| FEATURE |
How Urology Can Affect Sexual Health
Women’s bodies go through many changes as they age. One area of the body women may not focus on is the pelvis. The pelvic floor can undergo changes over time that increase the risk of many kinds of urine leaks, also known as urinary incontinence. The good news is there are steps women can take to address these changes and maintain a healthy pelvic floor, according to Elizabeth Timbrook Brown, MD, MPH, Associate Professor of Urology at Georgetown University School of Medicine.
Your Sexual Health is Important
People often keep quiet about their sexual health. We tend to keep this part of our lives private. But really, sexual health may be key for our relationships and self-esteem. Dr. Akanksha Mehta, Associate Professor from the Emory University School of Medicine and an expert in this topic says, “Our sexual health is linked to our overall physical health, urologic health and mental health.”
Dr. Mehta hopes people will talk with their doctors about sexual health. She says, “I think there is too much false information online. It can be hard to distinguish between reliable and non-reliable sources. Good sexual health starts by talking with a doctor you trust. Doctors can direct you to the most reliable information. If they cannot answer your questions, they will refer you to someone who can.”
What urologic conditions could affect sexual health?
Many urologic conditions could affect sexual health. For example:
An infection or inflammation, like:
- Prostatitis – pain in and around the pelvic area, starting with the prostate. It can happen to men of all ages. Some causes include infection from bacteria and inflammation from injury or infection.
- Orchitis – swelling or pain in one or both testicles, usually from an infection or virus.
- Epididymitis – swelling or pain in the back of the testicle in the coiled tube (epididymis) that stores and carries sperm.
- Urinary Tract Infections (UTIs) – when bacteria gets into your urine and travels up to your bladder. UTIs are very common.
- Interstitial cystitis/bladder pain syndrome (BPS) – a chronic bladder health issue. It is a feeling of pain and pressure in the bladder area. Along with this pain are lower urinary tract symptoms that have lasted for more than six weeks, without having an infection or other clear causes.
These can lead to painful sex. Some people wonder if they’ll put their partner at risk.
A physical concern, like:
- Urinary Incontinence – leaking of urine that you cannot control. It affects both men and women.
- Overactive bladder – the name for a group of urinary symptoms. It is not a disease. Some symptoms may include a sudden, uncontrolled need or urge to urinate and/or the need to pass urine many times during the day and night.
- Pelvic floor dysfunction – when your pelvic floor muscles are not strong enough to prevent urine leakage. Certain exercises can help.
- Erectile dysfunction – trouble getting or keeping an erection that's firm enough for sex. It is the most common sex problem reported by men.
- Premature ejaculation – when ejaculation happens sooner than a man or his partner would like during sex. It is also known as rapid ejaculation, premature climax or early ejaculation.
- Peyronie’s disease – where plaques (segments of flat scar tissue) form under the skin of the penis. These plaques can cause the penis to bend or become indented during erections. The plaques can often be felt through the skin and can be painful.
- Surgery of organs in the pelvis.
Along with pain, these can also cause fear or shame. A patient may feel embarrassed by incontinence during sex, for example.
Urologic cancers and treatment for urologic cancer, like surgery, radiation or chemotherapy, can cause:
• Damage to nerves that control sexual function
• Damage to pelvic organs
• Changes in the way a person can orgasm
• The need to use an ostomy bag
Tumors as well as surgery or cancer treatment can affect sexual health. Keep communication with your partner and doctor open. Ask questions both before and after treatment. Your doctor may suggest things you can do to prevent or ease sexual problems.
"Sexual health is complex. There are many things that can affect how we function."
Akanksha Mehta MD, MS
Associate Professor and Director of Male Reproductive Health, Department of Urology, Emory University School of Medicine
Are there common risk factors that affect sexual health?
Our overall health impacts how we function sexually. Things like hypertension, diabetes and obesity can lead to sexual problems. Stress from anxiety, depression or worry can also affect our sexual health. Erectile dysfunction, for example, is closely linked to stress and worry.
Our bodies are designed as connected systems. Dr. Mehta explains, “Sexual health is complex. It involves nerve function, blood flow, mental wellbeing, past sexual relationships and the health of sexual organs. There are many things that can affect how we function.”
What can people do to support their sexual health?
It’s critical to manage your overall physical and mental health. It’s also important to maintain good social habits, diet and exercise. If you have specific sexual health questions, Dr. Mehta suggests talking with a provider or a Sexual Health specialist.
- Men can get referrals and information from the Sexual Medicine Society of North America (SMSNA)
- Women can get referrals from the International Society for the Study of Women’s Health (ISSWH)
- Anyone can find referrals from the American Association of Sexuality Educators, Counselors and Therapists (AASECT)
One of the most valuable things Dr. Mehta says you can do is to bring your partner with you to appointments. It helps to talk with your urologist or sexual health provider together. “It clearly takes two to tango,” she points out. Dr. Mehta leaves us with this advice: “Don’t shy away from conversations about this important topic. Start with a doctor you feel close to. Stay away from online chat groups or sources that are not credible. There are often things we can do to support your intimate relationships.”
Listen to our Urology Care Podcast: What to Know about Sexual Dysfunction with Dr. Akanksha Mehta to learn more and hear Dr. Mehta talk about the topic of sexual dysfunction.
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