose are referred to collectively as “chems,” but they include crystal methamphetamine, cathinone (mephedrone, 3MMC, 4MMC), GHB/GBL (gammahydroxubutyrate/gammabutyrolactone), and freebase cocaine (or “crack”).
Historically, the gender binary, or the classification of gender into two distinct, opposite forms (masculine and feminine), was the prevailing system of gender classification. However, not everyone identifies as being exclusively male or female, and not everyone’s gender identity matches the sex that they were assigned at birth.
Peyronie’s disease (PD) is a condition in which fibrous plaques (sections of scar tissue) develop under the skin of the penis, resulting in curved, sometimes painful erections. Other symptoms may include erectile dysfunction (ED) and shortening of the penis. Penile traction therapy (PTT) is a treatment option for PD that is aimed at reducing penile curvature, regaining length, and enhancing girth. PTT involves wearing a penile traction device that stretches the penis straight out or stretches it in the opposite direction of the curve for a specified amount of time each day.
Polycystic ovary syndrome (PCOS) is a condition in which a woman’s body produces an excess of androgens. Androgens are thought of as male hormones, but women have them too, though usually in small amounts. The hormonal imbalance can cause irregular periods, excess facial and body hair, severe acne, cysts in the ovaries, and/or infertility due to anovulation. Anovulation is the medical term to describe the absence of ovulation, meaning that an egg does not release from the ovary during a woman’s menstrual cycle.
A comprehensive patient history can help a health care provider understand a patient’s state of health, assess any health risks that they may be facing, and determine the appropriate preventative health care measures to be taken. Sexual health is an important part of a person’s overall health, but one that is often overlooked during patient health history taking and routine medical visits.
A woman’s sexuality can change over the course of her life as a result of different life phases and/or life events. Pregnancy and childbirth have been shown to have a big impact on a woman’s sexual function. Research indicates that sexual function declines during pregnancy and typically does not fully recover to pre-pregnancy levels until about 12 months postpartum (Chayachinda, 2015).
Transgender individuals, or people whose gender identity does not align with the sex that they were assigned at birth, may choose to transition through gender-affirming hormone therapy, gender-affirming surgery (GAS), or both. A recent survey of 27,715 transgender participants in the United States indicated that 25% of the respondents had undergone at least one GAS such as chest surgery (breast augmentation or mastectomy) or genital surgery (phalloplasty or vaginoplasty).
Vaginismus is a sexual pain disorder characterized by involuntary vaginal spasms that can make vaginal penetration difficult and painful. Although it was defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) as a distinct condition, the 5th edition (DSM-5) combines vaginismus and dyspareunia (painful intercourse) into one condition known as genito-pelvic pain/penetration disorder (GPPPD).
Pornography has become widely available in recent years with the advent of free online porn streaming sites. Its increased availability has sparked debate as to whether or not viewing pornography has an impact on a person’s sex life/sexual health. While some suggest that frequent pornography use may have a detrimental effect on a person’s relationships, sexual satisfaction, and even mental health (possibly contributing to depression), the research thus far has been limited in scope and often contradictory.
