5 Things Your Doctor Didn't Tell You About Sex

By Lauren Streicher, MD

If you are like 97% of women, your annual visit has come and gone and for the third year in a row, despite the fact that your doctor asked you if you had any other concerns or questions, you just couldn’t bring yourself to spit out that one question you really wanted to ask. You just wish it wasn’t up to you to bring up that you can't have an orgasm , sex hurts like hell and what about that funny odor? No wonder you have no libido and no little pink pill is going to fix it.

Well, problem solved.  Sex Rx: Hormones, Health, and Your Best Sex Ever, speaks to women about the physical, hormonal and medical aspects of maintaining all aspects of peak sexual health with up to date information (OK, the now out of date libido section says that flibanserin might get approved! humor, and best of all, no stirrups.

The goal of Sex Rx is help you achieve “SexABILITY,” my term for the ability to enjoy fulfilling, exciting sex by working with, if not overcoming, your body’s unique challenges. Just because you didn't get a solution to your problem at your last doctor visit doesn't mean there isn't one.

For example, did you know…

1. Your diabetes may be getting in the way of your ability to have an orgasm. Your doctor asked about decreased sensation in your feet, but he or she didn’t mention that your clitoris might also be a little numb from vascular or neurologic changes that commonly occur with diabetes.

2. Your vibrator won’t mess with your pacemaker. No way do you want to tell your cardiologist that you are terrified that sex with your regular partner “Bob” (AKA Battery Operated Boyfriend) will cause a pacemaker malfunction. Rest assured, clitoral or vaginal vibration will not unpace your pacemaker.

3. Your birth control pills can dry up your vagina. You know that menopause is years away, yet lately, even though you are totally in the mood, your vagina is more like the Sahara desert than the waterfall it used to be. While it’s not typical, around 3 percent of the population has this distressing side affect from hormonal contraception.

4. A headache with an orgasm may be a sign of a serious problem. You mentioned your bad headache to your doc, but neglected to mention that, oh, by the way, the really bad headache is simultaneous with an orgasm.  That’s one you want to check out sooner rather than later since 4 to 12 percent of patients with a sub-arachnoid hemorrhage report that a severe headache at the time of climax was their first indication of a problem.

5. The recurrent vaginal infections may be because you use Vaseline as a lubricant.Vaseline makes your chapped lips feel so much better that it stands to reason it would be the perfect product to keep your other lips moist as well. Unfortunately, Vaseline has been shown to double the chance of bacterial vaginosis, the most common cause of odor and irritating vaginal discharge.

 Sex Rx speaks to all women who struggle with physical or hormonal issues related to sexual function — menopause, incontinence, stress, chronic lack of sleep — as well as medical conditions such as heart disease, diabetes, cancer, and more. No it won't help you fix your broken relationship, but it will help you fix your broken vagina.

Updated August 21, 2015. Original published Apr 9, 2014 EveryDay Health

Why Would Your Doctor Recommend a Vibrator?

by Lauren Streicher, MD


“Edna, are you all right?” My 70-year-old patient was looking at me blankly and finally burst out, "Did you really  just say I  should buy a vibrator?”

Actually, that is exactly what I had told her, and if you have never entered the wonderful world of vibrators, dildos, and erotica, you may want to give it some thought. And while you may think it odd that this slightly unorthodox recommendation comes from a board-certified gynecologist on faculty at a major medical school, it’s not so strange.

Historically, vibrators were originally not sexual items that women bought for themselves, but medical devices used as treatment by doctors during Victorian times. This gradually fell out of favor, and by the 1970s, scientific publications stated that vibrators were harmful and never to be used by “normal” women. Twenty years later, attitudes began to shift again and polls showed that many women, while they didn’t own a vibrator, were “interested.” Interest turned into practice, and by 2004, almost half of American women had at least tried one.

Fast forward to today. Vibrators are routinely used, and as a physician and sexual health expert, there are a number of situations and medical conditions that prompt my recommendation to use a vibrator.

Reach Orgasm
Many of my patients have never had an orgasm.   Ever. They expect to have an orgasm during intercourse, and when it doesn’t happen, they are not only at a loss, but also often feel like there is something wrong with them. It was Sigmund Freud that set the stage for the notion that women should expect to have vaginal orgasms. This myth was propagated until the more realistic (and scientific) team of Kinsey and Hite reported in 1953 that “sexual intercourse is an extremely inefficient way to stimulate the clitoris.”

According to recent scientific studies, only about 5-10% of women are able to reach orgasm with vaginal intercourse. The rest require digital, oral, or other form of clitoral stimulation. But for many normal women, the intensity of a vibrator is the only way they are able to climax.

Enhance Arousal
As women’s hormones decline, very often so does sensation. Many post-menopausal women find that achieving an orgasm becomes a lot more difficult.  In addition, medical conditions, such as diabetes cause nerve damage requiring more intense stimulation to achieve the same effect.

Spice Up a Stagnant Sex Life
Face it – spending years with the same partner can get a little boring. As I once said on The Dr. Oz Show, “If you have cornflakes for breakfast every day for 30 years, you get to the point where you don’t even want breakfast any more. If one day a chocolate chip  pancake   shows up on your plate, suddenly breakfast is a lot more appealing.”

Partner Issues
This is actually one of the most common reasons women buy and use a vibrator. Many women have no partner, or have a partner that is physically incapable of intercourse. Sometimes men who suffer from erectile dysfunction avoid intimacy knowing that they can’t follow thorough. They are thrilled and relieved to find a way to pleasure their partner without intercourse.

It’s not surprising that a 2009 scientific study found 52% of women reported not only having used a vibrator but having increased sexual satisfaction as a result. And far from being something that is used only for masturbation, vibrators were used by couples 80% of the time.

