Intimate Details: Your Sexual Health Guide
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Fitness

Intimate Details: Your Sexual Health Guide

You're well versed in taking care of your body from head to toe. Yet when it comes to your sexual health, you're less certain that you're doing the right thing. Have pressing questions? We've got answers. Read on for our top docs' advice.

How Your Weight Affects Your Sexual Health

Wearing a paper gown featuring a peekaboo bum does not exactly foster self-confidence and a speak-your-mind attitude. But the thing is, we want to talk. We really, really do. In fact, 72 percent of those participating in a Women's Sexual Health Foundation survey said they would welcome their doctor initiating a discussion with them about anything related to sexual health -- and one in two of them is still waiting. Looking for an opening line? Borrow a page (or just a thought) from FITNESS's must-know guide.

What Your Weight Has to Do with It

What scares women more than the speculum? The scale, say experts. "I know many people are self-conscious about their weight," says Mona Saint, MD, an ob-gyn in Orange County, California. "But it's important to be open and honest with your doctor about your eating and exercise habits so you can brainstorm together ways to get your weight in check." Why is it so important? For starters, shedding pounds can...

Boost Fertility

Excess pounds can cause your body to produce extra estrogen, which may throw off your menstrual cycle, hampering your chances of conceiving. Losing just 5 to 10 percent of your body weight may help improve your ovulation and pregnancy rates.

Ease PMS

Very overweight women are almost three times more likely to have severe PMS symptoms, such as period-related cramps, bloating, and mood swings, than those at healthy weights, a study shows. Changing hormone levels are a likely cause.

Reduce Incontinence

If you're carrying extra baggage, losing 8 percent of your body mass can cut leaky episodes nearly in half, according to a University of California at San Francisco study. Why? Most likely because additional fat around the belly puts pressure on your bladder.

Make Your Pregnancy a Healthy One

Women entering their first trimester with a high BMI are at greater risk for developing high blood pressure and diabetes during their pregnancies and having complications during childbirth.

Solutions to Common Sexual Health Problems

We asked the experts for the tips and tricks they use to keep a handle on these sexual health issues.

The Problem: Heavy flow

Expert Fix: Take ibuprofen.
Why It Works: It reduces levels of prostaglandins, chemicals that cause blood vessels to open.

The Problem: Nausea from birth control pills

Expert Fix: Try taking them at different times of day or night.
Why It Works: Hormones in the pill may be easier on your stomach depending on the time of day.

The Problem: Pee leakage during exercise

Expert Fix: Switch from high-impact exercise to lower-impact in the two weeks before your period.
Why It Works: Incontinence peaks during the second half of your cycle. Likely reason? An estrogen dip. Less-strenuous exercise is better during that time.

The Problem: Vaginal aroma

Expert Fix: Wax or trim your bikini area.
Why It Works: Hair traps sweat and bacteria, causing odor.

The Problem: Squeaky sex

Expert Fix: Do four daily sets of 10 Kegel exercises.
Why It Works: They strengthen vaginal muscles that may have stretched out.

Your Biggest Sexual Health Secret

Nearly two out of three women have felt pain during intercourse at some point, according to the American College of Obstetricians and Gynecologists, yet "patients have a hard time speaking up about it, to their doctors or partners," says Mona Saint, MD. Endometriosis, vaginismus, vulvodynia, fibroids, cysts, pelvic inflammatory disease, and an infection, among others, can be causes -- and all are treatable conditions. Your gyno can do a pelvic exam and possibly an ultrasound to diagnose you. Unless your pain is severe, try increasing foreplay for added lubrication, or use an OTC vaginal lubricant and experiment with different positions, since pain is often caused by the angle of penetration or pressure on certain muscles and joints.

Your Top 5 Sexual Health Concerns

Chances are, the sexual health concern you've been putting off talking to your doc about is a worry many women share. Here's what's topping the list right now:

Mystery Discharge

Doctors get more calls and visits about funky vaginal fluids than practically anything else. "Four or five patients come to my office every day just for this," says Amy Rosenman, MD, a clinical assistant professor of obstetrics and gynecology at UCLA School of Medicine.

What You Need to Know
If it's gray or greenish and smells bad, you may have bacterial vaginosis or an STD; both can be treated with antibiotics. Thick, odorless, burning, and itchy? Could be a yeast infection. Three-day over-the-counter remedies may not pack enough punch, so try a five-day one instead, says Dr. Saint. Condition not improving? See your doc.

Human Papillomavirus

"A few years ago, almost none of my patients had heard of HPV," says Suzanne Trupin, MD, a clinical professor of obstetrics and gynecology at the University of Illinois at Urbana-Champaign. "When the HPV vaccine came out in 2006, everyone started asking about it."

What You Need to Know
Between 11 and 27? Get the vaccine; it inoculates against HPV strains that can cause cervical cancer and genital warts, says Hilda Hutcherson, MD, a clinical professor of obstetrics and gynecology at Columbia University. Thirty or over? Get the new DNA test for HPV along with your next Pap to assess your risk for those strains.

Birth Control

More possibilities can mean more uncertainty. "Women are excited about the new choices that are available to them, but many patients have questions about the safety of some of the options, like no-period pills and vaginal rings," says Dr. Saint.

What You Need to Know
Pills that eliminate your menstrual periods are fine, say experts (you may have occasional breakthrough bleeding). Other options: The NuvaRing, a thin, flexible vaginally inserted hormone ring that you remove and replace monthly; and FC2, the new and improved female condom.

Herpes

"Genital herpes causes more angst than any other STD," says Dr. Rosenman. The reason? It has no cure and few symptoms, and up to one in four women has it.

What You Need to Know
If you have a history of STDs or more than one sex partner, you're at higher risk and should be screened. Tested positive? Genital herpes is contagious; use latex condoms, and ask your doc about antiviral meds.

Fertility

"I'm seeing more women who want to start families later in life than ever before," says Lisa Masterson, MD, attending physician at Cedars-Sinai Medical Center in Los Angeles and cohost of the TV show The Doctors.

What You Need to Know
If you're in good health but having problems conceiving, talk to your ob-gyn about a fertility evaluation -- imaging studies and blood tests can help pinpoint why. If you're in your 20s or 30s and want to delay childbirth, ask about freezing your eggs.

Your Doc's Favorite Products

Ever wonder what your doc uses after hours? We polled our panel of ob-gyns for the products they swear by.

For Worry-Free Workouts
Gaiam Silver Linings panties ($20, gaiam.com). Antimicrobial-treated organic cotton is breathable and helps banish odor and prevent infections during your 90-minute Spinning class.

For Relief of Vaginal Dryness
Try an OTC product like Replens ($16.99, drugstore.com), or talk to your doc about a prescription estrogen cream.

For Maximum Comfort During Your Period
Seventh Generation tampons ($5.19, drugstore.com). They're chlorine-free and cut down on irritation and itch.

For Smoother Sex
Creme de la Femme ($14.95, amazing-solutions.com). This lube with mineral oil is especially silky (but don't use it with latex condoms or a diaphragm).

For Safe Encounters
Inspiral condoms ($13 for 12, condomania.com). As exciting as prophylactics get: The spiral-shaped tip helps increase sensitivity for both of you.

Originally published in FITNESS magazine, July/August 2009.

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