What is the benefit of coupling?

Countless research data show a survival benefit for being coupled or married. In a 2006 study, never-married people were 58% likelier to die in an 8-year period than their married counterparts. Marriage often signals changes: decreased nightclubbing, decreased alcohol consumption, and balanced meals. A Centers for Disease Control and Prevention (CDC) report in 2004 states that married people are less likely to smoke or drink alcohol than single or divorced people are. These changes in lifestyle habits may translate into less cardiovascular disease, cancer, and respiratory problems. Married people also have lowered rates of mental illness, sexual transmitted diseases, and suicide; marriage may help spouses

What are some erotic or erogenous zones?

Sexual intimacy not only involves the genitals but other areas of increased sensitivity and sensuality, including the neck, mouth, nipples, underarms, thighs, buttocks, and even the toes. Most women believe that the whole body can be erotic and erogenous. Most healthcare providers in the field of sexual medicine will encourage you and your partner to explore your whole bodies and get accustomed to what feels good for you. Sexual erogenous zones are unique to individuals.

Raye comments:

Coupling has many physical and sexual benefits for most people. We are raised to believe from the beginning that you are to be married and have a lifelong partner. When I was a little, little girl, I wanted the big white wedding and white picket fence and a dog named Spot. It is almost engrained in us that we need to pick a partner to share our lives with. Sharing your life with a partner and sharing intimacy as a couple, I think, is beneficial to both your health and your psychological well-being. I know relationships go through good and bad times, and overall it does take lots of hard work, but the benefits are worth it!

What is a sexual history?

A detailed history is critical for correct assessment of female sexual complaints. It is often helpful for you to characterize your complaint in your own words, and your clinician may facilitate this process by being an active listener. For clinicians, understanding the time frame of the complaint is essential. Has it been lifelong? Acquired? Is it present in all situations with all partners or only in selected relationships? Can you attribute the onset of the complaint to a certain event, life change, or trauma?

Your clinician will assess your gynecologic, menstrual, and obstetric history and request a list of medications you take, including any herbs and over-the-counter supplements. Prior surgeries as well as an assessment of ongoing chronic medical illnesses and their timelines and treatments are also required. Your clinician may require a psychosocial, marital, and psychiatric history. Your past medical history, current health status, and that of your partner, as well as an evaluation of your neurologic and endocrine systems can be helpful. Life stressors including financial pressures, employment, and social responsibilities are also critical and can affect sexuality.

Your clinician will attempt to assess and quantify your symptomatology, especially if you experience pain during sex or vaginal dryness. These symptoms can be complex and often encompass urinary or bladder concerns (frequency, urgency, incontinence, and frequent urinary tract infections) as well as vaginal complaints (dryness, painful intercourse, bleeding/ spotting, itchiness, pain, pressure, or foul-smelling discharge). Your clinician will assess any symptoms, including stress, anxiety, and depression, and their impact on sexual intimacy or desire. Evaluation of depressive symptoms, domestic abuse, and substance use or abuse is also necessary for a comprehensive detailed evaluation.

Your partner can also be an important source of information, and many women advocate having their partner present at some point during the history. Your healthcare provider should strive to ensure that confidentiality of your health information and continuity between visits is maintained. Also, a positive, safe therapeutic alliance between you and your healthcare provider is critical to successful outcomes.

Sometimes structured, formalized interview scales and checklists can be incorporated into your workup. Do not be concerned or afraid if your healthcare provider asks you to complete some checklists or formal questionnaires. They are helpful in teasing out symptoms and are often used to help diagnose the sexual complaint. Some healthcare providers use checklists and scales for research purposes, so it is always important to ask whether your information will be kept confidential (as it should be). Also, make certain that your name and any other personal identifiers such as address, social security number, or insurance policy number are not on the forms. Some of the more popular screening and assessment tools include the Female Sexual Function Index (FSFI) and the Brief Sexual Symptom Checklist. These questionnaires often are mailed to you in advance or you can complete them in the waiting room. Some healthcare providers make them available on their Web sites for easy downloading and completion.

What is cross-cultural sexuality?

Culture plays an important role in our sexual belief system and make-up. Many healthcare providers lack the cultural sensitivity to understand certain cultural issues specific to certain ethnic and racial groups. A healthcare provider lacking cultural awareness may erroneously assume that the poor woman is not interested in sexual function, the quiet Asian woman does not have any concerns regarding intercourse, or the African-American woman is more worried about other healthcare concerns. Some cultures, such as those in West Africa, consider heavier women more attractive than thin ones, whereas some cultures, such as those found in New Guinea, have institutionalized oral sex. Some Islamic cultures practice various forms of female circumcision[1], and polygamy (the practice of having more than one wife), although accepted in some places, is criminalized in the United States. Some cultures permit the viewing of erotic material whereas others find such activities reprehensible.

Understanding your own culture and belief system can help you educate your healthcare provider. The young and the elderly; those who are married, single, divorced, widowed, or partnered; and those of Asian, Hispanic, Middle Eastern, or African-American background are entitled to easy access, assessment, diagnosis, and treatment of sexual healthcare concerns. Sexual wellness and vitality are rights of all women irrespective of their color or social or economic class.

Raye comments:

A sexual history is your complete history pertaining to anything having to do with everything from your sexual past and present. Sexual abuse, partners past, number of sexual partners, pregnancies, STDs [sexually transmitted diseases], complaints, gynecological issues, health, surgeries, illnesses, concerns. I know it is hard to talk about some personal things, but once you find a healthcare provider who is sensitive and caring, he or she can make you feel comfortable. It often takes courage to keep looking for the right healthcare provider when you have had bad experiences, but don't give up.

It is often helpful to the clinician to examine your body in the sexual healthcare setting.

  • [1] Any form of ritualized genital cutting or excision or destruction of parts of the female genitalia.
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