So next time you ask your doctor for a prescription to help your sex life, don’t be surprised if he or she gives you the address of the local erotica store. If you bump into Edna, be sure and ask her how things are going and tell her she is overdue for her annual exam.

Originally published Jan 30, 2013 doctoroz.com

Pain for Pleasure? The O-Shot

by Lauren Streicher, MD

You have to study for the test to get the “A,” prepare the meal to enjoy eating it, and lift those weights to get fabulous toned arms. No pain, no gain. One of the few exceptions to that rule is having orgasms. Not only are orgasms predictably pleasurable, but also the getting there is half the fun.

Unless that is you need to get a shot in your vagina or a surgical procedure in order to achieve orgasm. That’s why when I first heard about the O-Shot, my reaction, like many others’ was, you get a shot WHERE????

Up to 25% of women have an orgasmic dysfunction, which is defined as the persistent or recurrent delay or absence of orgasm following a normal sexual excitement phase. The list of reasons this might happen is long and includes medications, hormone issues, medical problems or relationship issues. Studies also show that if you or your partner are depending on intercourse alone or need a map to the clitoris, it’s unlikely to happen.

Enter, the O-Shot. The O-Shot is not a drug. It’s a procedure performed in a doctor’s office in which your own blood platelets are injected into vaginal tissue. The theory proposed by the inventor, Dr. Charles Runels is that platelets naturally attract your own stem cells to the injected area, and according to his website, “generate healthier and more functional tissue in the areas of sexual response in the vagina (G-Spot, O-Spot, Skene’s Glands, urethra, and vaginal wall).”  This is the same technique used by Dr. Runels when he invented the Vampire Facelift.

In addition to claiming to improve your sex life, The O-Shot also promises to “cure” urinary incontinence (when you accidentally leak when laughing, coughing or exercising).  It’s true that many of the same women who have difficulty achieving orgasm also have problems with involuntary loss of urine, since weak pelvic floor muscles can be responsible for both problems.

While some women are thanking their doctors for bringing the zest back into their bedrooms with the O-shot, most gynecologists aren’t on board. There simply has not been adequate research to prove its safety and effectiveness for either orgasmic dysfunction or incontinence. It may well work, and it may be safe, but the studies have not been done.

The O-shot isn’t the only procedure some women are enduring in the quest for a decent orgasm. A machine where you simply push a button to climax is in development. There is a slight down side. This device requires surgery in order to implant a cigarette pack size generator into your buttocks. Oh, and there would also need to be electric contacts surgically inserted into your spinal cord. The remote control sends a signal to the implant, which then stimulates the nerves with electrical impulses to trigger an orgasm. I could be wrong, but I just can’t see women standing in line to surgically implant electrodes into their spinal cord and a box in their butt in order to have remote control orgasms. The inventor, however, who is starting clinical trials, expects to have no trouble getting women to sign up since women “currently endure more painful operations to enlarge their breasts.” Huh?

I am not diminishing how frustrating and upsetting it is for women who have lost the ability to orgasm, but there are a number of easier ways to achieve this pleasure than plunging a needle into your vagina, or having spinal surgery. (The details are in my book, Sex Rx)

One interesting alternative is a  device called Intensity that exercises and tones pelvic floor muscles combined with clitoral stimulation. And here’s the interesting part… many of the doctors that administer the O-Shot recommend that their patients use Intensity as well. So before you plunk down $1200 or more to get platelets injected into your vagina (no, insurance does not cover it, and yes it does need to be repeated) you might want to invest in an Intensity ($230 and it’s yours forever) to get the desired affect. No pain… and great gain.

“Not Tonight Honey, I’m About to Get a Headache”

By Lauren Streicher, MD

Jul 8, 2013 Everyday Health

Last year a patient mentioned to me that every time she had an orgasm she experienced a terrible headache. I advised her to see her internist, or maybe a neurologist. Quite frankly, I thought she was someone who suffered from migraines and the correlation with her orgasm was simply a coincidence.

Wrong! Now I know there is a specific entity known as orgasmic headache. I want to be clear- headache associated with sexual activity is not the same as headache before sexual activity, as in “Not tonight honey, I’ve got a headache.”

This is not a common problem, only affecting about 1% of the population, but even if only one in a hundred women experience a headache during sexual activity, that’s significant. Fortunately, 75% of the time this is a one-time event, so more likely than not if you only experienced it once, you will not again.

I learned more about sexual headache when I heard a lecture by Dr. Robert Cowan, the director of The Headache Program at Stanford University. He emphasized that there are two very distinct categories of sexual headaches.

Pre-orgasmic headaches occur during arousal and usually start as a mild dull ache in the head and neck. Many women describe a throbbing, pressure like sensation in the head accompanied by a muscle contraction in the neck or jaw. Pre-orgasmic headaches get worse with increased sexual excitement and can last up to 3 hours.

While a real romance killer, these sexual headaches are generally not an indication of anything serious. Take some indomethacin , an anti-inflammatory medication, 30 minutes prior to sexual activity (I know, it’s not like you have a schedule for intercourse) and if that doesn’t work, see your doctor for further evaluation and a prescription remedy.

A true orgasmic headache is a sudden explosive headache that is simultaneous with orgasm. It starts in one spot and quickly spreads.

This is the important part. A true orgasmic headache has a very high correlation with a more serious problem, such as stroke or brain hemorrhage. In fact, 4-12% of patients with a sub-arachnoid hemorrhage report that their first indication that something was wrong was when they experienced an excruciating headache during sex.

The bottom line is, if you have a severe explosive headache simultaneous with orgasm, put on your clothes and get yourself to an emergency room. A head CT or MRI will determine if there is something serious going on. In many cases it will turn out to be nothing. But if you have a ruptured aneurysm, your orgasm will have literally saved your life.